Evaluation of sarcopenia with ultrasound in patients with diabetes mellitus

Introduction: As a syndrome that usually occurs with advancing age, characterized by generalized and progressive muscle mass and loss of strength, sarcopenia can cause bad consequences such as physical disability, poor quality of life and death. assessment of Sarcopenia in current guidelines is based on the examination of low muscle strength, low muscle amount or quality and low physical performance by various methods. Diabetes mellitus is associated with significant complications in all systems in the body. Mobility and daily life activities have been impaired in diabetes patients, with a higher rate of decrease in muscle strength and functional capacity than healthy individuals. The aim of this study is to investigate whether sarcopenia or possible sarcopenia is more common in patients with diabetes mellitus between the ages of 40-65, compared to healthy individuals. Method: 37 patients, 20 type 2 diabetes patients and 17 healthy controls, were included in our study. Demographic data of all patients were recorded. Muscle strength assessment; Upper limb hand grip strength was done with Jamar dynamometer, lower extremity knee extension muscle strength and ankle plantar flexion muscle strength were performed with Microfet3 (Handheld dynamometer) manual muscle tester. Muscle mass was evaluated by bioelectrical impedance method (BIA), lean muscle mass (FFMI) and appendicular lean muscle mass (SMI), ultrasonography, lower extremity rectus femoris muscle and gastrocnemius muscle thickness and area measurements. The physical performance of the patients was assessed with a 6-meter walking test, and daily physical activity levels were assessed using the International Physical Activity Index (UFAA) short form. In the diagnosis of sarcopenia, the criteria of "European Working Group on Sarcopenia in Older People (EWSGOP) 2", which consist of hand grip strength, 6-meter walking test and BIA measurements, whole body lean muscle mass index, appendicular lean muscle mass index, were used. Results: In our study, no statistically significant difference was found between the diabetes and control groups in terms of age, gender, BMI, and the number of additional diseases. Possible sarcopenia was detected in 5(%25) patients in the diabetes group and 3(%17.1) patients in the control group. All patients with possible sarcopenia were female. The walking distance assessed by a 6-min walk test in diabetic patients was shorter compared to the control group, and the difference was statistically significant.DG: 548.5m (350-800), CG: 666m (450-850) p: 0.017). There was no difference between diabetic patient group and control group in terms of hand grip strength, lower extremity muscle strength measurements, BIA measurement indices (FFMI, SMI) and ultrasonographic muscle measurements. A negative correlation was found between sarcopenia and muscle strength, walking distance and physical activity levels (p <, 005). Conclusion: In our study, there was no relationship between type 2 diabetes mellitus and increased risk of sarcopenia in patients aged 40-65 years In order to determine the effect of diabetes-related factors on sarcopenia at an early age, there is a need for studies that prospectively examine more patients. Keywords: Sarcopenia, diabetes, ultrasound, EWSGOP 2