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Type 2 Diabetes Mellitus is Associated with Increased Risk of Sarcopenia: A Systematic Review and Meta-analysis

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Abstract

Diabetes mellitus (DM) is associated with an increased risk of fractures, mainly due to impaired bone architecture and microvascular complications. Whether DM is also associated with increased risk of sarcopenia is not yet known, with studies yielding inconclusive results. The aim of this study was to systematically review and synthesize the best available evidence regarding the association between DM and sarcopenia risk. A comprehensive search was conducted in PubMed, CENTRAL and Scopus databases. Data are expressed as odds ratio (OR) with 95% confidence intervals (CI). The I2 index was employed for heterogeneity. Only studies which had implemented at least two of the three criteria for sarcopenia diagnosis (low muscle mass, muscle strength and/or muscle performance), as defined by the international studying groups, were included. Fifteen studies fulfilled eligibility criteria, yielding a total of 1832 patients with type 2 DM (T2DM) and 1159 cases of sarcopenia. Patients with T2DM demonstrated a higher risk of sarcopenia compared with euglycemic subjects (OR 1.55, 95% CI 1.25–1.91, p < 0.001; I2 34.6%). This risk remained significant when analysis was restricted to studies matched for age and sex. Sarcopenia risk was independent of disease definition or study design. Notably, T2DM patients presented lower muscle performance and strength compared with euglycemic subjects, whereas no difference in muscle mass was observed between groups. Patients with T2DM have an increased risk of sarcopenia compared with euglycemic subjects.

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Authors and Affiliations

  1. Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Panagiotis Anagnostis & Dimitrios G. Goulis

  2. Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece

    Panagiotis Anagnostis, Nifon K. Gkekas, Eustathios Kenanidis, Michael Potoupnis, Eleftherios Tsiridis & Dimitrios G. Goulis

  3. Academic Orthopedic Unit, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece

    Panagiotis Anagnostis, Nifon K. Gkekas, Charoula Achilla, Georgia Pananastasiou, Polyxeni Taouxidou, Maria Mitsiou, Eustathios Kenanidis, Michael Potoupnis & Eleftherios Tsiridis

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  1. Panagiotis Anagnostis
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Contributions

PA designed the research, analyzed the extractable data and wrote the first draft of the paper. NKG, CA, GP, PT, and MM searched the literature, extracted and analyzed the data. NKG was responsible for the statistical analysis and reviewed the manuscript. EK, MP and ET reviewed the manuscript and provided critical scientific input. DGG resolved discrepancies regarding the quality of the studies included in the meta-analysis, provided critical scientific input and had the primary responsibility for the paper’s final content.

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Correspondence to Panagiotis Anagnostis.

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Panagiotis Anagnostis, Nifon K. Gkekas, Charoula Achilla, Georgia Pananastasiou, Polyxeni Taouxidou, Maria Mitsiou, Eustathios Kenanidis, Michael Potoupnis, Eleftherios Tsiridis, and Dimitrios G. Goulis declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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Anagnostis, P., Gkekas, N.K., Achilla, C. et al. Type 2 Diabetes Mellitus is Associated with Increased Risk of Sarcopenia: A Systematic Review and Meta-analysis. Calcif Tissue Int 107, 453–463 (2020). https://doi.org/10.1007/s00223-020-00742-y

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