The effect of nitric oxide and HbA1c on muscle mass in elderly with diabetes mellitus

Context: Diabetes mellitus (DM) in the elderly is followed by the incidence of sarcopenia, one of which is a decrease in muscle mass. Hyperglycemia and decreased nitric oxide (NO) levels in the elderly will affect the degradation and regeneration of skeletal muscle, thereby affecting muscle mass. Aims: To determine the effect of NO and HbA1c levels on muscle mass in elderly with DM. Methods: This is a cross-sectional study using purposive sampling techniques, and from the sample size formula, we get 30 elderlies with DM who visited the Geriatric Clinic. We take the serum for NO and HbA1c assays and muscle mass measurements by DXA. We used SPSS 22 for statistical analysis using the Shapiro-Wilk test for data normality, correlation analysis, and multiple linear regression with a significance value of p<0.05. Results: The BMI of subjects varied, with low average handgrip strength and normal TUG results. NO levels have a positive and significant effect on muscle mass, with a significant degree of 5 percent (p=0.003). HbA1c negatively and significantly affects muscle mass (p=0.04). The multiple correlation test results showed that NO and HbA1c significantly affected muscle mass (p=0.001). Conclusion: There was a positive effect of nitric oxide levels on muscle mass in the elderly with diabetes mellitus. If NO levels increase, it promotes muscle mass growth, conversely, if NO levels decrease, it will reduce muscle mass in the elderly with DM.