A cross-sectional study

Abstract

Sarcopenia is a geriatric syndrome and it impairs physical function. Patients with type 2 diabetes mellitus (T2DM) are at a higher risk of sarcopenia. The purpose of this study is to explore characteristics of general information and metabolic factors of sarcopenia in patients with T2DM in the northeast of China, and provide information for the prevention and treatment of sarcopenia in clinical practice. Patients with T2DM aged ≥65 were recruited in Changchun from March 2017 to February 2018. Questionnaires of general information, physical examination, laboratory and imaging examination were conducted. The patients were assigned into sarcopenia group and non-sarcopenia group according to the diagnostic criteria proposed by Asian working group for sarcopenia (AWGS), and the differences between 2 groups were analyzed. A total of 132 participants were included in this study, of which, 38 (28.8%) were diagnosed with sarcopenia. 94 (71.2%) were with no sarcopenia. Logistic regression analysis showed that age (OR: 1.182, 95%CI: 1.038–1.346), trunk fat mass (TFM) (OR: 1.499, 95%CI: 1.146–1.960) and free thyroxine (FT4) (OR: 1.342, 95%CI: 1.102–1.635) were independent risk factors for sarcopenia. BMI (body mass index) (OR: 0.365, 95%CI: 0.236–0.661), exercise (OR: 0.016, 95%CI: 0.001–0.169), female (OR: 0.000, 95%CI: 0.00–0.012), metformin (OR: 0.159, 95%CI: 0.026–0.967) and TSM (trunk skeletal muscle mass) (OR: 0.395, 95%CI: 0.236–0.661) were protective factors for sarcopenia. Sarcopenia in patients with T2DM is associated with increased age, increased TFM and increased FT4 level. Regular exercise, female, metformin administrations, high BMI and increased TSM are associated with lower risk of sarcopenia.

A Narrative Review on Sarcopenia in Type 2 Diabetes Mellitus: Prevalence and Associated Factors

“…In particular, the paper by Cui et al showed that dividing participants according to diabetes duration, the prevalence of sarcopenia was 27.6%, 21.8%, and 52.6%, respectively in the groups with a diabetes duration below 10, between 10 and 20, and above 20 years [ 65 ]. However, other studies [ 49 , 52 , 56 , 57 , 60 , 65 ] did not find any association between disease duration and sarcopenia ( Figure 2 A). This was confirmed by the meta-analysis of Anatagostis et al showing no difference in sarcopenia prevalence between individuals with a mean T2DM duration of ≥9 years or <8.5 years [ 68 ].…”

“…In some studies, a significantly higher prevalence of sarcopenia in men [ 48 , 63 , 64 ] or women [ 65 , 70 ] was reported. However, other studies [ 47 , 49 , 50 , 51 , 52 , 53 , 54 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 66 ] did not find any difference in gender distribution among T2DM with sarcopenia.…”

“…Most of the studies have shown that individuals with T2DM and sarcopenia on the average are older than those without sarcopenia: 73.6 years and 67.2 years, respectively ( Figure 1 A). In fact, as observed by Cui et al, the prevalence of sarcopenia in T2DM rises progressively by increasing age (17.4% in the age group 65–69 years, 28.1% in the age groups 70–74 years, 52.4% in the age groups 75–80 years, and 60% in the age groups above 80 years) [ 56 ]. Similarly, Murata et al showed that approximately 40% of T2DM patients ≥80 years old present with sarcopenia [ 67 ].…”

“…In epidemiological studies, the prevalence of sarcopenia in T2DM has a wide range, varying from 7% to 29.3% in different populations [ 6 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ], ( Table 1 ).…”

“…Regarding other lifestyle factors, epidemiological studies do not report differences in smoking and drinking habits between T2DM individuals with and without sarcopenia ( Table 2 ), also when the analysis was performed separately in men and women [ 51 , 60 ]. Conversely, in T2DM individuals with sarcopenia the prevalence of physical activity has been found to be lower [ 56 , 64 , 77 ]; similarly, walking >5401 steps/day has been shown to have a protective effect since it is associated with a 70% lower prevalence of sarcopenia in T2DM patients [ 64 ].…”