{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:12:47Z","timestamp":1791213167527,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,7,9]],"date-time":"2016-07-09T00:00:00Z","timestamp":1468022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5RO1 NS46259\u201003"],"award-info":[{"award-number":["5RO1 NS46259\u201003"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["5\u20102002\u2010185"],"award-info":[{"award-number":["5\u20102002\u2010185"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To quantify muscle strength and size in subjects with impaired glucose tolerance (<jats:styled-content style=\"fixed-case\">IGT<\/jats:styled-content>) in relation to intramuscular non\u2010contractile tissue, the severity of neuropathy and vitamin D level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 20 subjects with impaired glucose tolerance and 20 control subjects underwent assessment of strength and size of knee extensor, flexor and ankle plantar and dorsi\u2010flexor muscles, as well as quantification of intramuscular non\u2010contractile tissue and detailed assessment of neuropathy and serum 25\u2010hydroxy vitamin D levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In subjects with impaired glucose tolerance, proximal knee extensor strength (<jats:italic>P<\/jats:italic> = 0.17) and volume (<jats:italic>P<\/jats:italic> = 0.77), and knee flexor volume (<jats:italic>P<\/jats:italic> = 0.97) did not differ from those in control subjects. Ankle plantar flexor strength was significantly lower (<jats:italic>P<\/jats:italic> = 0.04) in the subjects with impaired glucose tolerance, with no difference in ankle plantar flexor (<jats:italic>P<\/jats:italic> = 0.62) or dorsiflexor volume (<jats:italic>P<\/jats:italic> = 0.06) between groups. Intramuscular non\u2010contractile tissue level was significantly higher in the ankle plantar flexors and dorsiflexors (<jats:italic>P<\/jats:italic> = 0.03) of subjects with impaired glucose tolerance compared with control subjects, and it correlated with the severity of neuropathy. Ankle plantar flexor muscle strength correlated significantly with corneal nerve fibre density (<jats:italic>r<\/jats:italic> = 0.53; <jats:italic>P<\/jats:italic> = 0.01), a sensitive measure of small fibre neuropathy, and was significantly lower in subjects with vitamin D deficiency (<jats:italic>P<\/jats:italic> = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>People with impaired glucose tolerance have a significant reduction in distal but not proximal leg muscle strength, which is not associated with muscle atrophy, but with increased distal intramuscular non\u2010contractile tissue, small fibre neuropathy and vitamin D deficiency.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13163","type":"journal-article","created":{"date-parts":[[2016,6,9]],"date-time":"2016-06-09T15:56:25Z","timestamp":1465487785000},"page":"356-363","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Distal lower limb strength is reduced in subjects with impaired glucose tolerance and is related to elevated intramuscular fat level and vitamin D deficiency"],"prefix":"10.1111","volume":"34","author":[{"given":"M. M.","family":"Almurdhi","sequence":"first","affiliation":[{"name":"Centre for Endocrinology and Diabetes Institute of Human Development University of Manchester and Central Manchester NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. D.","family":"Reeves","sequence":"additional","affiliation":[{"name":"School of Healthcare Science Faculty of Science and Engineering Manchester Metropolitan University Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. L.","family":"Bowling","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology and Diabetes Institute of Human Development University of Manchester and Central Manchester NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. J. M.","family":"Boulton","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology and Diabetes Institute of Human Development University of Manchester and Central Manchester NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Jeziorska","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology and Diabetes Institute of Human Development University of Manchester and Central Manchester NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. A.","family":"Malik","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology and Diabetes Institute of Human Development University of Manchester and Central Manchester NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"},{"name":"Weill\u2010Cornell Medicine\u2010Qatar Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20080079"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001250050788"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2014.10.005"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcm095"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/71.4.885"},{"key":"e_1_2_9_7_1","first-page":"1","article-title":"Poor Lower Extremity Function Was Associated with Pre\u2010Diabetes and Diabetes in Older Chinese People","volume":"22","author":"Zhang W","year":"2014","journal-title":"PLOS One"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.4329\/wjr.v6.i4.119"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/841248"},{"key":"e_1_2_9_10_1","first-page":"22","article-title":"Does glucose tolerance affect elderly persons\u2019 balance, gait or muscle strength?","volume":"9","author":"Hiltunen LA","year":"2001","journal-title":"Cent Eur J Public Health"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2007.0669"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2010.03023.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.53.6.1543"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-009-1320-0"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2257"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1108"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2015.01.011"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.149393"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-53480-4.00009-6"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-0279"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-2733"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24310"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.125"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-53480-4.00007-2"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-10-0186"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-543X.2004.00071.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnutbio.2014.09.014"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-015-0405-5"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/953241"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/320930"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-015-3151-9"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13163","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13163","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13163","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:19:03Z","timestamp":1696292343000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.13163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,9]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1111\/dme.13163"],"URL":"https:\/\/doi.org\/10.1111\/dme.13163","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,9]]},"assertion":[{"value":"2016-06-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}