Determination of sarcopenia risk factors in individuals with TYPE 2 diabetes age 65 and over

Aim: Sarcopenia is a geriatric syndrome that is characterized by progressive and generalised loss of muscle strength, and can cause adverse outcomes such as physical disability, falls, impaired quality of life and mortality. It is known that the frequency of sarcopenia is also increased in patients with type 2 diabetes. In this study, it was aimed to determine the risk factors for sarcopenia in 65 years and older type 2 diabetes patients. Methods: In this cross-sectional study, 202 (109 males and 93 females), 65 years and older type 2 diabetes patients, those admitted to Akdeniz University Hospital Endocrinology and Metabolism outpatient clinic were included. Anthropometric measurements of the patients were made. EWGSOP2 criteria were used for the diagnosis of sarcopenia. SARC-F test, Lawton-Brody instrumental daily living activity scale, Tinetti balance and gait scale were applied to all patients. Hand grip strength, muscle mass, and walking speed were measured. The lean mass index (FFMI) measured by BIA was used to diagnose sarcopenia. Medications, comorbidities, complications of diabetes, vitamin D, creatinine, albumin, ALT, hemoglobin, HbA1c, TSH, LDL, and triglyceride levels were recorded. Results: The mean age of the patients included in the study was 70,43±4,85 years. The prevalence of sarcopenia was 25.2% (32.3% of women, 19.3% of men). Severe sarcopenia was observed in 72.5% of the patients with sarcopenia. The rate of sarcopenia between the age of 65-74 was 20.9%, among 75 years and older patients it was 43.6%, and it was found that the rate of sarcopenia was higher in elderly patients (p = 0.003). SARF-C values of sarcopenia patients were higher than those without sarcopenia (p <0.001), grip strength (p <0.001), daily living activity score (p = 0.039), Tinetti balance score (p <0.001), Tinetti gait score (p <0.001), walking speed (p <0.001) and BIA values (p <0.001) were statistically lower. There was no statistically significant relationship between the rate of sarcopenia, according to the patients' BMI values (p = 0.95) and the duration of diabetes (p = 53 0.316). Serum vitamin D (p = 0.028) and albumin (p = 0.027) levels were observed to be lower in patients with sarcopenia. Sarcopenia was more common in patients with abnormal TSH levels (41.9%) than those with normal levels (22.6%) (p = 0.024). There was no significant relationship between sarcopenia and hemoglobin values (p = 0.427), anemia (p = 0.242), ALT (p = 0.157), GFR (p = 0.383), LDL (p = 0.333), TG (p = 0.402), HbA1c (p = 0.215) and calcium (p = 0.801) levels of patients. When the distribution of sarcopenia was compared according to the presence of additional diseases and medications used, no statistically significant difference was detected (p> 0.05). Low body weight (OR: 0.966; 95% CI: 0.936- 0.997; p = 0.031), presence of retinopathy (OR: 3.524; 95% CI: 1, 03-12.059; p = 0.045) and the presence of neuropathy (OR: 3.137; 95% CI: 1.345-7.314; p = 0.008) were found to be risk factors for sarcopenia. Conclusion: Decreased weight, retinopathy and neuropathy have been identified as risk factors for sarcopenia. With regulation of diabetes, development of sarcopenia as well as microvascular complications can be prevented. Key Words: Sarcopenia, Type 2 Diabetes, Senility