Sarcopenia in elderly patients with type 2 diabetes: risk factors

Abstract

Aim to determine the risk factors for sarcopenia in elderly patients with type 2 diabetes (T2DM).
 Material and methods. The study included 395 elderly patients with T2DM (mean age 65.1 2.7 years). The probable sarcopenia group (n = 185) included participants with low muscle strength, the control group (n = 210) included participants without sarcopenia. In all participants we registered the anthropometric indicators; fasting blood glucose; glycated hemoglobin (HbA1c); albumen; creatinine; body composition; handgrip strength. The food diary was used to calculate total daily calories, the amount of carbohydrates, proteins and fats eaten per day, as well as the proportion of calories provided by these macronutrients.
 Results. Compared with the controls, the male and female patients with probable sarcopenia were older (p0.001) and had lower waist-to-hip ratio (p=0.038 and p=0.018, respectively) and BMI (p=0.001 and p0.001 respectively), eGFR (p=0.030 and p=0.018, respectively), bone mineral content (p0.001), basal metabolic rate (p=0.016 and p0.001, respectively), appendicular skeletal muscle mass (p=0.043 and p0.001, respectively), appendicular musculoskeletal mass index (p=0.002 and p0.001, respectively) and muscle quality (p0.001), high fasting plasma glucose (p=0.017 and p=0.007, respectively) and HbA1c (p0.001 and p=0.004, respectively). In men with probable sarcopenia, the percentage of calories provided by carbohydrates was lower (p=0.041), while the percentage provided by fats (p= 0.012) was higher than in the control group.
 Conclusion. The multivariate logistic regression analysis showed that age (OR = 1.517, 95% CI: 1.127-2.043, p=0.006), male sex (OR = 0.196, 95% CI: 0.142-0.271, p0.001), BMI 28 kg/m2 (OR = 0.683, 95% CI: 0.467-0.998, p=0.049), HbA1c level 10% (OR = 1.396, 95% CI: 1.018-1.915, p=0.038), diabetic nephropathy (OR = 1.439, 95% CI: 1.033-2.006, p=0.031) and decreased serum albumin (OR = 0.917, 95% CI: 0.883-0.953, p0.001) were risk factors associated with low muscle strength in patients with type 2 diabetes type.