Importance of Assessing Sarcopenia in Patients with Type 2 Diabetes Mellitus Based on Body Fat Percentage Measured by Dual-Energy X-Ray Absorptiometry in Different Genders

Overview

Journal Diabetes Metab Syndr Obes

Publisher Dove Medical Press

Specialty Endocrinology

Date 2024 Jul 1

PMID 38946913

Authors

Bingmei Hou

Xing Wei

Mianyu Yang

Yonghong Cao

Wu Dai

Affiliations

Soon will be listed here.

Abstract

Background: Growing evidence indicates that there is a close relationship between type 2 diabetes mellitus (T2DM) and sarcopenia, and T2DM patients are often accompanied by obesity. However, research exploring the connection between body fat percentage (BFP) and sarcopenia is currently limited.

Methods: This was a cross-sectional study that included 676 patients with T2DM over 50 years old. The appendicular skeletal muscle mass index (ASMI), handgrip strength, and 5-time chair stand test (5-TCST) were measured, and sarcopenia was diagnosed according to the Asian Working Group on Sarcopenia (AWGS). Spearman's coefficient was used to evaluate the correlation of BFP and body mass index (BMI) with the diagnostic elements of sarcopenia, and BFP and other relevant covariates were included in the binary logistic regression model. The subgroup performed an interaction test for statistically significant population baseline information.

Results: The prevalence of sarcopenia was 18.0% in males and 11.6% in females. Spearman correlation analysis showed that BFP was positively correlated with ASMI in women (=0.107, =0.029), but not in men. BFP was negatively correlated with grip strength (male: = -0.187, =0.003; female: =-0.108, =0.029). There was a positive correlation between BFP and 5-TCST (male: =0.199, =0.001; female: =0.144, =0.003). After adjusting for confounding factors, BFP was an independent risk factor for sarcopenia (men, OR: 1.33, 95% CI: 1.15-1.54; women, OR: 1.26, 95% CI: 1.13-1.41). This correlation was generally consistent, as demonstrated in further subgroup analyses.

Conclusion: High BFP was significantly associated with sarcopenia risk, and this association was independent of gender, age, and BMI.

References

Sinclair A, Abdelhafiz A, Rodriguez-Manas L . Frailty and sarcopenia - newly emerging and high impact complications of diabetes. J Diabetes Complications. 2017; 31(9):1465-1473. DOI: 10.1016/j.jdiacomp.2017.05.003. View

. [Clinical guidelines for prevention and treatment of type 2 diabetes mellitus in the elderly in China (2022 edition)]. Zhonghua Nei Ke Za Zhi. 2022; 61(1):12-50. DOI: 10.3760/cma.j.cn112138-20211027-00751. View

Abe S, Ezaki O, Suzuki M . Medium-chain triglycerides (8:0 and 10:0) are promising nutrients for sarcopenia: a randomized controlled trial. Am J Clin Nutr. 2019; 110(3):652-665. DOI: 10.1093/ajcn/nqz138. View

Xiu S, Sun L, Mu Z, Fu J . Low prealbumin levels are associated with sarcopenia in older men with type 2 diabetes mellitus: A cross-sectional study. Nutrition. 2021; 91-92:111415. DOI: 10.1016/j.nut.2021.111415. View

Wang L, You X, Zhang L, Zhang C, Zou W . Mechanical regulation of bone remodeling. Bone Res. 2022; 10(1):16. PMC: 8857305. DOI: 10.1038/s41413-022-00190-4. View

Laurent M, Dedeyne L, Dupont J, Mellaerts B, Dejaeger M, Gielen E . Age-related bone loss and sarcopenia in men. Maturitas. 2019; 122:51-56. DOI: 10.1016/j.maturitas.2019.01.006. View

Wang N, Chen M, Fang D . Relationship between serum triglyceride to high-density lipoprotein cholesterol ratio and sarcopenia occurrence rate in community-dwelling Chinese adults. Lipids Health Dis. 2020; 19(1):248. PMC: 7716486. DOI: 10.1186/s12944-020-01422-4. View

Mizgier M, Casas M, Contreras-Ferrat A, Llanos P, Galgani J . Potential role of skeletal muscle glucose metabolism on the regulation of insulin secretion. Obes Rev. 2014; 15(7):587-97. DOI: 10.1111/obr.12166. View

Almeida M, Laurent M, Dubois V, Claessens F, OBrien C, Bouillon R . Estrogens and Androgens in Skeletal Physiology and Pathophysiology. Physiol Rev. 2016; 97(1):135-187. PMC: 5539371. DOI: 10.1152/physrev.00033.2015. View

10.

Li C, Yu K, Shyh-Chang N, Jiang Z, Liu T, Ma S . Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review. J Cachexia Sarcopenia Muscle. 2022; 13(2):781-794. PMC: 8977978. DOI: 10.1002/jcsm.12901. View

11.

He J, Zhang B, Fan Y, Wang Y, Zhang M, Li C . Comparison of bioelectrical body and visceral fat indices and anthropometric measures in relation to type 2 diabetes by sex among Chinese adults, a cross-sectional study. Front Public Health. 2023; 11:1001397. PMC: 10661931. DOI: 10.3389/fpubh.2023.1001397. View

12.

Xu W, Perera S, Medich D, Fiorito G, Wagner J, Berger L . Height loss, vertebral fractures, and the misclassification of osteoporosis. Bone. 2010; 48(2):307-11. PMC: 3021585. DOI: 10.1016/j.bone.2010.09.027. View

13.

Sun L, Fu J, Mu Z, Duan X, Chan P, Xiu S . Association between body fat and sarcopenia in older adults with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne). 2023; 14:1094075. PMC: 9911832. DOI: 10.3389/fendo.2023.1094075. View

14.

Chen L, Woo J, Assantachai P, Auyeung T, Chou M, Iijima K . Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020; 21(3):300-307.e2. DOI: 10.1016/j.jamda.2019.12.012. View

15.

Park J, Lee M, Shin H, Yoon K, Lee J, Park J . Lower skeletal muscle mass is associated with diabetes and insulin resistance: A cross-sectional study. Diabetes Metab Res Rev. 2023; 39(7):e3681. DOI: 10.1002/dmrr.3681. View

16.

Martin A, Priego T, Lopez-Calderon A . Hormones and Muscle Atrophy. Adv Exp Med Biol. 2018; 1088:207-233. DOI: 10.1007/978-981-13-1435-3_9. View

17.

Batsis J, Villareal D . Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018; 14(9):513-537. PMC: 6241236. DOI: 10.1038/s41574-018-0062-9. View

18.

McKenzie K, Lee C, Mijatovic J, Haghighi M, Skilton M . Medium-Chain Triglyceride Oil and Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Trials. J Nutr. 2021; 151(10):2949-2956. DOI: 10.1093/jn/nxab220. View

19.

Axelrod C, Dantas W, Kirwan J . Sarcopenic obesity: emerging mechanisms and therapeutic potential. Metabolism. 2023; 146:155639. PMC: 11448314. DOI: 10.1016/j.metabol.2023.155639. View

20.

Hill C, James R, Cox V, Tallis J . Does Dietary-Induced Obesity in Old Age Impair the Contractile Performance of Isolated Mouse Soleus, Extensor Digitorum Longus and Diaphragm Skeletal Muscles?. Nutrients. 2019; 11(3). PMC: 6470722. DOI: 10.3390/nu11030505. View