Endocrine Abstracts

Background: Diabetic peripheral neuropathy (DPN) is considered to be the risk factor for the development of sarcopenia. Various previous studies showed the correlation between DPN and muscle disorders, but the study regarding the association between sarcopenia and nerve conduction parameters in diabetic peripheral neuropathy is limited.

Aim: This study was planned to detect the association between sarcopenia with peripheral nerve functions in type 2 diabetes mellitus (T2DM) patients.

Methods: A total of 174 participants aged ≧ 45 years were included in the study. Out of 174, group-1 58, were age and gender matched healthy volunteers (28 males and 30 females); group-2,56 were T2DM without neuropathy (30 males and 26 females); group-3, 60 were T2DM with neuropathy (30 males and 30 females). The mean age of the T2DM subjects was 47.5±7.7(range 42-68 years, mean HbA1c of 7.4%. All the participants underwent peripheral nerve function tests by nerve conduction studies and sarcopenia was evaluated according to the Asian Working Group for Sarcopenia (AWGS) criteria using prediction equation.

Results: According to ASMI cut-off [ALM/height 2: <7.0 kg/m2 (men) <5.4 kg/m2(women)], T2DM with neuropathy had sarcopenia of 67%, T2DM without neuropathy prevalence of sarcopenia was 46%. There was a statistically significant difference in sarcopenia between DM with and without neuropathy (P<0.002). All the patients with T2DM with neuropathy are having reduced handgrip strength in contrast to 94% without neuropathy. In addition, there was a significant correlation between ASMI and nerve conduction parameters found in men but in women, significance was found between right common peroneal latency.

Discussion: The prevalence of diabetic neuropathy detected by using nerve conduction studies in our population was 33%. Based on the Sarc-Calf questionnaire score > 11 was about 63% of patients with neuropathy and 29.6% of patients without neuropathy are diagnosed with sarcopenia. Skeletal Muscle mass was compared between the three groups and it was found that there was a statistically significant difference between the groups with ASMI, Handgrip strength, and Sarcopenia calf score (P-value <0.05) in males but not in females except for sarcopenic calf score.

Conclusion: The prevalence of sarcopenia in T2DM patients with neuropathy is higher in comparison to those without neuropathy. Therefore, regular screening for skeletal muscle mass and strength may be performed in T2DM patient with DPN.gKeywords Diabetic peripheral neuropathy; sarcopenia; Appendicular skeletal muscle mass index(ASMI); Sarc-Calf questionnaire score.