Metabolic and Nutritional Characteristics in Middle-Aged and Elderly Sarcopenia Patients with Type 2 Diabetes

Abstract

Sarcopenia is considered to be a new complication of type 2 diabetes (T2DM) leading to increased risk of adverse outcome. We performed a survey to evaluate glucose metabolism and nutritional status in sarcopenia patients with T2DM. Diabetic participants aged ≥50 years were grouped into a probable sarcopenia group with low muscle strength ( n = 405 ) and a nonsarcopenia group with normal muscle strength ( n = 720 ) according to the revised recommendations from EWGSOP2 (2018). Compared to the controls, the probable sarcopenia participants were older and had lower waist-to-hip ratio and BMI, longer diabetes duration, higher fasting plasma glucose level and glycosylated hemoglobin (HbA1c), decreased estimated glomerular filtration rate and lower bone mineral content, lower fatless upper arm circumference, lower appendicular skeletal muscle mass index (ASMI), and muscle quality in both genders. Multivariable logistic regression analysis showed increased age, male, low BMI, and increased HbA1c, combined with diabetic nephropathy and decreased serum albumin levels, were risk factors associated with low muscle strength in diabetes patients. In conclusion, diabetic patients with sarcopenia had worse glucose metabolism and nutritional status, decreased renal function and reduced muscle quality ,and muscle mass with a greater likelihood of osteoporosis, who need an overall health management to improve outcomes. This clinical trial registration is registered with the Chinese Clinical Trial Registry, ChiCTR-EOC-15006901.

The Relationship Between Fat-Free Mass and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis

“…Considering that skeletal muscle plays a major role in glucose metabolism, most previous research concerns the negative relationship of muscle mass with T2D ( 24 – 26 ). However, a recent study has shown that sarcopenia is a new complication of T2D ( 27 ), and there is a reverse causality between muscle mass and T2D in middle-aged and elderly individuals. In order to exclude the influence of confounding factors such as age and degenerative disease, the study of the pediatric population could be better to clarify the relationship between muscle mass and glucose metabolism.…”

Focus on Nutritional Aspects of Sarcopenia in Diabetes: Current Evidence and Remarks for Future Research

“…Some articles further explored the aspect of the relationship between malnutrition and sarcopenia. One study evaluated some metabolic characteristics (including parameters of glucose metabolism) in addition to the nutritional status of both middle-aged and elderly subjects with sarcopenia and T2DM [34]. Subjects were grouped into a probable sarcopenia group (low muscle strength, n = 405) and a non-sarcopenia control group (normal muscle strength, n = 720).…”

Anti‐diabetic drugs and sarcopenia: emerging links, mechanistic insights, and clinical implications

“…In a multicentre study of 588 Japanese patients with T2DM, it was found that poor glycaemic control was significantly associated with SMM or gait speed in Japanese patients 97 . A recent survey in T2DM patients with or without sarcopenia revealed that sarcopenia patients with T2DM had worse glucose metabolism and nutritional status 98 . Therefore, the importance of nutritional and metabolic control for the prevention of muscle decline and sarcopenia is highlighted.…”

“… 97 A recent survey in T2DM patients with or without sarcopenia revealed that sarcopenia patients with T2DM had worse glucose metabolism and nutritional status. 98 Therefore, the importance of nutritional and metabolic control for the prevention of muscle decline and sarcopenia is highlighted. To decrease the risk of sarcopenia, optimization of nutritional therapy is undoubtedly needed in diabetes care.…”