Age and Glycated Hemoglobin Levels Raise Risk of Sarcopenia in Diabetes

Close up of nurse pinching patients finger to measure sugar level with a glucometer at the hospital
Although risk factors of sarcopenia in people with diabetes have been analyzed, more comprehensive investiagion is needed to show the connection between the two diseases. Researchers sough to explore the link.

Age, glycated hemoglobin (HbA1c) visceral fat area (VFA), and diabetic nephropathy are associated with the risk for sarcopenia among patients with diabetes, according to a study in the Journal of Clinical Endocrinology and Metabolism.

The findings are based on a meta-analysis regarding the prevalence and risk factors of sarcopenia in patients with diabetes.

Investigators identified relevant studies published through November 30, 2020, from the PubMed, Embase, Web of Science, WanFang, Chinese Academic Journals (CNKI), VIP, and Chinese Biomedical Literature (CBM) databases. Observational studies of participants aged ≥18 years with clinically diagnosed diabetes, regardless of sex or type of diabetes, were eligible for inclusion.

A total of 45 studies with 12,237 participants were included. The overall prevalence of sarcopenia in patients with diabetes was 18% (95% CI, 0.16-0.20). Men with diabetes had a higher prevalence of sarcopenia (20%; 95% CI, 0.17-0.22), compared with women with diabetes (0.17%; 95% CI, 0.14-0.19).

Body mass index (odds ratio [OR] = 0.59; 95% CI, 0.52-0.68) was significantly associated with a decreased risk for sarcopenia.

The highest regional prevalence of sarcopenia was 19% (95% CI, 0.16-0.21) for patients with diabetes in Asia, followed by those in South America (13%; 95% CI, 0.08-0.18) and Oceania (9%; 95% CI, 0.00-0.17).

Analysis showed that age (18 studies; odds ratio [OR] = 1.10; 95% CI, 1.07-1.14) was a risk factor for sarcopenia in patients with diabetes. In addition, HbA1c (7 studies; OR = 1.16; 95% CI, 1.09-1.24), duration of diabetes (8 studies; OR = 1.06; 95% CI, 1.00-1.11), high-sensitivity C-reactive protein level (2 studies; OR = 1.33; 95% CI, 1.12-1.58), diabetic nephropathy (2 studies; OR = 2.54; 95% CI, 1.60-4.03), VFA (2 studies; OR = 1.03; 95% CI, 1.02-1.05), and diabetic foot (1 study; OR = 2.83; 95% CI, 1.64-4.9) increased the risk of sarcopenia in patients with diabetes.

The researchers noted that their study was limited by the use of multiple diagnostic definitions and evaluation tools for sarcopenia in the studies included for analysis. Also, several of the indicators that were evaluated were included in only a few studies, recall bias may exist in some articles, and only Chinese and English studies were included, which could have led to a language bias.

“Clinical researchers should conduct early screening of high-risk groups in a timely manner to guide patients with diabetes to avoid risk factors, encourage them to perform exercise training, and guide them to use rational drug combinations to prevent further development and deterioration of sarcopenia,” stated the study authors. “This would reduce the occurrence of adverse events and prevent unnecessary economic loss, as well as improving the quality of life in patients with diabetes.”


Feng L, Gao Q, Hu K, et al. Prevalence and risk factors of sarcopenia in patients with diabetes: a meta-analysis. J Clin Endocrinol Metab. Published online December 14, 2021. doi:10.1210/clinem/dgab884