%BF, Rather Than BMI, is Associated with an Increased Risk of Sarcopenia in Hospitalized Postmenopausal Chinese Women with Type 2 Diabetes Mellitus

Overview

Journal Diabetes Metab Syndr Obes

Publisher Dove Medical Press

Specialty Endocrinology

Date 2024 Nov 12

PMID 39529616

Authors

Lanyu Lu

Guohui Du

Chaogang Qi

Junru Liu

Xing Wang

Dongmei Fan

Lina Sun

Ning Wang

Bowei Liu

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate the relationship between obesity indices and sarcopenia in postmenopausal patients with type 2 diabetes mellitus (T2DM) at different body mass index (BMI) levels.

Patients And Methods: This retrospective cross-sectional study included 298 hospitalized postmenopausal women diagnosed with T2DM. We collected demographic, biochemical, and anthropometric data on each subject. Body composition was measured using dual-energy X-ray absorptiometry (DXA), and skeletal muscle mass index (SMI) and body fat percentage (%BF) were calculated. According to BMI stratification, the patients were divided into normal group A (18.5 kg/m≤BMI < 24 kg/m), overweight group B (24.0 kg/m≤BMI < 28 kg/m), and obesity group C (28.0 kg/m ≤BMI < 35 kg/m).

Results: From group A to group C, SMI (5.21±0.56 vs 5.48±0.56 vs 6.03±0.69) increased gradually (P < 0.05). Logistic regression analysis indicated that for each 1-unit increase in BMI, the risk of sarcopenia decreased by 63.2% (OR=0.368, 95% CI 0.215-0.629, P=0.000) in group A. Age (OR=1.077, 95% CI 1.015-1.144, P=0.015) and %BF (OR=1.094, 95% CI 1.010-1.186, P=0.028) increased the risk of sarcopenia by 1.077 and 1.094 times, respectively, in group B. While every 1-unit increase in BMI, the risk of sarcopenia decreased by 35% (OR=0.650, 95% CI 0.430-0.983, P=0.041) in group B. %BF (OR=1.459, 95% CI 1.093-1.949, P=0.010) increased the risk factors of sarcopenia by 1.459 times in group C.

Conclusion: In postmenopausal patients with T2DM, BMI had a protective effect on the occurrence of sarcopenia within a certain range, and with the increase of BMI, the risk of sarcopenia was increasing by increased %BF levels in overweight and obese patients.

References

Wang J, Liu C, Zhang L, Liu N, Wang L, Wu J . Prevalence and associated factors of possible sarcopenia and sarcopenia: findings from a Chinese community-dwelling old adults cross-sectional study. BMC Geriatr. 2022; 22(1):592. PMC: 9290196. DOI: 10.1186/s12877-022-03286-y. View

Yi Q, Wu J, Shen Y, Zhu Y, Zhou Y, Bai H . Associations of concurrent early-life famine exposure and adulthood obesity with type 2 diabetes mellitus in middle-aged Chinese. J Diabetes. 2023; 16(2):e13480. PMC: 10859315. DOI: 10.1111/1753-0407.13480. View

He X, Song Y, Ma L, Ainsworth B, Liu Y, Chen N . Prevalence and Factors Influencing Sarcopenia Among Community-Dwelling Older Adults Using the Asian Working Group for Sarcopenia Definition. Clin Interv Aging. 2022; 17:1707-1727. PMC: 9719269. DOI: 10.2147/CIA.S388319. View

Liu C, Wong P, Chung Y, Chow S, Cheung W, Law S . Deciphering the "obesity paradox" in the elderly: A systematic review and meta-analysis of sarcopenic obesity. Obes Rev. 2022; 24(2):e13534. DOI: 10.1111/obr.13534. View

Lu L, Liu B, Ma Y . Association of Different Obesity Phenotypes with Sarcopenia in Han Chinese Middle-Aged and Elderly with Type 2 Diabetes Individuals. Diabetes Metab Syndr Obes. 2023; 16:841-848. PMC: 10039658. DOI: 10.2147/DMSO.S398475. View

Izzo A, Massimino E, Riccardi G, Della Pepa G . A Narrative Review on Sarcopenia in Type 2 Diabetes Mellitus: Prevalence and Associated Factors. Nutrients. 2021; 13(1). PMC: 7826709. DOI: 10.3390/nu13010183. View

Hung J, McQuillan B, Thompson P, Beilby J . Circulating adiponectin levels associate with inflammatory markers, insulin resistance and metabolic syndrome independent of obesity. Int J Obes (Lond). 2008; 32(5):772-9. DOI: 10.1038/sj.ijo.0803793. View

Raman V, Kose V, Somalwar S, Dwidmuthe K, Rao S . Prevalence of Metabolic Syndrome and Its Association With Menopausal Symptoms in Post-Menopausal Women: A Scoping Review. Cureus. 2023; 15(5):e39069. PMC: 10267665. DOI: 10.7759/cureus.39069. View

Yu R, Wong M, Leung J, Lee J, Auyeung T, Woo J . Incidence, reversibility, risk factors and the protective effect of high body mass index against sarcopenia in community-dwelling older Chinese adults. Geriatr Gerontol Int. 2014; 14 Suppl 1:15-28. DOI: 10.1111/ggi.12220. View

10.

Bagheri A, Khosravy T, Moradinazar M, Nachvak S, Pasdar Y, Soleimani D . Optimal cut-off points of fat mass index and visceral adiposity index associated with type 2 diabetes mellitus. Food Sci Nutr. 2022; 10(8):2710-2717. PMC: 9361442. DOI: 10.1002/fsn3.2874. View

11.

Kurmaev D, Bulgakova S, Treneva E, Chetverikova I, Bashinskaya S . [Sarcopenia and type 2 diabetes mellitus in geriatric patients (literature review).]. Adv Gerontol. 2023; 35(6):818-826. View

12.

Li C, Kang B, Zhang T, Gu H, Man Q, Song P . High Visceral Fat Area Attenuated the Negative Association between High Body Mass Index and Sarcopenia in Community-Dwelling Older Chinese People. Healthcare (Basel). 2020; 8(4). PMC: 7712146. DOI: 10.3390/healthcare8040479. View

13.

Cao Y, Li Y, Han W, Jia X, Zhu P, Wei B . Sodium Butyrate Ameliorates Type 2 Diabetes-Related Sarcopenia Through IL-33-Independent ILC2s/IL-13/STAT3 Signaling Pathway. J Inflamm Res. 2023; 16:343-358. PMC: 9888475. DOI: 10.2147/JIR.S392350. View

14.

Cho E, Choi Y, Jung S, Kwak H . Role of exercise in estrogen deficiency-induced sarcopenia. J Exerc Rehabil. 2022; 18(1):2-9. PMC: 8934617. DOI: 10.12965/jer.2244004.002. View

15.

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

16.

Zhou B . Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci. 2002; 15(1):83-96. View

17.

Merchant R, Seetharaman S, Au L, Wong M, Wong B, Tan L . Relationship of Fat Mass Index and Fat Free Mass Index With Body Mass Index and Association With Function, Cognition and Sarcopenia in Pre-Frail Older Adults. Front Endocrinol (Lausanne). 2022; 12:765415. PMC: 8741276. DOI: 10.3389/fendo.2021.765415. View

18.

Yoo M, Won C, Soh Y . Association of high body mass index, waist circumference, and body fat percentage with sarcopenia in older women. BMC Geriatr. 2022; 22(1):937. PMC: 9724283. DOI: 10.1186/s12877-022-03643-x. View

19.

Choi S, Chon J, Ah Lee S, Yoo M, Yun Y, Chung S . Central obesity is associated with lower prevalence of sarcopenia in older women, but not in men: a cross-sectional study. BMC Geriatr. 2022; 22(1):406. PMC: 9082840. DOI: 10.1186/s12877-022-03102-7. View

20.

De Carvalho F, Justice J, DE Freitas E, Kershaw E, Sparks L . Adipose Tissue Quality in Aging: How Structural and Functional Aspects of Adipose Tissue Impact Skeletal Muscle Quality. Nutrients. 2019; 11(11). PMC: 6893709. DOI: 10.3390/nu11112553. View