diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12745diaendo-12745Research ArticleОригинальные исследованияOriginal StudiesОценка связи между предиабетом и низкой мышечной массой на основе уровня креатинина кровиAssessment of the relationship between prediabetes and low skeletal mass based on blood creatinine levelhttps://orcid.org/0000-0002-2295-672XИбрагимоваС. И.IbragimovaS. I.

Ибрагимова Сарвинисо Исламовна, докторант

Туркестан

161200-161205, Туркестан, улица Едиге батыра, д. 51

Sarviniso I. Ibragimova, PhD, student

51, Edigebatyr street, 161200-161205, Turkestan

sarvinisso.ibragimova@ayu.edu.kzhttps://orcid.org/0000-0003-2139-3221НускабаеваГ. О.NuskabayevaG. O.

Нускабаева Гульназ Оразбековна, кандидат медицинских наук, доцент

Туркестан

Gulnaz O. Nuskabayeva, MD, PhD, associate professor

Turkestan

nuskabayeva.gulnaz@ayu.edu.kzhttps://orcid.org/0000-0003-0069-3073ШалхароваЖ. Н.ShalkharovaZ. N.

Шалхарова Жанат Нагметовна, доктор медицинских наук, профессор

Туркестан

Zhanat N. Shalkharova,MD, PhD, Professor

Turkestan

zhanat.shalkharova@ayu.edu.kzhttps://orcid.org/0000-0001-8623-2539СадыковаК. Ж.SadykovaK. Zh.

Садыкова Карлыгаш Жарылкасыновна, профессор

Туркестан

Karlygash Zh. Sadykova, PhD

Turkestan

karlygash.sadykova@ayu.edu.kzhttps://orcid.org/0000-0001-7452-5625ДжунусбековаГ. А.JunusbekovaG. A.

Джунусбекова Гульнара Алдешовна, доктор медицинских наук, ассоциированный профессор

Алматы

Gulnara A. Junusbekova, MD, PhD, Professor

Almaty

gulnara_1010@mail.ruhttps://orcid.org/0000-0001-6949-3585ОранМ.OranM.

Мустафа Оран, доцент, доктор

Текирдаг

Mustafa Oran, MD, PhD

Tekirdag

moran@nku.edu.trМеждународный казахско-турецкий университет имени Ходжи Ахмеда ЯсавиКазахстанKhoja Akhmet Yassawi International Kazakh-Turkish UniversityKazakhstanКазахский медицинский университет непрерывного образованияКазахстанKazakh Medical University of Continuing EducationKazakhstanУниверситет Намыка КемалаТурцияNamik Kemal UniversityTurkey202205062022253226238Copyright © Ибрагимова С.И., Нускабаева Г.О., Шалхарова Ж.Н., Садыкова К.Ж., Джунусбекова Г.А., Оран М., 20222022Ибрагимова С.И., Нускабаева Г.О., Шалхарова Ж.Н., Садыкова К.Ж., Джунусбекова Г.А., Оран М.Ibragimova S.I., Nuskabayeva G.O., Shalkharova Z.N., Sadykova K.Z., Junusbekova G.A., Oran M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12745ОБОСНОВАНИЕ

ОБОСНОВАНИЕ. Низкая мышечная масса повышает риск развития сахарного диабета 2 типа (СД2) и предиабета. Питание пациентов является важным фактором в изучении связи между низкой мышечной массой и развитием нарушений углеводного обмена.

ЦЕЛЬ

ЦЕЛЬ. Оценить связь между предиабетом и низкой мышечной массой на основе уровня сывороточного креатинина с учетом питания пациентов.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. В исследование включены 551 пациент в возрасте 18–69 лет, не страдающие СД2. Уровень глюкозы определен натощак и после орального глюкозотолерантного теста. Гипергликемия оценена по классификации Всемирной организации здравоохранения. Для оценки фактора питания использован опросник MedDietScore, определяющий приверженность пациентов к средиземноморской диете. С целью оценки отношений шансов (ОШ) и 95% доверительного интервала (ДИ) проведена бинарная логистическая регрессия.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. Распространенность предиабета в группе с наименьшим и наибольшим уровнями креатинина крови составила 31,9 и 17,5% соответственно (р=0,016). В результате проведенного нескорректированного регрессионного анализа выявлена статистически значимая связь между низким уровнем креатинина и шансами наличия предиабета (ОШ 2,07;95% ДИ 1,21–3,56), которая сохранялась после коррекции на социально-демографические, антропометрические факторы, уровень стресса и физической активности, а также мышечную силу. После добавления в статистическую модель данных по MedDietScore выявленная связь терялась (р=0,187).

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Низкий сывороточный креатинин увеличивает шансы наличия предиабета независимо от пола, возраста, индекса массы тела, объема бедер, соотношения объема талии к росту, а также физической активности, уровня стресса и мышечной силы. Однако шансы наличия предиабета не различаются у лиц с низким креатинином крови в зависимости от приверженности к средиземноморской диете среди популяции проживающих в Туркестанской области.

BACKGROUND

BACKGROUND: Low muscle mass increases the risk of developing type 2 diabetes mellitus (DM 2) and prediabetes. Nutrition is an important factor in the study of the relationship between low muscle mass and the development of glucose metabolic disorders.

AIM

AIM: The present study was conducted to assess the relationship between prediabetes and low muscle mass on the basis of serum creatinine levels, taking into account patient nutrition.

MATERIALS AND METHODS

MATERIALS AND METHODS: The study included 551 patients aged 18–69 years without DM 2. The glucose level was determined based on fasting glucose and after an oral glucose tolerance test (OGTT). Hyperglycemia is assessed according to the classification of the World Health Organization. The MedDietScore questionnaire was used to assess the nutritional factor, which determines the adherence of patients to the Mediterranean diet. In order to assess odds ratios (OR) and 95% confidence interval (CI), a binary logistic regression was performed.

RESULTS

RESULTS: The prevalence of prediabetes in the group with the lowest and highest blood creatinine level was 31.9% and 17.5% respectively (p=0.016). As a result of the conducted regression analysis, a statistically significant relationship was found between low creatinine levels and the chances of having prediabetes (crude OR 2,07, 95% CI 1,21; 3,56), which persisted after adjusting for socio-demographic, anthropometric factors, stress level and physical activity as well as muscle strength. After adding the data on MedDietScore to the statistical model, the revealed relationship was lost (p = 0.187).

CONCLUSION

CONCLUSION: Low serum creatinine increases the chances of the presence of prediabet regardless of gender, age, body weight index, the volume of the hips, the ratio of the volume of the waist to growth, as well as physical activity, the level of stress and muscular power. However, the chances of the presence of prediabet do not differ in persons with low creatinine blood depending on the commitment to the Mediterranean diet among the population of those living in the Turkestan region.

предиабетпредиабетическое состояниекреатининмышечная массасредиземноморская диетаprediabetesprediabetic conditioncreatininemuscle massMediterranean dietReferencesJing C, Wang Z, Fu X. Effect of diabetes mellitus on survival in patients with gallbladder Cancer: A systematic review and meta-analysis. BMC Cancer. 2020;20(1):1-8. doi: https://doi.org/10.1186/s12885-020-07139-yJing C, Wang Z, Fu X. Effect of diabetes mellitus on survival in patients with gallbladder Cancer: A systematic review and meta-analysis. BMC Cancer. 2020;20(1):1-8. doi: https://doi.org/10.1186/s12885-020-07139-yBullard KMK, Saydah SH, Imperatore G, et al. Secular changes in U.S. prediabetes prevalence defined by hemoglobin A 1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010. Diabetes Care. 2013;36(8):2286-2293. doi: https://doi.org/10.2337/dc12-2563Bullard KMK, Saydah SH, Imperatore G, et al. Secular changes in U.S. prediabetes prevalence defined by hemoglobin A 1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010. Diabetes Care. 2013;36(8):2286-2293. doi: https://doi.org/10.2337/dc12-2563Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes, MetabSyndrObes Targets Ther. 2014;7:587-591. doi: https://doi.org/10.2147/DMSO.S67400Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes, MetabSyndrObes Targets Ther. 2014;7:587-591. doi: https://doi.org/10.2147/DMSO.S67400Rhee E-J. Diabetes in Asians. Endocrinol Metab. 2015;30(3):263. doi: https://doi.org/10.3803/EnM.2015.30.3.263Rhee E-J. Diabetes in Asians. Endocrinol Metab. 2015;30(3):263. doi: https://doi.org/10.3803/EnM.2015.30.3.263Harita N, Hayashi T, Sata KK, et al. Lower serum creatinine is a new risk factor of type 2 diabetes: The kansai healthcare study. Diabetes Care. 2009;32(3):424-426. doi: https://doi.org/10.2337/dc08-1265Harita N, Hayashi T, Sata KK, et al. Lower serum creatinine is a new risk factor of type 2 diabetes: The kansai healthcare study. Diabetes Care. 2009;32(3):424-426. doi: https://doi.org/10.2337/dc08-1265Takeuchi M, Imano H, Muraki I, et al. Serum creatinine levels and risk of incident type 2 diabetes mellitus or dysglycemia in middle-aged Japanese men: a retrospective cohort study. BMJ Open Diabetes Res Care. 2018;6(1):e000492. doi: https://doi.org/10.1136/bmjdrc-2017-000492Takeuchi M, Imano H, Muraki I, et al. Serum creatinine levels and risk of incident type 2 diabetes mellitus or dysglycemia in middle-aged Japanese men: a retrospective cohort study. BMJ Open Diabetes Res Care. 2018;6(1):e000492. doi: https://doi.org/10.1136/bmjdrc-2017-000492Kim JA, Hwang SY, Chung HS, et al. Proportion and characteristics of the subjects with low muscle mass and abdominal obesity among the newly diagnosed and drug-naïve type 2 diabetes mellitus patients. Diabetes Metab J. 2019;43(1):105-113. doi: https://doi.org/10.4093/dmj.2018.0036Kim JA, Hwang SY, Chung HS, et al. Proportion and characteristics of the subjects with low muscle mass and abdominal obesity among the newly diagnosed and drug-naïve type 2 diabetes mellitus patients. Diabetes Metab J. 2019;43(1):105-113. doi: https://doi.org/10.4093/dmj.2018.0036Patel SS, Molnar MZ, Tayek JA, et al. Serum creatinine as a marker of muscle mass in chronic kidney disease: Results of a cross-sectional study and review of literature. J Cachexia Sarcopenia Muscle. 2013;4(1):19-29. doi: https://doi.org/10.1007/s13539-012-0079-1Patel SS, Molnar MZ, Tayek JA, et al. Serum creatinine as a marker of muscle mass in chronic kidney disease: Results of a cross-sectional study and review of literature. J Cachexia Sarcopenia Muscle. 2013;4(1):19-29. doi: https://doi.org/10.1007/s13539-012-0079-1Clark RV, Walker AC, O’Connor-Semmes RL, et al. Total body skeletal muscle mass: Estimation by creatine (methyl-d3) dilution in humans. J Appl Physiol. 2014;116(12):1605-1613. doi: https://doi.org/10.1152/japplphysiol.00045.2014Clark RV, Walker AC, O’Connor-Semmes RL, et al. Total body skeletal muscle mass: Estimation by creatine (methyl-d3) dilution in humans. J Appl Physiol. 2014;116(12):1605-1613. doi: https://doi.org/10.1152/japplphysiol.00045.2014Noori N,Kovesdy CP,Bross R, et al. Novel equations to estimate lean bodymassin maintenance hemodialysis patients. Am J Kidney Dis. 2011;57(1):130-139.doi: https://doi.org/10.1053/j.ajkd.2010.10.003Noori N,Kovesdy CP,Bross R, et al. Novel equations to estimate lean bodymassin maintenance hemodialysis patients. Am J Kidney Dis. 2011;57(1):130-139.doi: https://doi.org/10.1053/j.ajkd.2010.10.003Thongprayoon C, Cheungpasitporn W, Kashani K. Serum creatinine level, a surrogate of muscle mass, predicts mortality in critically ill patients. J Thorac Dis. 2016;8(5):E305-E311. doi: https://doi.org/10.21037/jtd.2016.03.62Thongprayoon C, Cheungpasitporn W, Kashani K. Serum creatinine level, a surrogate of muscle mass, predicts mortality in critically ill patients. J Thorac Dis. 2016;8(5):E305-E311. doi: https://doi.org/10.21037/jtd.2016.03.62Hjelmesæth J, Røislien J, Nordstrand N, et al. Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: A cross-sectional study. BMC Endocr Disord. 2010;10(1):1-6. doi: https://doi.org/10.1186/1472-6823-10-6Hjelmesæth J, Røislien J, Nordstrand N, et al. Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: A cross-sectional study. BMC Endocr Disord. 2010;10(1):1-6. doi: https://doi.org/10.1186/1472-6823-10-6Kashima S, Inoue K, Matsumoto M, Akimoto K. Low serum creatinine is a type 2 diabetes risk factor in men and women: The Yuport Health Checkup Center cohort study. Diabetes Metab. 2017;43(5):460-464. doi: https://doi.org/10.1016/j.diabet.2017.04.005Kashima S, Inoue K, Matsumoto M, Akimoto K. Low serum creatinine is a type 2 diabetes risk factor in men and women: The Yuport Health Checkup Center cohort study. Diabetes Metab. 2017;43(5):460-464. doi: https://doi.org/10.1016/j.diabet.2017.04.005Hu H, Nakagawa T, Honda T, et al. Low serum creatinine and risk of diabetes: The Japan Epidemiology Collaboration on Occupational Health Study. J Diabetes Investig. 2019;10(5):1209-1214. doi: https://doi.org/10.1111/jdi.13024Hu H, Nakagawa T, Honda T, et al. Low serum creatinine and risk of diabetes: The Japan Epidemiology Collaboration on Occupational Health Study. J Diabetes Investig. 2019;10(5):1209-1214. doi: https://doi.org/10.1111/jdi.13024Yoshida N, Miyake T, Yamamoto S, et al. The serum creatinine level might be associated with the onset of impaired fasting glucose: A community-based longitudinal cohort health checkup study. InternMed. 2019;58(4):505-510. doi: https://doi.org/10.2169/internalmedicine.0760-18Yoshida N, Miyake T, Yamamoto S, et al. The serum creatinine level might be associated with the onset of impaired fasting glucose: A community-based longitudinal cohort health checkup study. InternMed. 2019;58(4):505-510. doi: https://doi.org/10.2169/internalmedicine.0760-18Sakai S, Tanimoto K, Imbe A, et al. Decreased β-cell function is associated with reduced skeletal muscle mass in Japanese subjects without diabetes. PLoS One. 2016;11(9):1-11. doi: https://doi.org/10.1371/journal.pone.0162603Sakai S, Tanimoto K, Imbe A, et al. Decreased β-cell function is associated with reduced skeletal muscle mass in Japanese subjects without diabetes. PLoS One. 2016;11(9):1-11. doi: https://doi.org/10.1371/journal.pone.0162603Aleman-Mateo H, Lopez Teros MT, Ramirez C FA, Astiazaran-Garcia H. Association Between Insulin Resistance and Low Relative Appendicular Skeletal Muscle Mass: Evidence From a Cohort Study in Community-Dwelling Older Men and Women Participants. Journals Gerontol Ser A Biol Sci Med Sci. 2014;69(7):871-877. doi: https://doi.org/10.1093/gerona/glt193Aleman-Mateo H, Lopez Teros MT, Ramirez C FA, Astiazaran-Garcia H. Association Between Insulin Resistance and Low Relative Appendicular Skeletal Muscle Mass: Evidence From a Cohort Study in Community-Dwelling Older Men and Women Participants. Journals Gerontol Ser A Biol Sci Med Sci. 2014;69(7):871-877. doi: https://doi.org/10.1093/gerona/glt193Moon SS. Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population: The Korea National health and nutrition examination survey (KNHANES) 2009-2010. Endocr J. 2014;61(1):61-70. doi: https://doi.org/10.1507/endocrj.EJ13-0244Moon SS. Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population: The Korea National health and nutrition examination survey (KNHANES) 2009-2010. Endocr J. 2014;61(1):61-70. doi: https://doi.org/10.1507/endocrj.EJ13-0244Токтарова Н.Н., Базарбекова Р.Б., Досанова А.К. Распространенность сахарного диабета 2 типа среди взрослого населения Казахстана (результаты регистрового национального исследования NOMAD) // Медицина (Алматы). — 2017. — T. 6. — №180. — С. 43-51.Toktarova NN, Bazarbekova RB, Dosanova AK. The prevalence of type 2 diabetes mellitus in adult population of Kazakhstan (results of NOMAD national register study). Medicine (Almaty). 2017;6(180):43-51. (In Russ.).Дедов И.И., Шестакова М.В., Галстян Г.Р. Распространенность сахарного диабета 2 типа у взрослого населения России (исследование NATION) // Сахарный диабет. — 2016. — Т. 19. — №2. — С. 104-112. doi: https://doi.org/10.14341/DM2004116-17Dedov II, Shestakova MV, Galstyan GR. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Diabetes Mellitus. 2016;19(2):104-112. (In Russ.). doi: https://doi.org/10.14341/DM2004116-17Mohammad A, Ziyab AH, Mohammad T. Prevalence of prediabetes and undiagnosed diabetes among kuwaiti adults: A cross-sectional study. Diabetes, MetabSyndrObes Targets Ther. 2021;14:2167-2176. doi: https://doi.org/10.2147/DMSO.S296848Mohammad A, Ziyab AH, Mohammad T. Prevalence of prediabetes and undiagnosed diabetes among kuwaiti adults: A cross-sectional study. Diabetes, MetabSyndrObes Targets Ther. 2021;14:2167-2176. doi: https://doi.org/10.2147/DMSO.S296848Andes LJ, Cheng YJ, Rolka DB, et al. Prevalence of Prediabetes among Adolescents and Young Adults in the United States, 2005-2016. JAMA Pediatr. 2020;174(2). doi: https://doi.org/10.1001/jamapediatrics.2019.4498Andes LJ, Cheng YJ, Rolka DB, et al. Prevalence of Prediabetes among Adolescents and Young Adults in the United States, 2005-2016. JAMA Pediatr. 2020;174(2). doi: https://doi.org/10.1001/jamapediatrics.2019.4498Aekplakorn W, Tantayotai V, Numsangkul S, et al. Detecting Prediabetes and Diabetes: Agreement between Fasting Plasma Glucose and Oral Glucose Tolerance Test in Thai Adults. J Diabetes Res. 2015;2015:1-7. doi: https://doi.org/10.1155/2015/396505Aekplakorn W, Tantayotai V, Numsangkul S, et al. Detecting Prediabetes and Diabetes: Agreement between Fasting Plasma Glucose and Oral Glucose Tolerance Test in Thai Adults. J Diabetes Res. 2015;2015:1-7. doi: https://doi.org/10.1155/2015/396505Mustafa N, Kamarudin NA, Ismail AA, et al. Prevalence of abnormal glucose tolerance and risk factors in urban and rural Malaysia. Diabetes Care. 2011;34(6):1362-1364. doi: https://doi.org/10.2337/dc11-0005Mustafa N, Kamarudin NA, Ismail AA, et al. Prevalence of abnormal glucose tolerance and risk factors in urban and rural Malaysia. Diabetes Care. 2011;34(6):1362-1364. doi: https://doi.org/10.2337/dc11-0005Hostalek U. Global epidemiology of prediabetes — present and future perspectives. ClinDiabetesEndocrinol. 2019;5(1):1-5. doi: https://doi.org/10.1186/s40842-019-0080-0Hostalek U. Global epidemiology of prediabetes — present and future perspectives. ClinDiabetesEndocrinol. 2019;5(1):1-5. doi: https://doi.org/10.1186/s40842-019-0080-0Sharabi K, Tavares CDJ, Rines AK, Puigserver P. Molecular pathophysiology of hepatic glucose production. Mol Aspects Med. 2015;46:21-33. doi: https://doi.org/10.1016/j.mam.2015.09.003Sharabi K, Tavares CDJ, Rines AK, Puigserver P. Molecular pathophysiology of hepatic glucose production. Mol Aspects Med. 2015;46:21-33. doi: https://doi.org/10.1016/j.mam.2015.09.003Yoshida N, Miyake T, Yamamoto S, et al. The serum creatinine level might be associated with the onset of impaired fasting glucose: A community-based longitudinal cohort health checkup study. InternMed. 2019;58(4):505-510. doi: https://doi.org/10.2169/internalmedicine.0760-18Yoshida N, Miyake T, Yamamoto S, et al. The serum creatinine level might be associated with the onset of impaired fasting glucose: A community-based longitudinal cohort health checkup study. InternMed. 2019;58(4):505-510. doi: https://doi.org/10.2169/internalmedicine.0760-18Larsen BA, Wassel CL, Kritchevsky SB, et al. Association of muscle mass, area, and strength with incident diabetes in older adults: The Health ABC Study. J Clin Endocrinol Metab. 2016;101(4):1847-1855. doi: https://doi.org/10.1210/jc.2015-3643Larsen BA, Wassel CL, Kritchevsky SB, et al. Association of muscle mass, area, and strength with incident diabetes in older adults: The Health ABC Study. J Clin Endocrinol Metab. 2016;101(4):1847-1855. doi: https://doi.org/10.1210/jc.2015-3643Kuk JL, Kilpatrick K, Davidson LE, et al. Whole-body skeletal muscle mass is not related to glucose tolerance or insulin sensitivity in overweight and obese men and women. Appl PhysiolNutrMetab. 2008;33(4):769-774. doi: https://doi.org/10.1139/H08-060Kuk JL, Kilpatrick K, Davidson LE, et al. Whole-body skeletal muscle mass is not related to glucose tolerance or insulin sensitivity in overweight and obese men and women. Appl PhysiolNutrMetab. 2008;33(4):769-774. doi: https://doi.org/10.1139/H08-060Granic A, Sayer AA, Robinson SM. Dietary patterns, skeletal muscle health, and sarcopenia in older adults. Nutrients. 2019;11(4):1-29. doi: https://doi.org/10.3390/nu11040745Granic A, Sayer AA, Robinson SM. Dietary patterns, skeletal muscle health, and sarcopenia in older adults. Nutrients. 2019;11(4):1-29. doi: https://doi.org/10.3390/nu11040745Kelaiditi E, Jennings A, Steves CJ, et al. Measurements of skeletal muscle mass and power are positively related to a Mediterranean dietary pattern in women. Osteoporos Int. 2016;27(11):3251-3260. doi: https://doi.org/10.1007/s00198-016-3665-9Kelaiditi E, Jennings A, Steves CJ, et al. Measurements of skeletal muscle mass and power are positively related to a Mediterranean dietary pattern in women. Osteoporos Int. 2016;27(11):3251-3260. doi: https://doi.org/10.1007/s00198-016-3665-9Bloom I, Shand C, Cooper C, et al. Diet quality and sarcopenia in older adults: A systematic review. Nutrients. 2018;10(3):1-28. doi: https://doi.org/10.3390/nu10030308Bloom I, Shand C, Cooper C, et al. Diet quality and sarcopenia in older adults: A systematic review. Nutrients. 2018;10(3):1-28. doi: https://doi.org/10.3390/nu10030308Silva R, Pizato N, da Mata F, et al. Mediterranean Diet and Musculoskeletal-Functional Outcomes in CommunityDwelling Older People: A Systematic Review and Meta-Analysis. J Nutr Heal Aging. 2018;22(6):655-663. doi: https://doi.org/10.1007/s12603-017-0993-1Silva R, Pizato N, da Mata F, et al. Mediterranean Diet and Musculoskeletal-Functional Outcomes in CommunityDwelling Older People: A Systematic Review and Meta-Analysis. J Nutr Heal Aging. 2018;22(6):655-663. doi: https://doi.org/10.1007/s12603-017-0993-1Craig J V., Bunn DK, Hayhoe RP, et al. Relationship between the Mediterranean dietary pattern and musculoskeletal health in children, adolescents, and adults: Systematic review and evidence map. Nutr Rev. 2017;75(10):830-857. doi: https://doi.org/10.1093/nutrit/nux042Craig J V., Bunn DK, Hayhoe RP, et al. Relationship between the Mediterranean dietary pattern and musculoskeletal health in children, adolescents, and adults: Systematic review and evidence map. Nutr Rev. 2017;75(10):830-857. doi: https://doi.org/10.1093/nutrit/nux042Falguera M, Castelblanco E, Rojo-López MI, et al. Mediterranean diet and healthy eating in subjects with prediabetes from the mollerussa prospective observational cohort study. Nutrients. 2021;13(1):1-10. doi: https://doi.org/10.3390/nu13010252Falguera M, Castelblanco E, Rojo-López MI, et al. Mediterranean diet and healthy eating in subjects with prediabetes from the mollerussa prospective observational cohort study. Nutrients. 2021;13(1):1-10. doi: https://doi.org/10.3390/nu13010252Buchanan A, Villani A. Association of Adherence to a Mediterranean Diet with Excess Body Mass, Muscle Strength and Physical Performance in Overweight or Obese Adults with or without Type 2 Diabetes: Two Cross-Sectional Studies. Healthcare. 2021;9(10):1255. doi: https://doi.org/10.3390/healthcare9101255Buchanan A, Villani A. Association of Adherence to a Mediterranean Diet with Excess Body Mass, Muscle Strength and Physical Performance in Overweight or Obese Adults with or without Type 2 Diabetes: Two Cross-Sectional Studies. Healthcare. 2021;9(10):1255. doi: https://doi.org/10.3390/healthcare9101255Alexandrov NV, Eelderink C, Singh-Povel CM, et al. Dietary protein sources and muscle mass over the life course: The lifelines cohort study. Nutrients. 2018;10(10):1-17. doi: https://doi.org/10.3390/nu10101471Alexandrov NV, Eelderink C, Singh-Povel CM, et al. Dietary protein sources and muscle mass over the life course: The lifelines cohort study. Nutrients. 2018;10(10):1-17. doi: https://doi.org/10.3390/nu10101471

The authors declare that there are no conflicts of interest present.