975-P: Adverse Muscle Composition Is Linked to a Higher Risk Type 2 Diabetes Phenotype

Background: The link between type 2 diabetes (T2D) and muscle health is not fully understood. Magnetic resonance imaging allows detection of Adverse muscle composition (MC). Method: Thigh fat-free muscle volume (FFMV, higher better) and muscle fat infiltration (MFI, higher worse) was measured in 38974 UK Biobank participants using AMRA Researcher. Persons with T2D (N=1881) were divided into four MC groups: (1) Normal MC, (2) Only low muscle volume (FFMV z-score the population wide 75th percentile (sex-specific)), (4) Adverse MC (low muscle volume and high muscle fat). Cardiovascular disease (CVD) risk was compared between MC groups using Cox proportional hazard modeling (unadjusted and adjusted for sex, age, BMI, prior CVD; referent: Normal MC). Result: Within T2D, Adverse MC was associated with a >2 fold higher hazard ratio (HR) for incident CVD compared to Normal MC. The association persisted after adjusting for prior CVD (Table 1). T2D with Normal MC was only modestly associated with incident CVD compared to sex, age and BMI matched non-T2D controls (HR 1.26, p=0.20). Conclusion: All MC phenotypes were represented in T2D where Adverse MC most strongly associated with higher CVD incidence, whereas CVD risk was only modestly higher in T2D with normal MC compared to controls. Whether improved MC can lessen outcome risks in T2D needs investigation. Disclosure J. Linge: Employee; Self; AMRA Medical AB, Stock/Shareholder; Self; AMRA Medical AB. M. Petersson: Employee; Self; AMRA Medical AB. N. Sattar: Advisory Panel; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk, Pfizer Inc., Sanofi, Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc. O. Dahlqvist leinhard: Employee; Self; AMRA Medical AB, Stock/Shareholder; Self; AMRA Medical AB. Funding Pfizer Inc