Introduction & Objective: Pre-sarcopenia, characterized by early signs of muscle wasting and weakness, represents a critical stage for intervention and prevention strategies. While pre-sarcopenia is commonly observed in adults with diabetes, there is growing interests in understanding its occurrence in nondiabetic individuals. This study was aimed to identify a predictive biomarker of pre-sarcopenia in nondiabetic individuals.
Methods: This study included 1243 adults (Men 51.5%, median age: 58 [53-62] years) without baseline diabetes from 2013-2014. The follow-up assessment was conducted in 2015-2016. Participants underwent serum FGF23 measurement at baseline and follow-up visit. Serum FGF23 levels were determined using a sandwich enzyme-linked immunosorbent assay. Skeletal muscle mass was estimated by bioelectrical impedance analysis and converted to skeletal muscle index (SMI) adjusted for body weight. Pre-sarcopenia was defined as SMI less than 1 SD of the sex-specific mean for a young reference group. The glycemic status was defined according to the American Diabetes Association 2023 guideline.
Results: Serum FGF23 levels were significantly higher in participants with baseline pre-sarcopenia than those without (P = 0.001). During an average follow-up of 2.1 years, pre-sarcopenia occurred in 57 (5.3%) participants without baseline pre-sarcopenia. Multivariate Logistic regression model showed that, compared with lowest tertile of baseline FGF23, the highest tertile was associated with an elevated risk of incident pre-sarcopenia (HR 2.69, 95%CI 1.33-5.73). Further stratified by glycemic status, the predictive ability of serum FGF23 on pre-sarcopenia was more predominant in those with prediabetes.
Conclusion: Serum FGF23 levels may be a promising clinical marker for pre-sarcopenia in nondiabetic individuals, especially those with prediabetes.
Y. Xu: None. T. Hu: None. Y. Shen: None. Y. Wang: None. X. Ma: None. Y. Bao: None.
