Relationship between diabetic neuropathy and sarcopenia

Abstract

ObjectiveThe present study was designed to examine the prevalence of sarcopenia in patients who have Diabetic Neuropathy (DN); and to determine the relation between DN and sarcopenia. Material and methodsA total of 602 diabetic patients (mean age 60.2 ± 10.6 years; 40.5% male) were included in the study, which was designed as a cross-sectional study. The body composition was measured with the bioimpedance analysis method, and the muscle strength was measured by evaluating the hand grip strength. Those who showed only reduced handgrip strength were categorized in the s-presarcopenia group, whereas patients with only muscle volume loss were categorized in the v-presarcopenia group, those who had them together were defined as sarcopenia; and sarcopenia that was accompanied by obesity was defined as sarcopenic obesity. DN consisted of Diabetic Sensorimotor Polyneuropathy (DSPN) and Diabetic Autonomic Neuropathies (DAN) as two large groups. DAN consisted of its sub-groups of Cardiovascular Autonomic Neuropathy (CV-AN), Gastrointestinal Autonomic Neuropathy (GI-AN), Genitourinary Autonomic Neuropathy (GU-AN), Sudomotor Autonomic Neuropathy (SM-AN), which were identified with their own methods. Logistic regression analyzes were carried out to determine the relations of DN and its subgroups with sarcopenia and its components. ResultsThe DN prevalence was determined to be 85% in the entire patient population; and it was 80.2% in those who had normal muscle mass and strength, 84.4% in s-presarcopenic patients, 82.1% in v-presarcopenic patients, and 94.1% in sarcopenic patients. On the other hand, DN prevalence was 89.2% in non-obese sarcopenics; however, it was determined as 95,9% in sarcopenic obese patients. Similarly, the DN prevalence of non-sarcopenic patients was determined to be 76.7% in non-obese patients; and 88.5% in those who were obese. The sarcopenia incidence in patients who had DN was higher at a significant level than in those without DN (24.7%–8.9%). In the multivariate logistic regression analyzes, DN was determined to be associated with sarcopenia, independently from age and gender, even from accompanying concomitant diseases, BMI, Ha1c and GFR levels (OR: 2.38, 95% CI: 1.02–5.54). ConclusionsThe present study revealed the relation of sarcopenia with DN, especially with GI-AN and GU-AN.