Prevalence of sarcopenia and its association with diet and physical activity in older adults with type 2 diabetes: A cross-sectional study

Sarcopenia in type 2 Diabetes mellitus among Asian populations: prevalence and risk factors based on AWGS- 2019: a systematic review and meta-analysis

BACKGROUND

Sarcopenia is increasingly recognized as a significant complication in type 2 diabetes mellitus (T2DM), yet its prevalence and risk factors in Asian populations remain incompletely understood using the updated Asian Working Group for Sarcopenia (AWGS) 2019 criteria. The present review aimed to evaluate the prevalence of sarcopenia among Asian T2DM patients and identify associated risk factors using AWGS-2019 criteria through systematic review and meta-analysis.

METHODS

A comprehensive systematic review of PubMed, SCOPUS, Crossref, Google Scholar, Semantic Scholar, and OpenAlex followed PRISMA guidelines to identify observational studies assessing the magnitude of sarcopenia in type-2 Diabetes mellitus. Random-effect models were used to estimate pooled prevalence and odds ratios (OR) for associated factors. Heterogeneity was quantified using I2 statistics and Cochran's Q test, where I2 values of 25%, 50%, and 75% indicated low, moderate, and high heterogeneity, respectively. Subgroup analyses and meta-regression explored heterogeneity sources across all studies. The quality of the studies was assessed by the Joanna Briggs Institute (JBI) criteria. Publication bias was assessed by funnel plot and Egger's test.

FINDINGS

Thirty nine studies, including approximately 19,902 participants, were analyzed. The pooled prevalence of confirmed sarcopenia was 23% (95% CI: 18%-27%, p < 0.001) among Asian T2DM patients, with notably higher rates of possible sarcopenia at 61% (95% CI: 28%-86%, p < 0.001) and lower rates of severe sarcopenia at 12.1% (95% CI: 8.4%-16.7%, p < 0.001). Regional variations showed a higher prevalence in Southeast Asia (37.46%) compared to Western Pacific (21.95%). Meta-analysis revealed significant risk factors including older age (OR: 1.13, 95% CI: 1.11-1.16, p < 0.0001), male gender (OR: 2.37, 95% CI: 1.33-4.21, p = 0.0033), hypertension (OR: 3.65, 95% CI: 1.06-12.65, p = 0.0409), diabetes duration (OR: 1.35, 95% CI: 1.05-2.13, p = 0.02), and reduced physical activity (OR: 2.54, 95% CI: 1.92-3.36, p < 0.0001). Higher BMI (OR: 0.63, 95% CI: 0.53-0.75, p < 0.0001) and better vitamin D levels (OR: 0.91, 95% CI: 0.87-0.95, p < 0.001) demonstrated protective effects. Recent studies (2023-2024) showed a higher prevalence than pre-2022 studies (27.85% vs 18.42%, p = 0.0440). DXA-based measurements yielded higher prevalence estimates than BIA-based assessments (29.86% vs 19.52%, p = 0.7121).

INTERPRETATION

Sarcopenia affects nearly one-quarter of Asian T2DM patients, with significant regional variations. Age, male gender, hypertension, and physical inactivity were key risk factors, while maintaining a healthy BMI and good nutrition appeared protective. These findings emphasize the importance of regular screening and early intervention strategies, particularly for high-risk patients.

Sarcopenia in the Oldest-Old Adults in the Capital of Brazil: Prevalence and Its Associated Risk Factors

BACKGROUND

In light of the demographic context in which the older adult population is prominent, sarcopenia emerges as a significant concern for the health of these individuals.

AIM

To assess the frequency of sarcopenia and severe sarcopenia and the associated risk factors in the oldest adults living in the community.

METHODS

There were 399 participants aged 80 or older, of both sexes, using primary health care services in the metropolitan area of Brasília, Brazil. Sarcopenia was evaluated based on European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Muscle mass was measured by calf circumference, muscle function by handgrip strength, and muscle performance by gait speed. Clinical and socioeconomic variables, comorbidities, falls, and urinary incontinence were collected. The prevalence of sarcopenia was calculated with a 95% (IC) prevalence. Multivariate Poisson regression analysis was performed in Stata, with p < 5%.

RESULTS

Among participants, 78.2% were women. Prevalence of pre-sarcopenia was 31.8%, sarcopenia 3.3%, and severe sarcopenia 25.1%. After multivariate regression, sarcopenia was associated with the female sex, low weight, and a dependency for activities of daily living (ADLs). Similarly, severe sarcopenia remained associated with female sex, low weight, and an ADLs dependency. Sarcopenia and severe sarcopenia were not associated with the level of education, marital status, income, physical activity, medications, falls, nor comorbidities.

CONCLUSIONS

A quarter of older adults had severe sarcopenia. Sarcopenia and severe sarcopenia were associated with being a woman, being low weight, and have an ADLs dependence.

Association between Sarcopenia and Poor Glycemic Control in Older Adults with Type 2 Diabetes Mellitus

BACKGROUND

Aging is associated with a decrease in muscle mass. Insulin resistance and hyperglycemia accelerate muscle loss, leading to a deterioration in strength, muscle mass, and physical capacity in older adults. This study was conducted to determine the association between sarcopenia and poor glycemic control in older adults with type 2 diabetes mellitus (T2D).

METHODS

A cross-sectional study was carried out in older adults with T2D in geriatric outpatient clinics. Sarcopenia was diagnosed as per the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. According to glycosylated hemoglobin (HbA1c) levels, participants were classified into glycemic control (HbA1c ≤ 7.5%) and poor glycemic control (HbA1c ≥ 7.5%) groups.

RESULTS

Older adults with sarcopenia were found to have poor glycemic control compared to adults without sarcopenia (62.3% vs. 47.9%, p = 0.007). Logistic regression analysis showed an association between poor glycemic control and the presence of sarcopenia (odds ratio (OR): 1.79, 95% confidence interval (CI): 1.17-2.75) and low muscle mass (OR: 1.73, 95% CI: 1.07-2.73).

CONCLUSIONS

Poor glycemic control is associated with the presence of sarcopenia and low muscle mass, which highlights the need to implement better treatment strategies in order to reduce the loss of muscle mass.