Effect of Sarcopenia on Mortality in Type 2 Diabetes: A Long-Term Follow-Up Propensity Score-Matched Diabetes Cohort Study

Abstract

Purpose: The effect of sarcopenia on the survival of patients with type 2 diabetes remains unclear. Therefore, we designed a propensity score-matched population-based cohort study to compare the patients with diabetes with or without sarcopenia. Patients and Methods: We included patients with type 2 diabetes and categorized them into two groups according to whether they had sarcopenia and compared their survival; patients in the groups were matched at a ratio of 1:2. Results: The matching process yielded a final cohort of 201,698 patients (132,805 and 68,893 in the sarcopenia and nonsarcopenia diabetes groups, respectively) who were eligible for further analysis. According to both univariate and multivariate Cox regression analyses, the adjusted hazard ratios (aHRs; 95% confidence interval [CI]) of all-cause death for the sarcopenia diabetes group compared with the control group: 1.35 (1.33–1.38; p < 0.001). The aHRs (95% CIs) of all-cause death for those aged 41–50, 51–60, and >60 years (compared with those aged ≤40 years) were 1.53 (1.48–1.60), 2.61 (2.52–2.72), and 6.21 (5.99–6.45), respectively. The aHR (95% CI) of all-cause death for the male patients compared with the female patients was 1.56 (1.54–1.60). The aHRs (95% CIs) of all-cause death for those with adapted Diabetes Complications Severity Index (aDCSI) scores of 1, 2, 3, 4, and ≥5 (compared with an aDCSI score of 0) were 1.01 (1.00–1.14), 1.38 (1.35–1.42), 1.58 (1.54–1.63), and 2.23 (2.14–2.33), respectively. Conclusion: Patients with type 2 diabetes and sarcopenia had higher mortality than did those without sarcopenia.

The relationship between sarcopenia and mortality in Chinese community-dwelling adults: a 7-year cohort study with propensity score matching and Mendelian randomization

“…For instance, Lin et al. demonstrated that patients with both type 2 diabetes and sarcopenia were at higher risk for mortality than those without sarcopenia ( 13 ). Similarly, Bang et al.…”

“…Chronic inflammation, hormonal shifts, and malnutrition are pivotal factors linking sarcopenia to mortality ( 25 , 29 ). They can initiate or worsen various chronic diseases, significantly elevating the risk of premature death ( 10 , 13 ). Strategies aimed at managing chronic diseases, reducing inflammation, optimizing hormone levels, and ensuring adequate nutrition can collectively improve the overall wellbeing of sarcopenic individuals, potentially reducing their mortality risk.…”

“…Moreover, the relationship between sarcopenia and mortality can be confounded by chronic diseases and other factors that commonly occur with aging. Propensity score matching has been used in previous research to account for these confounding factors, but typically for a single disease (11)(12)(13)(14).…”

“…Sarcopenia is linked to a doubling of mortality risk in both community-dwelling adults and nursing home residents and a tripling of risk in cancer patients (11)(12)(13)(14). As the world's population continues to age, addressing the health implications of sarcopenia has become a critical priority.…”

The Association Between Sarcopenia and Diabetes: From Pathophysiology Mechanism to Therapeutic Strategy

“… 17 Recent studies have shown that patients with T2DM and sarcopenia have a higher mortality rate than those without sarcopenia. 18 However, little attention has been paid to elderly T2DM patients with sarcopenia. Hence, it is important to study the pathogenesis of both for a proper management of this clinical complexity.…”