抄録
【Background/Objectives】This study aimed to explore the association between changes in body weight and changes in upper-limb, lower-limb, and trunk muscle mass among patients with type 2 diabetes mellitus (T2DM) undergoing hospitalization for diabetes education using a mixed-effects model.＜
【Methods】Eighty-one patients with T2DM were included. The diabetes education hospitalization program lasted two weeks and involved multifaceted interventions, including pharmacotherapy, physical therapy, dietary therapy, and educational guidance. Body composition was assessed at admission and discharge, and changes (Δ) in body weight and site-specific muscle mass (upper-limb, lower-limb, and trunk) were calculated. A linear mixed-effects model was applied, with Δ muscle mass as the dependent variable; Δ body weight, site, age, sex, and pre-admission body weight as fixed effects; and subject identifier as a random effect. Interaction terms between Δ body weight and each site were also included.
【Results】A significant positive association was identified between Δ body weight and Δ muscle mass (β= 0.42, p＜0.01). Among the assessed sites, lower-limb muscle mass showed the highest responsiveness to Δ body weight, with the most significant correlation. All of the interaction terms between Δ body weight and the different sites were significant, indicating that Δ muscle mass in the upper-limb (β= ‐0.33, p＜0.01) and trunk (β= ‐0.26, p＜0.05) were less sensitive to weight changes vs. the lower limbs, and showed more gradual variation. Age also had a significant negative effect on Δ muscle mass (β= ‐0.01, p＜0.05). The random intercept for the subject identifier indicated significant variability, confirming that appropriate adjustments had been made for repeated measures within individuals.
【Conclusions】These findings suggest that Δ body weight during hospitalization in patients with T2DM exerts differential effects on muscle mass in different bodily regions.
