Last updated August 27, 2026
Key finding
Appendicular muscle mass expressed relative to the sarcopenia threshold decreased by 5.6% ± 2.5% in the prediabetic group.
This study investigated the relationship between metabolic dysfunction and musculoskeletal dysfunction in individuals with overweight/obesity, finding significant changes in muscle and bone metrics in prediabetic participants.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Short-Term (≤3 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study investigated the relationship between metabolic dysfunction and musculoskeletal dysfunction in individuals with overweight/obesity, finding significant changes in muscle and bone metrics in prediabetic participants.
These findings highlight the importance of addressing metabolic dysfunction in overweight and obese individuals, as it may lead to significant musculoskeletal issues. Understanding these associations can help clinicians develop targeted interventions to improve muscle and bone health, potentially reducing the risk of further complications associated with obesity and metabolic disorders.
The study's sample size may limit the generalizability of findings. Results are specific to prediabetic individuals and may not apply to other populations. The study design does not account for long-term effects of insulin therapy.
Published in
Publication details and source links for this paper.
Alan F, Clifton J. H, Chao C, et al. In people with overweight/obesity, metabolic dysfunction associates with musculoskeletal dysfunction independent of adiposity. Journal of Cachexia, Sarcopenia and Muscle. 2026;17(1):e70198. doi:10.1002/jcsm.70198
Appendicular muscle mass decreased by 5.6% in the prediabetic group (p=0.05).
Bone mineral density T-score decreased by 0.22 in the prediabetic group (p=0.05).
Myofibres were approximately 25% smaller in the prediabetic group (p=0.05).
Muscle Type 2 macrophages were approximately 40% fewer in the prediabetic group (p=0.05).
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Insulin therapy and Bone mineral density (BMD), Cross-sectional area of adipocytes, Intramyocellular lipid content, and 3 more.
This study contributes evidence to
Primary intervention
Insulin therapy
Primary outcomes
Evidence topics
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
3
Related topics
6
Evidence pairs
292
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Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Related evidence
Evidence relationship
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Evidence relationship
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Core evidence
The primary outcomes reported in this study.
Insulin therapy → Bone mineral density (BMD)
Insulin therapy → Bone mineral density (BMD)
Insulin therapy → Intramyocellular lipid content
Insulin therapy → Intramyocellular lipid content
Insulin therapy → Muscle M2 macrophage abundance
Insulin therapy → Muscle M2 macrophage abundance
Insulin therapy → Cross-sectional area of adipocytes
Insulin therapy → Cross-sectional area of adipocytes
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Insulin Therapies and Bone Mineral Density, Insulin Therapies and Cross-sectional area of adipocytes.
This study contributes to the evidence on the following intervention-outcome relationships.
Medications
Curated evidence collections and hubs this study is part of.
All studies measuring Bone Mineral Density
Measures Bone Mineral Density as a key outcome.
All studies measuring Cross-sectional area of adipocytes
Measures Cross-sectional area of adipocytes as a key outcome.
All studies on Insulin Therapies
Contributes to Insulin Therapies evidence base.
All studies measuring Intramyocellular lipid content
Measures Intramyocellular lipid content as a key outcome.
Latest published studies
Published within the last 2 years.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Current evidence does not show a clear benefit of Insulin Therapies for Muscular Strength.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Muscular strength
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Insulin Therapies may worsen Bone Mineral Density or be associated with harm.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Bone mineral density (BMD)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | moderate negative | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Insulin Therapies may worsen Body Composition or be associated with harm.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Lean body mass
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | moderate negative | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Insulin therapy appears to improve Cross-sectional area of adipocytes.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Cross-sectional area of adipocytes
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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