<p>Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship</p>

Abstract

The incidence and prevalence of metabolic and musculoskeletal diseases are increasing. Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, inflammation, advanced glycation end-product accumulation and increased oxidative stress. These characteristics can negatively affect various aspects of muscle health, including muscle mass, strength, quality and function through impairments in protein metabolism, vascular and mitochondrial dysfunction, and cell death. Sarcopenia is a term used to describe the agerelated loss in skeletal muscle mass and function and has been implicated as both a cause and consequence of T2DM. Sarcopenia may contribute to the development and progression of T2DM through altered glucose disposal due to low muscle mass, and also increased localized inflammation, which can arise through inter-and intramuscular adipose tissue accumulation. Lifestyle modifications are important for improving and maintaining mobility and metabolic health in individuals with T2DM and sarcopenia. However, evidence for the most effective and feasible exercise and dietary interventions in this population is lacking. In this review, we discuss the current literature highlighting the bidirectional relationship between T2DM and sarcopenia, highlight current research gaps and treatments, and provide recommendations for future research.

What are the association patterns between handgrip strength and adverse health conditions? A topical review

“…94,95 Similarly, a longitudinal, bidirectional association may exist between HGS and metabolic diseases such as diabetes. 96,97 Such findings indicate that when paralleling associations exist, losses of function in one factor could lead to losses in the other. Figure 1 provides a conceptual model for identifying third factors for paralleling associations between HGS and diseases that are metabolically or neurologically driven, while Figure 2 postulates how such mediators may influence strength capacity and health through the muscular and nervous systems.…”

Association of Serum Bilirubin Levels With Sarcopenia in Patients With Type 2 Diabetes: a Cross-Sectional Study in China

“…The bidirectional relationship between T2DM and sarcopenia has been demonstrated in a previous review [10]. T2DM is characterized by insulin resistance, an in ammatory phenotype, oxidative stress and increased advanced glycation end-products (AGEs), which may lead to cell death and further losses in skeletal muscle mass, strength, and function, nally facilitating the occurrence of sarcopenia [10]. Bilirubin is one of the most active endogenous antioxidant molecules and has been proved bene cial to the prevention and treatment of T2DM [11][12][13][14]21].…”

“…With aging, there is a rise in the prevalence of metabolic and musculoskeletal diseases, including T2DM and sarcopenia [5,20]. The bidirectional relationship between T2DM and sarcopenia has been demonstrated in a previous review [10]. T2DM is characterized by insulin resistance, an in ammatory phenotype, oxidative stress and increased advanced glycation end-products (AGEs), which may lead to cell death and further losses in skeletal muscle mass, strength, and function, nally facilitating the occurrence of sarcopenia [10].…”

“…It is well known that elevated oxidative stress and in ammation play important roles in the pathogenesis of diabetic sarcopenia [10]. Bilirubin, the end product of heme metabolism, has been recently con rmed to play a protective role in metabolic syndrome and diabetes through antagonizing oxidative stress and chronic in ammation [11][12][13][14].…”

Sarcopenia and diabetes mellitus: evidence for a bi-directional relationship

“…Hyperglycaemia in DM leads to increased oxidative stress, advanced glycation end-product accumulation and chronic low-grade systemic inflammation, which contribute to micro-and macrovascular complications. These characteristics and complications can directly and indirectly affect all components of sarcopenia through impaired protein metabolism, mitochondrial dysfunction, neuropathy, nephropathy and myopathy [5]. However, a fundamental difference between type 1 and type 2 DM is skeletal muscle insulin resistance, which appears to be the initial metabolic defect in type 2 DM [6].…”