Prevalence of diagnosed diabetes and prediabetes among U.S. adults with low muscle mass: A cross-sectional study, 2011-2018.

ObjectiveTo estimate the prevalence, temporal trends, and sociodemographic disparities of diagnosed diabetes and prediabetes among U.S. adults with low muscle mass using 2011-2018 National Health and Nutrition Examination Survey (NHANES) data.MethodsThis cross-sectional analysis leveraged nationally representative NHANES data (2011-2018). A total of 12,753 adults aged ≥18 years with complete appendicular skeletal muscle mass, body mass index, and glycemic status data were included. Crude and age-standardized prevalence rates were analyzed across sociodemographic strata. Multivariate logistic regression analysis was employed to assess the association between low muscle mass and diabetes and prediabetes.ResultsFrom 2011 to 2018, age-standardized low muscle mass prevalence increased from 10.3% (95% confidence interval (CI): 8.6-12.0) to 18.4% (16.1-20.7). Among adults with low muscle mass, 14.4% (12.2-16.6) had diabetes and 26.5% (23.5-29.6) had prediabetes. Striking age-related disparities emerged: adults aged 40-59 years exhibited a 3.1-fold higher diabetes prevalence (22.6% [19.1-26.5] vs. 7.4% [5.1-10.5] in those aged 18-39) and a 1.7-fold higher prediabetes prevalence (34.2% [29.4-39.2] vs. 20.0% [16.4-24.3]). Mexican Americans had 1.6 times higher diabetes prevalence than non-Hispanic Whites, while non-Hispanic Blacks showed 1.3 times higher prevalence than non-Hispanic Whites. Multivariate logistic regression revealed that low muscle mass was significantly associated with a higher risk of diabetes (odds ratio: 1.38, 95% CI: 1.07-1.78).ConclusionsLow muscle mass is an independent predictor of diabetes risk. Over 40% of U.S. adults with low muscle mass exhibit dysglycemia, with rising prevalence and marked sociodemographic gradients. The prolonged diabetes duration in individuals with low muscle mass highlights accelerated metabolic deterioration.