Men with diabetes treated with thiazolidinediones (n = 31) did not differ significantly from normoglycemic men in the amount of total lean mass loss (β = –0.62, P = 0.37, LSM change −2.4%[95%% CI −3.7 to −1.0]) or appendicular lean mass loss (β = –0.15, P = 0.86, LSM change −3.1%[−4.88 to −1.4]).
It could be debated if the nutritional supplementation should have been lasting longer than six months, however the idea was to attenuate lean mass loss during the first six postoperative months when the effects of trauma and surgery on weight and lean mass is most pronounced.
Men who were taking insulin sensitizers to treat diabetes had the least amount of total and appendicular lean mass loss.
In general, these studies have shown greater lean mass loss, especially in those with higher activity of disease and disability.
Indeed, our findings revealed that diabetic men treated with insulin sensitizers had significantly less appendicular lean mass loss than diabetic men who were untreated or using other therapies.
Moreover very low caloric diets (<800 Kcal) are associated with substantial nutritional deficiencies, lean mass loss, greater weight regain secondary to stable decrease in energy expenditure and increased risk of gallstones and cholecystitis due to increased peripheral mobilization of cholesterol.
Moreover, women with breast cancer receiving adjuvant chemotherapy underwent unfavourable changes in body composition with lean body loss due to a negative nitrogen balance [ 35] even in the absence of an overall weight change [ 4].
Further analysis of specific insulin sensitizers revealed that diabetic men on metformin or metformin + thiazolidinediones had significantly less total and appendicular lean mass loss than men with untreated diabetes or diabetes treated without insulin sensitizers.
49 Further, when negative energy balance is combined with reduced physical activity, such as that occurring with bed rest, space flight, or sometimes physiological aging, accelerated protein turnover results in greater lean tissue loss.
Higher release of IL-1, IL-2, IL-6, IFN-γ and TNF-α is associated with lean mass loss in patients with AIDS, cancer, chronic obstructive pulmonary disease, kidney failure, RA, acute myocardial infarction [ 13, 14].
