Background: A recent study on UK Biobank showed today’s sarcopenia definitions (using functional measures and muscle quantity) are highly BMI dependent and consequently underestimates sarcopenia within obesity. As obesity is common in T2D, this should also affect sarcopenia diagnosis and management in T2D patients. In addition, combined magnetic resonance imaging (MRI) based muscle assessment including sex and body size adjusted fat-free muscle volume (FFMV) and muscle fat infiltration (MFI) showed high diagnostic performance for detecting individuals with low function across BMI classes.
Methods: 9724 participants were included. Prevalence of low functional performance and sarcopenia was assessed using hand grip strength, dual energy X-ray absorptiometry and questionnaire data in T2D (N=434) and controls (N=9154 without diabetes). FFMV and MFI were quantified using MRI. For each participant, a matched virtual control group (VCG) was created to calculate an individualized z-score (sex and body size specific) for FFMV (FFMVVCG). Adverse muscle composition was defined as low FFMVVCG (below 25th percentile, whole cohort) and high MFI (above 75th percentile (sex specific), whole cohort).
Results: Although prevalence of sarcopenia was not different comparing T2D to controls (3.5 vs. 2.4 %, p=0.24), prevalence of low functional performance was higher in T2D: low hand grip strength 10.6 vs. 6.1 %, slow walking pace 14.8 vs. 3.9 %, no stair climbing 11.8 vs. 7.7 %, more than one fall last year 8.1 vs. 4.7 %, (all p<.003). FFMVVCG was lower, mean -0.31 (SD 1.03) vs. 0.02 (0.98) SDs from sex and body size matched reference VCG, MFI higher 8.62 (2.37) vs. 7.34 (1.81) % (1.66 (2.24) pp from sex matched reference) and adverse muscle composition more common in T2D (26.0 vs. 9.5 %) (all p<.001).
Conclusion: Sarcopenia related problems were much more common in T2D as compared to controls. This was not reflected in higher prevalence of sarcopenia within T2D but more accurately described using MRI-based muscle composition.
J. Linge: Employee; Self; AMRA Medical. O. Dahlqvist Leinhard: Employee; Self; AMRA Medical. Stock/Shareholder; Self; AMRA Medical.