Supplementary Material for: Type 2 Diabetes as a Predictor of Muscle Strength Decline over 11 years among Men and Women Aged 55 Years and Older

<b><i>Background:</i></b> Long-term associations between type 2 diabetes, prediabetes, and muscle strength are obscure in older adults. The aim of this study was to examine type 2 diabetes as a predictor of handgrip strength decline during an 11-year follow-up among men and women aged 55 years. <b><i>Methods:</i></b> We used Finnish population-based Health 2000 Survey and its follow-up measurements in 2011. The study population consisted of 1,200 individuals, aged 55–86 years at baseline. Baseline fasting glucose level or use of diabetes medication was used to categorize the participants into diabetes (≥7.0 mmol/L), prediabetes (≥6.1 mmol/L but &lt;7.0 mmol/L), and nondiabetes (&lt;6.1 mmol/L) groups. Handgrip strength was measured at baseline and during 11-year follow-up. <b><i>Results:</i></b> Mean handgrip strength at baseline did not differ between diabetes groups in men or women. Among men during the 11-year follow-up, decline in muscle strength was significantly greater among diabetes group (−131.5 Newtons [<i>N</i>], 95% confidence interval (CI) −182.7 to −80.4) than nondiabetes group (−98.9 N, 95% CI −139.5 to −58.3) after adjusting for age, education, lifestyle factors, chronic conditions, and diabetes status at follow-up. Among women, muscle strength decline did not differ between diabetes, prediabetes, or nondiabetes groups after adjusting for all potential covariates, the results being −45.0 N (95% CI −73.2 to −16.7), −29.4 N (95% CI −59.7 to 0.9), and −42.3 N (95% CI −70.5 to −14.1), respectively. <b><i>Conclusions:</i></b> The presence of type 2 diabetes was associated with greater muscle strength decline among older men but not among older women.

**<i>研究背景：</i>** 老年人群中2型糖尿病（type 2 diabetes）、糖尿病前期（prediabetes）与肌肉力量之间的长期关联尚不明确。本研究旨在针对55岁及以上的男女群体，探究11年随访期间，2型糖尿病是否可作为握力下降的预测因素。
**<i>研究方法：</i>** 本研究采用芬兰基于人群的《健康2000调查》（Health 2000 Survey）及其2011年的随访测量数据。研究队列共纳入1200名受试者，基线时年龄为55~86岁。依据基线空腹血糖水平或降糖药物使用情况，将受试者分为糖尿病组（空腹血糖≥7.0 mmol/L）、糖尿病前期组（空腹血糖≥6.1 mmol/L且<7.0 mmol/L）及非糖尿病组（空腹血糖<6.1 mmol/L）。分别于基线及11年随访期间测量受试者的握力。
**<i>研究结果：</i>** 无论男性还是女性，不同糖尿病分组的基线平均握力均无显著差异。在男性群体中，校正年龄、教育水平、生活方式因素、慢性疾病状况及随访时的糖尿病状态后，糖尿病组的肌肉力量下降幅度（-131.5牛顿[N]，95%置信区间[CI]：-182.7~-80.4）显著大于非糖尿病组（-98.9 N，95%CI：-139.5~-58.3）。在女性群体中，校正所有潜在协变量后，糖尿病组、糖尿病前期组与非糖尿病组的肌肉力量下降幅度均无显著差异，各组下降值分别为-45.0 N（95%CI：-73.2~-16.7）、-29.4 N（95%CI：-59.7~0.9）及-42.3 N（95%CI：-70.5~-14.1）。
**<i>研究结论：</i>** 2型糖尿病的存在与老年男性更大幅度的肌肉力量下降相关，但未在老年女性中观察到这一关联。