Alternative skeletal muscle index for sarcopenia diagnosis in elderly patients with type 2 diabetes mellitus: A pilot study
Lanyu Lu, Bowei Liu, Fuzai Yin
Abstract
Purpose To determine an alternative skeletal muscle index (a-SMI), easy diagnosis of sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM). Patients and methods 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. Results 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 ( B = 2.463, 95% CI : 3.640 ~ 37.883, p = 0.000), HTN ( B = 1.404, 95% CI : 1.599 ~ 10.371, p = 0.003), BMI ( B = -0.344, 95% CI : 0.598 ~ 0.839, p = 0.000), 25-(OH) VitD ( B = -0.058, 95% CI : 0.907 ~ 0.982, p = 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 ( p < 0.001). Conclusion 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.