Sarcopenic obesity is associated with a faster decline in renal function in people with type 2 diabetes

Abstract

Aim To evaluate the association between sarcopenic obesity and the decline in estimated GFR in people with type 2 diabetes. Methods We enrolled 745 people with type 2 diabetes (mean age 64.6 years, 53.6% men). Body composition was evaluated using dual‐energy X‑ray absorptiometry. Skeletal muscle index, calculated as appendicular non‐fat mass (kg) divided by height squared (m2), was used to determine sarcopenia. Sarcopenic obesity was defined as the coexistence of sarcopenia and a ratio of android to gynoid fat mass greater than the median values in each gender. The association of sarcopenic obesity both with the annual rate of decline in estimated GFR and a >30% decline in estimated GFR was evaluated using multivariate linear regression models and Cox proportional hazard models, respectively. Results Participants with sarcopenic obesity were at an increased risk of a high annual rate of decline in estimated GFR, even after adjustment for the confounding variables (standardized β = −0.228, P <0.001). Sarcopenic obesity was also significantly associated with risk of a >30% decline in estimated GFR (hazard ratio 4.52, 95% CI 2.16–9.47; P < 0.01) in multivariate model. Conclusions Sarcopenic obesity evaluated by dual energy X‑ray absorptiometry is associated with a faster decline in renal function in people with type 2 diabetes.

Effect of Low Skeletal Muscle Mass and Sarcopenic Obesity on Chronic Kidney Disease in Patients with Type 2 Diabetes

“…In line with these observations, our study demonstrated that general obesity de ned by BMI was not signi cantly associated with incident CKD, while visceral obesity was associated with a 1.77-fold increased risk of incident CKD in combination with sarcopenia. This relationship is similar to that observed in a recent longitudinal study, which demonstrated a strong link between sarcopenic obesity, de ned by the android/gynoid percent fat ratio, and faster renal function decline in people with T2DM, while there was no association when sarcopenic obesity was de ned by BMI 12 .…”

“…Limited studies involving patients with diabetes have also indicated that sarcopenia or sarcopenic obesity is associated with CKD [11][12][13] . To date, only a single longitudinal study has examined the causal relationship between sarcopenic obesity and renal function decline exclusively in patients with T2DM 12 . Furthermore, no studies have assessed the association between low muscle mass and the risk of incident CKD in a large cohort of patients with T2DM and preserved renal function.…”

Effect of low skeletal muscle mass and sarcopenic obesity on chronic kidney disease in patients with type 2 diabetes

“…Limited studies involving patients with diabetes have also indicated that sarcopenia or sarcopenic obesity is associated with CKD [11][12][13]. To date, only a single longitudinal study, to our knowledge, has examined the causal relationship between sarcopenic obesity and renal function decline exclusively in patients with T2DM [12].…”

Association between osteosarcopenia and coronary artery calcification in asymptomatic individuals

“…Due to the relatively younger age of subjects, the present study considered only the quantity of muscle mass for defining sarcopenia. Moreover, many previous studies were reported with defining sarcopenia based on the low muscle mass alone 44 , 47 , 48 . Third, this was a cross-sectional design which prevented our accessing causal relationships.…”