Association of accumulated advanced glycation end‐products with a high prevalence of sarcopenia and dynapenia in patients with type 2 diabetes

Abstract

Aims/Introduction Advanced glycation end‐products (AGEs), which are a major cause of diabetic vascular complications, accumulate in various tissues under chronic hyperglycemic conditions, as well as with aging in patients with diabetes. The loss of muscle mass and strength, so‐called sarcopenia and dynapenia, has recently been recognized as a diabetic complication. However, the influence of accumulated AGEs on muscle mass and strength remains unclear. The present study aimed to evaluate the association of sarcopenia and dynapenia with accumulated AGEs in patients with type 2 diabetes. Materials and Methods We recruited 166 patients with type 2 diabetes aged ≥30 years (mean age 63.2 ± 12.3 years; body mass index 26.3 ± 4.9 kg/m2; glycated hemoglobin 7.1 ± 1.1%). Skin autofluorescence as a marker of AGEs, limb skeletal muscle mass index, grip strength, knee extension strength and gait speed were assessed. Results Sarcopenia and dynapenia were observed in 7.2 and 13.9% of participants, respectively. Skin autofluorescence was significantly higher in patients with sarcopenia and dynapenia. Skin autofluorescence was the independent determinant for skeletal muscle mass index, grip strength, knee extension strength, sarcopenia and dynapenia. Conclusions Accumulated AGEs could contribute to reduced muscle mass and strength, leading to sarcopenia and dynapenia in patients with type 2 diabetes.

Clinical impact of sarcopenia and dynapenia on diabetes

“…According to AWGS criteria, the prevalence of sarcopenia is 4-11% in Asian individuals over 65 years, whereas 11-15% in patients with type 2 diabetes [6,14,15]. We also indicated that sarcopenia was frequently observed even in 16.6% of patients with type 1 diabetes aged over 40 years [5].…”

“…We observed a high prevalence rate of low knee extension strength as well as sarcopenia in type 1 diabetes [5]. Moreover, we recently reported that the prevalence rate of dynapenia was higher than sarcopenia in patients with type 2 diabetes [6]. In addition, the prevalence of poor muscle strength has been found to be higher in patients with type 1 and 2 diabetes, than in the general elderly Japanese population [7].…”

Apitherapy for Age-Related Skeletal Muscle Dysfunction (Sarcopenia): A Review on the Effects of Royal Jelly, Propolis, and Bee Pollen

“…Given its high prevalence in the general population, which ranges between 5 and 40% in western countries and increases up to 50% in advanced age, sarcopenia is considered a public health problem [ 4 , 15 ]. It causes progressive decline of functional capacity, contributes to frailty, increases the risk of falls and hospitalization in old people [ 16 , 17 ], and leads to poor outcomes in patients with COVID-19 [ 18 ].…”

Correlation between lower extremity arterial disease and skeletal muscle mass in patients with type 2 diabetes mellitus

“…In a state of long-term hyperglycemia, nonenzymatic protein glycosylation causes thickening of skeletal muscle capillary basement membrane, increases exchange distance between blood and tissues, hinders oxygen diffusion and metabolite exchange, and aggravates ischemia and hypoxia in skeletal muscles; these changes ultimately lead to nutritional and metabolic disorders of muscle tissue. 21,22 Second, many pathophysiological changes occur in skeletal muscle during long-term hyperglycemia, including abnormal autophagy, enhanced apoptosis, reduced secretion of growth factors and adiponectin, and mitochondrial dysfunction. Furthermore, the exocrine function of skeletal muscle is severely impacted.…”