{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:08Z","timestamp":1787014088817,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,11,14]],"date-time":"2015-11-14T00:00:00Z","timestamp":1447459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["2RO1AG7644\u201001A1"],"award-info":[{"award-number":["2RO1AG7644\u201001A1"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["2RO1AG017644"],"award-info":[{"award-number":["2RO1AG017644"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RE\/10\/005\/28296"],"award-info":[{"award-number":["RE\/10\/005\/28296"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000341","name":"Arthritis Research UK","doi-asserted-by":"publisher","award":["MR\/K006312\/1"],"award-info":[{"award-number":["MR\/K006312\/1"]}],"id":[{"id":"10.13039\/501100000341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Obesity is a well\u2010established risk factor for developing Type 2 diabetes. Evidence suggests that sarcopenia, the age\u2010related decline in muscle mass and strength, may exacerbate diabetes risk in obese individuals. The aim of this study was to determine the combined effect of obesity and low muscle strength, dynapenia, on the risk of incident Type 2 diabetes in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were 5953 (1670 obese) men and women from the English Longitudinal Study of Ageing without known Type 2 diabetes at baseline and for whom handgrip strength, biochemical and other clinical data were collected. A diagnosis of Type 2 diabetes was recorded from self\u2010reported physician diagnosis over 6 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For each unit increase in grip strength, there was a reduction in diabetes risk (age\u2010, sex\u2010 and\n                      <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>\n                      adjusted\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      ; 0.98; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.96\u20130.99). The risk of Type 2 diabetes was elevated in all obese participants, but was greatest in those with low handgrip strength (HR = 4.93, 95% CI 2.85, 8.53) compared with non\u2010obese individuals with high handgrip strength. Eleven per cent of the sample met the threshold for weakness (handgrip strength: men &lt; 26 kg; women &lt; 16 kg) that was associated with elevated Type 2 diabetes risk in obese (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      = 3.57, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      2.04, 6.24) but not in non\u2010obese (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      = 0.86, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 0.44, 1.68) compared with normal\/non\u2010obese participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Dynapenic obesity, determined by high\n                      <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>\n                      and low handgrip strength, is associated with increased risk of incident Type 2 diabetes in older people.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.12991","type":"journal-article","created":{"date-parts":[[2015,10,19]],"date-time":"2015-10-19T11:18:43Z","timestamp":1445253523000},"page":"1052-1059","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Dynapenic obesity and the risk of incident Type 2 diabetes: the English Longitudinal Study of Ageing"],"prefix":"10.1111","volume":"33","author":[{"given":"D. J.","family":"Cuthbertson","sequence":"first","affiliation":[{"name":"MRC\u2010Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing Institute of Ageing and Chronic Disease University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Public Health University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Y.","family":"Ng","sequence":"additional","affiliation":[{"name":"MRC\u2010Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing Institute of Ageing and Chronic Disease University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. J.","family":"Kemp","sequence":"additional","affiliation":[{"name":"MRC\u2010Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing Institute of Ageing and Chronic Disease University of Liverpool Liverpool UK"},{"name":"Musculoskeletal Biology Institute of Ageing and Chronic Disease University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kivimaki","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Public Health University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Hamer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Public Health University College London London UK"},{"name":"The National Centre for Sport and Exercise Medicine Loughborough University Loughborough 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