Sarcopenic phenotype in patients with newly diagnosed type 2 diabetes

J. Son; H. Jeong; S. Lee; S. Kim; D. Kim; S. Yoo

Objective - Sarcopenic phenotype is associated with the increased risk of insulin resistance and type 2 diabetes. We investigated the proportion of sarcopenia and sarcopenic obesity (SO) and their clinical characteristics in patients with newly diagnosed type 2 diabetes.

Research design and methods - We conducted a cross-sectional analysis of 133 (75 men, 58 women) patients with newly diagnosed type 2 diabetes. All patients underwent a 75 g oral glucose tolerance test. Sacopenia was assessed by appendicular skeletal muscle mass(ASM)/weight (%) using dual-energy X-ray absorptiometry and obesity was assessed by a visceral fat area using computed tomography.

Results - The mean age of the subjects was 47±12 years, the mean HbA1c level was 10.59±1.94% and the mean body mass index was 25.5±3.4 kg/m². ASM/weight (%) was inversely associated with the log-transformed homeostasis model assessment of insulin resistance (HOMA-IR) and HOMA-β. The proportion of obesity, sarcopenia and SO was 23.3%, 16.5% and 35.3%, respectively. Sarcopenic phenotype was more prevalent in women than in men (Sarcopenia 29.3% vs. 6.7% and, SO 44.8% vs. 28%, respectively). In comparison to normal phenotype (neither obese nor sarcopenia), SO was significantly associated with higher degree of HOMA-β and the surrogate markers of insulin resistance (HOMA-IR and insulin sensitivity index composite). Notably, SO subjects were more insulin resistant compared to obese without sarcopenia subjects, although there was no significant difference in HbA1c between two groups.

Conclusions - We found the high proportion of sarcopenia and SO in patients with newly diagnosed type 2 diabetes. Among metabolic phenotype, SO was strongly associated with the degree of insulin resistance and compensated hyperinsulinemia in the early phase type 2 diabetes.

Table 1 The proportion of each metabolic phenotype in patients with newly diagnosed type 2 diabetes
	Male(%)	Female(%)	Total(%)
Normal	24(32.0)	9(15.5)	33(24.8)
Sarcopenia	5(6.7)	17(29.3)	22(16.5)
Obesity	25(33.3)	6(10.4)	31(23.3)
Sarcopenic Obesity	21(28.0)	26(44.8)	47(35.3)
total	75(100)	58(100)	133(100)

Relationship of sarcopenic index with log HOMA-IR and logHOMA-B

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Endocrine Abstracts

P544