Sarcopenia Shortens Survival of People With Type 2 Diabetes

The study covered in this summary was published on Preprints With The Lancet and has not yet been peer reviewed.

Key Takeaways

Mortality was higher among patients with type 2 diabetes and sarcopenia than among those with type 2 diabetes but without sarcopenia, regardless of age, sex, and diabetes severity.
The effect of sarcopenia on overall survival was greater among those with lower Adapted Diabetes Complications Severity Index (aDCSI) scores, men, and younger patients.

Why This Matters

Characterized by loss of muscle mass, strength, and performance, sarcopenia is associated with increased rates of functional impairment, disability, falls, and mortality.
Sarcopenia is an independent risk factor related to overall survival in patients with many types of chronic diseases, including cancers, but researchers had not previously reported on its relationship with diabetes in a large, long-term study.
This is the largest and longest reported study of a cohort of patients with diabetes to estimate the association of overall survival with sarcopenia among patients with diabetes.

Study Design

The retrospective, observational, population-based cohort study used data from the Taiwan National Health Insurance Research Database and compared 132,805 patients with type 2 diabetes without sarcopenia to 68,893 propensity score–matched people with type 2 diabetes and sarcopenia.
The analysis used data from people first diagnosed with type 2 diabetes or type 2 diabetes and sarcopenia during 2008–2019 and followed them through the end of 2020.

Key Results

The average age of the patients in the study was about 60 years; 54% were women, and roughly half had an aDCSI score of zero.
All-cause death occurred in 19.19% of patients who did not have sarcopenia, compared with 25.16% of patients who did have sarcopenia (P < .0001).
In a multivariate Cox regression analysis that accounted for several demographic and clinical differences, the adjusted hazard ratio (aHR) for all-cause death in the sarcopenia and diabetes group relative to the control group was 1.356 (P < .0001).
The aHRs (95% CIs) of all-cause death for those aged 41–50, 51–60, and >60 years compared with those aged ≤40 years were 1.539 (1.48–1.60), 2.615 (2.52–2.72), and 6.213 (5.99–6.45), respectively.
For men compared with women, the aHR was 1.569 (1.54–1.60).
In a comparison of patients whose aDCSI score was zero with patients whose aDCSI scores were 1, 2, 3–4, and ≥5, the aHRs for all-cause death were 1.011 (1.00–1.14), 1.385 (1.35–1.42), 1.587 (1.54–1.63), and 2.233 (2.14–2.33), respectively.

Limitations

The study cohort consisted entirely of patients from Asia.
The diagnoses were derived from codings in patients’ charts.
The researchers had no information on patients’ dietary habits.

Disclosures

The study received no commercial funding.
The authors have disclosed no relevant financial relationships.

This is a summary of a preprint research study, “Effect of Sarcopenia on Mortality in Type 2 Diabetes: A Long-Term Follow-Up Propensity Score–Matched Diabetes Cohort Study,” written by researchers at Fu Jen Catholic University in Taipei, Taiwan, published on Preprints With the Lancet, provided to you by Medscape. The study has not yet been peer reviewed. The full text of the study can be found on papers.ssrn.com.

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