Abstract
Type 2 diabetes mellitus (T2DM) is a strong risk tfactor for osteosarcopenia. The relationship between musculoskeletal index and β-cell function remains controversial. We aimed to describe the clinical characteristics of osteosarcopenia and to explore the association between osteosarcopenia and β-cell function, as well as insulin resistance in patients with T2DM. A total of 150 middle-aged and older nonobese patients with T2DM were recruited. Bone mineral density (BMD) and body composition were measured by the dual-energy X-ray absorptiometry scanner. The homeostasis model assessment of insulin resistance and Matsuda index were used to evaluate insulin resistance status. β-Cell function was estimated by the area under the curve insulin/glucose (AUC-Ins/Glu) and the area under the curve C-peptide/glucose (AUC-CP/Glu). T2DM patients with osteosarcopenia had lower body mass index, waist circumference, body fat percentage, AUC-Ins/Glu, and AUC-CP/Glu. Both AUC-Ins/Glu (OR = 0.634, P = 0.008) and AUC-CP/Glu (OR = 0.491, P = 0.009) were negatively associated with the presence of osteosarcopenia. Multivariate linear regression analysis showed that β-cell function was positively associated with the skeletal muscle mass index, whereas it showed no correlation with lumbar or hip BMD. β-Cell function is associated with osteosarcopenia in middle-aged and older nonobese patients with T2DM. These findings suggest that β-cell function might be a protective factor against osteosarcopenia.
Highlights
The term “osteosarcopenia” designates, the simultaneous presence of sarcopenia and osteopenia/ osteoporosis [1,2]
Insulin resistance was estimated by the homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index [19,20]. β-Cell function was measured by the area under the curve insulin/glucose (AUC-Ins/Glu) and the area under the curve C-peptide/glucose (AUC-CP/Glu), which were calculated using the trapezoidal rule applied to the insulin, C-peptide, and glucose curves [20,21]
There was no significant difference in the history of smoking and drinking, diabetes duration, blood pressure (BP), lipid profile, renal function, albumin, HbA1c, or antidiabetic medication between the two groups
Summary
The term “osteosarcopenia” designates, the simultaneous presence of sarcopenia and osteopenia/ osteoporosis [1,2]. This new concept is known as geriatric syndrome, which associates with an increased risk of falls, fractures, and impaired mobility. It has been reported that the prevalence of osteosarcopenia ranges from 4.7 to 40% in older adults [3]. The patients with osteosarcopenia had a significantly higher risk of falls and fractures than those having either sarcopenia or osteoporosis [4]. Type 2 diabetes mellitus (T2DM) was considered as a strong risk factor for osteosarcopenia [2]. This work is licensed under the Creative Commons Attribution 4.0
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