Muscle mass and grip strength in relation to carotid intima-media thickness and plaque score in patients with type 2 diabetes

Background and aims: In this study, we examined the relationships of appendicular skeletal muscle mass (ASM) and grip strength (GS) with carotid intima-media thickness (CIMT) and plaque score (PS) in patients with type 2 diabetes. Methods and results: A total of 1185 patients were recruited. High CIMT and high PS were defined as ≥ 75 percentile of maximal CIMT of each sex and PS ≥ 3. Patients in the lowest ASM/body mass index (BMI) or GS/BMI tertile were older and had lower HDL cholesterol, and eGFR, but higher BMI, waist circumference (WC), HOMA-IR, and C-reactive protein than those in the highest tertile. Meanwhile, individuals in the lowest ASM or GS tertile group had lower BMI and WC than those in the highest one. CIMT and PS and the prevalence of high CIMT, carotid plaques, and high PS gradually increased with decreasing tertiles of ASM, ASM/BMI, GS, and GS/BMI (p < 0.001). After adjusting for age and sex, odds ratios (ORs) and 95% confidence intervals (CIs) for high CIMT and high PS were 0.98 (0.68–1.42), 1.64 (1.14–2.36), 2.000 (1.33–3.01), and 1.77 (1.22–2.58) and 1.63 (1.16–2.30), 1.78 (1.28–2.54), 1.91 (1.33–2.75), and 1.61 (1.13–2.28) in the lowest tertile of ASM, ASM/BMI, GS, and GS/BMI, respectively. After further adjusting for potential confounders, ORs and 95% CI for high CIMT and high PS remained significant in the lowest tertile group. Conclusions: Low ASM and low GS may be independent risk factors for high CIMT and high PS in patients with type 2 diabetes.