Endocrine Abstracts

Aim: To investigate the association between presence of sarcopenia and type 2 diabetes mellitus (T2DM).

Methods: The study included 76 women over 60 years old (Me72[67;77] years). Patients were examined with evaluation of muscle mass, muscle strength and muscle function. Skeletal muscle mass index (SMMI) was evaluated with bioimpedance testing. Sarcopenia was defined as a SMMI ≤6,75 kg/m². Peripheral neuropathy was studied with calculation of NIS-LL scale (max points = 96). Patients were divided into 2 groups: with sarcopenia (S+, n = 29) and without sarcopenia (S–, n = 47). We did not find any significant difference between age and diabetes duration in S+ and S- groups. Multivariable logistic regression model were adjusted for age. We plotted a ROC curve to compare the diagnostic accuracy of the anthropometric indicators and to find the optimal cut-off values of each indicators.

Results: The frequency of HbA1c level more then 8% were 72% in S+group and 49% in group S– (P = 0.041). S+ group less frequently received metformin (P = 0.011) and insulin (P = 0.044). Patients with sarcopenia demonstrated more often chronic kidney disease (70%) than S– (27%, P = 0.024). Diabetic neuropathy was more severein S+group than in S-group (NIS-LL: 12[7;17] vs 6 [4,8], P < 0.001). Frequency of falls and fractures was noted more often in S+ group in comparison with S-group (66% vs 36%, P = 0.013, 36% vs 13%, P = 0.003). Patients S+had smaller BMI vs S- (25.2 [20,72;29,24] vs 31.6[28,9;35,9] kg/m², P < 0.001), waist (89,5[83,75;100,5] vs 104[100;112] cm, P < 0.001) and neck circumferences (37[22,5;38] vs 40[35;40] cm, P < 0.001). According bioimpedance measurement S+patients was differed with more pronounced decrease of skeletal muscle massvs S-patients (16.5[14,8;17,3] vs 19,2[18,3;21,6] kg, P < 0.001), fat mass (22.35[18,65;29,175] vs 31.8[27,4;40] kg, P = 0.006) and mineralmass of bones (1.83[1,73;2,04] vs 2,18[2,09;2,45] kg, P < 0.001). The multivariable logistic regression analysis revealed the associations of presence of sarcopenia in T2DM patients with NISLL more then 11 points (OR-22,14;95% CI[3,68-133,30], P = 0.001). BMI cut-off points to identify sarcopeniasubjects was ≤ 29 kg/m² (sensitivity-87.2%; specificity-72.4%) for women with T2DM. Waist circumference cut-off pointsto identify sarcopenia subjects was ≤102,5 cm (sensitivity-85.1%; specificity-65.5%) for women with T2DM. Shoulder andlower leg circumferences were ≤30,5 cm (sensitivity-85.1%; specificity-65.5%) and ≤36 cm (sensitivity-91.5%; specificity 69%) for women with T2DM.

Conclusion: Sarcopenia was more often detected in patients with more severe peripheral neuropathy, poor glycemic control and history of falls. S+ patients characterized with more severe changes in the body composition not only in the skeletal muss, but also in the amount of fat mass and bone mineral density.