Aim

To examine the association between type 2 diabetes and the amount and quality of trunk muscle as assessed by CT scan.

Materials and methods

A total of 20,986 subjects (13,007 men and 7,979 women) who underwent abdominal CT scan as part of a routine health check-up were included. The total abdominal muscle area (TAMA) measured at the third lumbar vertebrae was classified into skeletal muscle area (SMA), and intermuscular adipose tissue area (IMAT). SMA was divided into good quality muscles (normal attenuation muscle area, NAMA) and poor quality muscles (low attenuation muscle area, LAMA). NAMA/TAMA index was calculated.

Results

Subjects with type 2 diabetes had higher values of TAMA and SMA but significantly lower values of NAMA and NAMA/TAMA index. Compared with those in the lowest quartile of NAMA/TAMA index, subjects in the highest quartile had metabolically favorable laboratory findings, a lower prevalence of type 2 diabetes (Q1 vs. Q4: 19.3% vs. 9.5% in men, 12.3% vs. 3.0% in women) and inverse association with type 2 diabetes (odds ratio for Q2, Q3, and Q4: 0.87, 0.78, and 0.75 in men; 0.82, 0.70, and 0.68 in women) after multivariable adjustment.

Conclusions

The amount of good quality muscle on CT scan was associated with a lower prevalence of type 2 diabetes.

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