Diabetes, sarcopenia and chronic kidney disease; the Screening for CKD among Older People across Europe (SCOPE) study
Francesç Formiga, Rafael Moreno‐González, Andrea Corsonello, Axel C. Carlsson, Johan Ärnlöv, Francesco Mattace‐Raso, Tomasz Kostka, Christian Weingart, Regina Roller‐Wirnsberger, Lisanne Tap, Agnieszka Guligowska, Cornel Sieber, Gerhard Wirnsberger, Rada Artzi‐Medvedik, Ilan Yehoshua, Cinzia Giuli, Fabrizia Lattanzio, Xavier Corbella, SCOPE investigators, Francesç Formiga, Rafael Moreno‐González, Xavier Corbella, Yurema Martínez, Carolina Polo, Josep M. Cruzado, Andrea Corsonello, Silvia Bustacchini, Silvia Bolognini, Paola D’Ascoli, Raffaella Moresi, Giuseppina Di Stefano, Cinzia Giammarchi, Anna Rita Bonfigli, Roberta Galeazzi, Federica Lenci, Stefano Della Bella, Enrico Bordoni, Mauro Provinciali, Robertina Giacconi, Cinzia Giuli, Demetrio Postacchini, Sabrina Garasto, Annalisa Cozza, Romano Firmani, Moreno Nacciariti, Mirko Di Rosa, Paolo Fabbietti, Johan Ärnlöv, Axel C. Carlsson, Tobias Feldreich, Francesco Mattace‐Raso, Lisanne Tap, Gijsbertus Ziere, Jeannette Goudzwaard, Tomasz Kostka, Agnieszka Guligowska, Łukasz Kroc, Bartłomiej K. Sołtysik, Katarzyna Smyj, Elizaveta Fife, Joanna Kostka, Małgorzata Pigłowska, Agnieszka Wójcik, Zuzanna Chrząstek, Natalia Sosowska, Anna Telążka, Christian Weingart, Ellen Freiberger, Cornel Sieber, Gerhard Wirnsberger, Regina Roller‐Wirnsberger, Carolin Herzog, Sonja Lindner, Rada Artzi‐Medvedik, Yehudit Melzer, A. Mark Clarfield, Itshak Melzer, Ilan Yehoshua, Pedro Gil Gregório, Sara Laínez Martínez, Mónica González Alonso, José Antonio Herrero Calvo, Fernando Tornero Molina, Lara Guardado Fuentes, Pamela Carrillo García, María Mombiedro Pérez, Roberto Bernabei, Christophe Büla, H. L. Haller, Carmine Zoccali, Kitty J. Jager, Wim Van Biesen, Paul E. Stevens
Abstract
BACKGROUND: Sarcopenia may be more present in older adults with diabetes (DM). Accordingly, we evaluated the prevalence of sarcopenia and its associated risk factors among community-dwelling older adults with DM. METHODS: A cross-sectional analysis of older people living in the community was carried out. Participants (aged 75 years and more) came from an European multicenter prospective cohort (SCOPE study). Global geriatric assessment including short physical performance battery, handgrip strength test and bioelectrical impedance analysis was performed. Sarcopenia was defined by the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Estimated glomerular filtration rate (eGFR) was calculated using Berlin Initiative Study (BIS) to define the stages of chronic kidney disease (CKD). Previous known DM was defined as physician-diagnosed DM registered in the patient's medical record or the use of DM-related medications. Hemoglobin A1c levels and specific DM therapies administered were collected. Time elapsed from the first diagnosis of DM was not collected and, therefore, was not included in the analyses. RESULTS: A total of 1,420 subjects were evaluated with a median age of 79.0 (6.0) years, of which 804 (56.6%) were women and 615 (43.3%) men; 315 (22.2%) participants had prior DM diagnosis, with a median age of 80.0 (6.0), 146 (46.3%) were women. Using EWGSOP2 definition, 150 (10.6%) participants in the SCOPE study met diagnostic criteria for sarcopenia. Participants without diabetes had more often normal results in the 3 sarcopenia components than participants with diabetes [887 (80.31%) vs. 227 (72.1%), p = 0.002], highlighting higher percentages of severe sarcopenia in participants with diabetes [27 (8.6%) vs. 58 (5.2%), p = 0.028]. Confirmed or severe sarcopenia was detected in 41 (13%) participants with diabetes and 109 (9.8%) participants without diabetes (p = 0.108). According to BIS equation, sarcopenia was not significantly more prevalent in the more advanced stages of CKD (p = 0.845). In multivariate analyses, older age (odds ratios [OR], 1.17; 95% confidence interval [CI], 1.08-1.27), and lower body mass index (OR, 0.79; 95% CI, 0.71-0.89 were associated with the presence of sarcopenia. CONCLUSIONS: One tenth of all older community-dwelling subjects have sarcopenia. Older age and being thinner, but not worse renal function, were associated with higher prevalence of sarcopenia in older older adults with diabetes.