Association between macro- and microvascular damage and sarcopenia index in individuals with type 2 diabetes mellitus

Appl Physiol Nutr Metab. 2024 Jun 1;49(6):762-772. doi: 10.1139/apnm-2023-0476. Epub 2024 Feb 12.

Abstract

Sarcopenia was recently reported to be relevant to an increased macro-and microvascular disease risk. Sarcopenia index (SI) has been identified as a surrogate marker for sarcopenia. The aim of the present study was to investigate the association between macro- and microvascular disease and SI in patients with type 2 diabetes mellitus (T2DM). A total of 783 patients with T2DM were enrolled in this cross-sectional study. The SI was calculated by (serum creatinine [mg/dL]/cystatin C [mg/L]) × 100. The subjects were divided into three groups according to SI tertiles: T1 (41.27-81.37), T2 (81.38- 99.55), and T3 (99.56-192.31). Parameters of macro- and microvascular complications, including diabetic retinopathy (DR), micro- and macroalbuminuria (MAU), diabetic peripheral neuropathy (DPN), and lower extremity peripheral artery disease (LEAD) were evaluated. Multivariate logistic regression analysis revealed that when taking the top tertile of SI as a reference, an increasing trend of the prevalence of DR, MAU, DPN, and LEAD were presented (all P for trend < 0.05), where the OR (95% CI) for DR prevalence was 1.967 (1.252-3.090) in T2, 2.195 (1.278-3.769) in T1, for MAU was 1.805 (1.149-2.837) in T2, 2.537 (1.490-4.320) in T1, for DPN was 2.244 (1.485-3.391) in T2, 3.172 (1.884-5.341) in T1, and for LEAD was 2.017 (1.002-4.057) in T2, 2.405 (1.107-5.225) in T1 (all P < 0.05). Patients with lower SI were more inclined to have an increased risk of macro- and microvascular damage in T2DM population, which may be related to sarcopenia.

Keywords: albuminuria; diabetic peripheral neuropathy; diabetic retinopathy; lower extremity peripheral artery disease; sarcopenia index; type 2 diabetes mellitus.

MeSH terms

  • Aged
  • Albuminuria / epidemiology
  • Creatinine / blood
  • Cross-Sectional Studies
  • Cystatin C / blood
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetic Angiopathies / epidemiology
  • Diabetic Neuropathies / epidemiology
  • Diabetic Retinopathy / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / complications
  • Peripheral Arterial Disease / epidemiology
  • Prevalence
  • Risk Factors
  • Sarcopenia* / complications
  • Sarcopenia* / epidemiology

Substances

  • Creatinine
  • Cystatin C