Lower body muscle strength, dynapenic obesity and risk of type 2 diabetes : longitudinal results on the chair-stand test from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Background: The chair-stand test is a measure of lower body muscle strength. In a longitudinal study with older adults, we investigated whether results of the five-repetition chair-stand test (CST-5) are associated with incident type 2 diabetes, and whether diabetes risk in obese persons is modified by dynapenia (age-related loss of muscle strength) in the lower limbs.

Methods: We used data of the Survey of Health, Ageing and Retirement in Europe (SHARE), a panel study with eight waves carried out between 2004 and 2020 in 28 European countries and Israel mainly in persons aged 50 years or older. Forty-six thousand one hundred nineteen persons (mean age 63.5 years, 44.1% men) with CST-5 data and follow-up data for diabetes were included from wave 2 and waves 4 to 7. The mean follow-up time was 5.3 years (standard deviation 2.9 years). Relative risks with 95% confidence intervals (CI) were estimated from log-linear models with a Poisson working likelihood and robust standard errors.

Results: In the crude model, increased risks of diabetes were found for persons who considered the CST-5 as not safe, or whose times for the test were in the highest or second highest quartiles (relative risks 2.18 (95% CI: 1.95–2.43), 1.71 (1.54–1.91), 1.44 (95% CI: 1.29–1.61), reference: lowest quartile). These associations were attenuated in the fully adjusted regression model (relative risks 1.32 (95% CI: 1.17–1.48), 1.23 (1.10–1.37), 1.19 (1.06–1.33)). Furthermore, in fully adjusted models, the risk of diabetes in obese persons did not depend on whether they had low muscle strength or not. In obese persons with times for 5 sits and stands > 15 seconds, the adjusted risk of diabetes was 2.56 (95% CI: 2.22–2.95) times higher than in non-obese persons with times ≤15 seconds. The corresponding relative risk in obese persons with times ≤15 seconds was 2.45 (2.25–2.67).

Conclusions: Poor results in the CST-5 were associated with an increased risk of diabetes. Among obese persons, the risk of diabetes was not modified by results of the CST-5.


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