Lower physical activity is associated with higher intermuscular adipose tissue in people with type 2 diabetes and peripheral neuropathy
Open accessAbstract
BACKGROUND: Increased lipid accumulation in skeletal muscle has been linked to insulin resistance, impaired muscle performance, and impaired physical function. It is unclear whether physical activity is associated with lipid content in skeletal muscle, muscle performance, or overall physical function. OBJECTIVE: The purpose of this study was to characterize physical activity levels (average daily step count) in a sample of people with diabetes and peripheral neuropathy and to determine the relationship among step count, intermuscular adipose tissue volume (IMAT), muscle performance (peak torque, power), and physical function. DESIGN: A cross-sectional design was used in this study. METHODS: Twenty-two people with diabetes and peripheral neuropathy (15 men and 7 women, mean age=64.5 years [SD=12.7], and mean body mass index=33.2 kg/m(2) [SD=6.4]) participated. Average daily step count, glycosylated hemoglobin, modified 9-item Physical Performance Test scores, Six-Minute Walk Test distance, calf intermuscular adipose tissue volume (via magnetic resonance imaging), and isokinetic dynamometry of the ankle muscles were recorded. RESULTS: Average daily step count was 7,754 (SD=4,678; range=3,088-20,079). Five participants had an average daily step count greater than 10,000. Average IMAT volume was 84 cm(3) (SD=88). Greater average daily step count was associated with younger age (r=-.39, P<.05) and with lower IMAT volume in the calf (r=-.44, P<.05). Lower IMAT volume was associated with greater muscle performance (r=-.45) and physical function (r=-.43 to -.48). LIMITATIONS: The sample in this study may be biased toward people with high levels of activity because participants were recruited for an exercise study. The results should not be generalized to people taking fewer than 3,000 steps/day or to those with a current foot ulcer, peripheral arterial disease, or severe foot deformity or amputation or who weigh more than 136 kg (300 lb). CONCLUSIONS: Average daily step count was inversely related to IMAT, and IMAT was inversely related to muscle performance and overall physical function. In addition, we found that people with diabetes and peripheral neuropathy and without severe foot deformity appear to be able to take a large number of steps per day.
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Studies show decreased SPPB score (or other similar tests such as the modified physical performance test) are related to increased myosteatosis in lower extremity muscles.
“Studies that show decreased SPPB score (or other similar tests such as the modified physical performance test) are related to increased myosteatosis in lower extremity muscles (Hilton et al., 2008; Tuttle et al., 2011, 2012; Anderson et al., 2016).”
From Myosteatosis in the Context of Skeletal Muscle Function Deficit: An Interdisciplinary Workshop at the National Institute on Aging (2020) · cites this paper as Tuttle et al., 2011
Multiple studies have found a similar relationship between increased myosteatosis in the lower extremities and decreased mobility.
“Multiple studies have found a similar relationship between increased myosteatosis in the lower extremities and decreased mobility (Tuttle et al., 2011, 2012; Marcus et al., 2012).”
From Myosteatosis in the Context of Skeletal Muscle Function Deficit: An Interdisciplinary Workshop at the National Institute on Aging (2020) · cites this paper as Tuttle et al., 2011
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- Authors
- Tuttle, L. J., Sinacore, D. R., Cade, W. T., & Mueller, M. J.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Tuttle, Lori J.
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-06-01
- Volume
- 91
- Issue
- 6
- Pages
- 923-930
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- PMC
- PMC3107439
- OpenAlex
- W2121522926
- Cited by
- 113
- References
- 32
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 9 · 2023: 9 · 2022: 10 · 2021: 9 · 2020: 9 · 2019: 6 · 2018: 8 · 2017: 8 · 2016: 14 · 2015: 4 · 2014: 5 · 2013: 5 · 2012: 3
- FWCI
- 3.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Physical Therapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Digital Commons@Becker (Washington University School of Medicine) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000448)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-074343, K01DK074343, P30DK056341)
- National Center for Research Resources (UL1RR024992)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R21HD058938, R24HD650837, T32HD007434)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Physiology › Adipose Tissue and Metabolism
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- type 2 diabetes, peripheral neuropathy, intermuscular adipose tissue, physical activity, step count, muscle performance, physical function, triceps surae, insulin resistance
- MeSH terms
- Adipose Tissue, Aged, Ankle, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Diabetic Neuropathies, Exercise Test, Female, Glycated Hemoglobin, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Motor Activity, Muscle, Skeletal, Muscle Strength, Muscle Strength Dynamometer
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