AUTHOR=Lu Lanyu , Liu Bowei , Yin Fuzai 

TITLE=Alternative skeletal muscle index for sarcopenia diagnosis in elderly patients with type 2 diabetes mellitus: A pilot study

JOURNAL=Frontiers in Endocrinology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1083722

DOI=10.3389/fendo.2023.1083722

ISSN=1664-2392

ABSTRACT=<sec><title>Purpose</title><p>To determine an alternative skeletal muscle index (a-SMI), easy diagnosis of sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM).</p></sec><sec><title>Patients and methods</title><p>This cross-sectional study included 223 inpatients with T2DM (100 males, age range 60-89; 123 females, age range 60-87). Screening for grip strength and gait speed, measuring SMI by dual-energy X-ray absorptiometry (d-SMI) for sarcopenia diagnosis, according to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus. The a-SMI was established by binary logistic regression analysis with positive screening population. To assess the conformance of the new diagnostic approach with the AWGS 2019.</p></sec><sec><title>Results</title><p>Sarcopenia was present in 36.3% of the study population. 59 had normal d-SMI and 81 had low d-SMI in screening patients with probable sarcopenia. In univariate analyses for all positive screening population, body mass index (BMI), 25-hydroxyvitamin D (25 - (OH) VitD), high density lipoprotein cholesterol (HDL-C), hypertension (HTN), and gender were correlates of d-SMI. Binary logistic regression analysis revealed that male (<italic>B</italic> = 2.463, 95%<italic>CI</italic>: 3.640 ~ 37.883, <italic>p</italic> = 0.000), HTN (<italic>B</italic> = 1.404, 95%<italic>CI</italic>: 1.599 ~ 10.371, <italic>p</italic> = 0.003), BMI (<italic>B</italic> = -0.344, 95%<italic>CI</italic>: 0.598 ~ 0.839, <italic>p</italic> = 0.000), 25-(OH) VitD (<italic>B</italic> = -0.058, 95%<italic>CI</italic>: 0.907 ~ 0.982, <italic>p</italic> = 0.004) were independent factors for d-SMI detection. Based on the extracted four correlates, the a-SMI was determined. The area under receiver operating characteristic (ROC) curve was 0.842, sensitivity and specificity for the new diagnostic approach were 84.0% and 84.5%. In a statistical measure of agreement between the AWGS 2019 and the new diagnostic approach, the kappa coefficient was 0.669 (<italic>p</italic> &lt; 0.001).</p></sec><sec><title>Conclusion</title><p>The a-SMI - based on gender, obesity status, 25-(OH) VitD, and HTN history - can be used in the absence of the d-SMI to supplement the algorithm for sarcopenia diagnosis in elderly patients with T2DM.</p></sec>