Comparison of sarcopenia frequency of patients with type 2 diabetes mellitus with nephropathy, patients with type 2 diabetes without complications and healty controls over 50 years of age

Introduction Populations are aging and the prevalence of diabetes mellitus is increasing tremendously. The number of older people with diabetes is increasing unexpectedly. International Diabetes Federation (IDF) has reported that 415 million adults with diagnosed diabetes. It is estimated that this number will be 439 million by 2030. Aging and diabetes are both risk factors for functional disability. Older people with diabetes have lower muscle mass and weaker muscle strength. In addition, diabetic complications like periferal neuropathy and retinopathy are also associated with sarcopenia. The aim of the study was to investigate the prevalence of sarcopenia in type 2 diabetes with nephropathy and type 2 diabetes without nephropathy, to compare sarcopenia frequency of diabetic patients with healty controls. Methods The study included 56 diabetic patients without complications (diabetes group), 50 diabetic patients with nephropathy (diabetes + nephropathy group), 53 age and sex matched healthy controls (control group). Demographic characteristics such as sex, age, anthropometric measurements such as weight, body mass index (BMI), hip circumference, waist circumference, waist circumference and upper arm circumference were performed. The percentage of muscle mass, percentage of fat tissue and visceral fat amount were evaluated by bioelectrical impedance method. Skin thickness was measured with a caliper. Physical performance of the patients were evaluated by 6-meter walking test. Hand grip strength was measured with a hand dynamometer. Laboratory measurements such as urea, creatinine, albumin, alanine aminotransferase (ALT), hemoglobin A1c (HbA1C), Tiroid Stimulating Hormone (TSH), White blood cell (WBC), platelet (PLT) and vitamin B12 were included in the analyzes. Sarcopenia diagnosis was based on European Working Group on Sarcopenia in Older People (EWGSOP) criteria which consist of hand grip strength, 6-meter walking test and muscle mass. Results The mean age of the patients was 60.9 ± 6.9 years (median 61 years, range 50-81 years). The mean duration of diabetes was 8.3 ± 6.9 years (median 7, range 0-30 years). The duration of diabetes in the diabetes + nephropathy group was higher than in the diabetes group (p = 0.014). The groups were similar in terms of hip (p = 0.870), waist (p=0.130), calf (p=0.852), upper arm (p=0.630) circumference, skin thickness (p=0.339). The frequency of sarcopenia was 21.4% (n = 12) in the diabetes group, 34% (n=17) in diabetes + nephropathy group, 15,1% (n=8) in control group. The frequency of sarcopenia was similar in diabetes and diabetes + nephropathy group, but higher in diabetes + nephropathy compared to controls (p=0.025). The frequency of sarcopenia was 25% in men, 22,3% in women (p=0.382). Age, duration of diabetes, HbA1C levels were higher in sarcopenic patients, but BMI and skin thickness were higher in non-sarcopenic patients. Fat percentage, creatinine, albumin and TSH levels are not affected by the presence of sarcopenia. Conclusion In the present study, we first examined prevalence of sarcopenia in diabetic patients with nephropathy, and the present study showed that the prevalence of sarcopenia was higher in patients with diabetic nephropathy compared to healty controls. Key words: Sarcopenia, diabetes, diabetic nephropathy, EWSGOP