Introduction: Sarcopenic obesity (SO), characterized by concurrent excessive body fat and reduced muscle mass, amplifies the risk of metabolic abnormalities, especially insulin resistance (IR). Irisin, a myokine linked to energy homeostasis, has shown inconsistent associations with sarcopenia. This study investigated irisin levels in T2DM patients with SO or non-sarcopenic obesity (NSO).
Methods: Patients with T2DM and BMI >30 kg/m² underwent glycometabolic assessment and irisin measurements. Muscle efficiency was evaluated using Handgrip Strength (HGS) and 5-times Sit To Stand Test (5-STST). Patients were categorized into SO and NSO groups per the 2022 ESPEN/EASO Consensus.
Results: Of 67 patients affected by obesity and T2DM, 50 had NSO and 17 SO. SO patients were older (70 [6] vs 66 [7] years, p=0.028), with higher BMI (36.7 [4.3] vs 34.7 [4] kg/m², p=0.036), FM (41.9 [7.7] vs 37.6 [8.7] kg, p=0.049), alcohol use (47.1% vs 22%, p=0.048), 5-STST (13.3 [4.1] vs 10.8 [3.1] s, p=0.016), and lower HGS results (24 [7.9] vs 36.4 [10.2] kg, p<0.001). No difference in HOMA-IR, HbA1c or irisin levels was found between SO and NSO patients. Irisin correlated negatively with HbA1c (r=-0.288, p=0.018), HGS (r=-0.249, p=0.042), muscle mass (r=-0.26, p=0.033), and creatinine (r=-0.308, p=0.011), and positively with relative FM (r=-0.274, p=0.025). Increasing HGS results predicted lower irisin levels (beta=-316, p=0.032). Multivariate logistic regression analysis associated older age with higher SO risk (OR=1.16, p=0.02), with a trend relationship for insulinemia (OR=1.05, p=0.073) and 5-STST (OR=1.19, p=0.068) (p=0.039, area under the curve=0.804).
Conclusion: People with T2DM and SO exhibit poorer lifestyle, anthropometric profile and physical performance. Irisin levels are linked with better glycemic control, negatively correlating with muscle mass and strength, suggesting a compensatory role in this context.
E. Rossi: None. L. Di Gioia: Consultant; Roche Diabetes Care, Eli Lilly and Company, Novo Nordisk, Sanofi. N. Marrano: None. S. Perrini: None. L. Laviola: Speaker's Bureau; A. Menarini Diagnostics, Abbott, AlfaSigma. Advisory Panel; Boehringer-Ingelheim, Eli Lilly and Company, Medtronic, Novo Nordisk. Speaker's Bureau; AstraZeneca. Advisory Panel; Roche Diabetes Care, Sanofi. Speaker's Bureau; Terumo Corporation. A. Natalicchio: Speaker's Bureau; AstraZeneca, Novo Nordisk, Sanofi, Eli Lilly and Company. F. Giorgino: Consultant; AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company, LifeScan Diabetes Institute, Merck Sharp & Dohme Corp., Medtronic, Novo Nordisk, Roche Diabetes Care, Sanofi. Research Support; Eli Lilly and Company, Roche Diabetes Care.
