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Comparing the prognostic value of the old and new sarcopenia criteria from the Asian Working Group on Sarcopenia in older adults with type 2 diabetes: Which set is more appropriate?

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Abstract

Background

This study aimed to compare the prevalence of sarcopenia according to the old and new Asian Working Group on Sarcopenia (AWGS) operational criteria and explore the effects of sarcopenia on adverse outcomes in older adults with type 2 diabetes (T2D).

Methods

A total of 386 patients with T2D aged ≥ 60 years were recruited in retrospective cohort study. Sarcopenia was assessed with different versions of the AWGS consensus, including the AWGS2014, AWGS2019H (muscle mass adjusted for height), and AWGS2019B (muscle mass adjusted for body mass index). The median follow-up period was 47 months. The composite primary endpoint was the first occurrence of cardiovascular disease (CVD), fragility fracture, and all-cause mortality and the secondary outcomes included the three separate components of the primary outcome.

Results

In this study, the prevalence of sarcopenia under different criteria was significantly different, with AWGS2019H having the highest prevalence of 31.3%. The agreement among sarcopenia criteria was unsatisfactory. By Cox regression analysis, all three AWGS definitions of sarcopenia were associated with the composite outcome of all-cause mortality, fracture and CVD (hazard ratio [HR], 2.69 vs. HR, 2.63; vs. HR, 2.23; model 3). Further exploratory analysis, sarcopenia defined by the AWGS2019H criteria was an independent risk factor for death, incident CVD, and fractures. While AWGS2014 criteria was an increased risk factor of death and CVD. The AWGS2019B criteria were only associated with incident fractures.

Conclusion

All three AWGS definitions of sarcopenia were associated the composite primary endpoint. Additionally, the AWGS2019H criteria may be a better independent risk factor for negative health outcomes.

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Data availability

Participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

References

  1. Dal Canto E, Ceriello A, Rydén L et al (2019) Diabetes as a cardiovascular risk factor: An overview of global trends of macro and micro vascular complications. Eur J Prev Cardiol. https://doi.org/10.1177/2047487319878371

    Article  Google Scholar 

  2. Sun H, Saeedi P, Karuranga S et al (2022) IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. https://doi.org/10.1016/j.diabres.2021.109119

    Article  PubMed  Google Scholar 

  3. American Diabetes Association (2019) 12 Older adults: standards of medical care in diabetes-2019. Diabetes Care. https://doi.org/10.2337/dc19-S012

    Article  Google Scholar 

  4. Kirkman MS, Briscoe VJ, Clark N et al (2012) Diabetes in older adults. Diabetes Care 35:2650–2664. https://doi.org/10.2337/dc12-1801

    Article  PubMed  PubMed Central  Google Scholar 

  5. Liccini A, Malmstrom TK (2016) Frailty and Sarcopenia as predictors of adverse health outcomes in persons with diabetes mellitus. J Am Med Dir Assoc 17:846–851. https://doi.org/10.1016/j.jamda.2016.07.007

    Article  PubMed  Google Scholar 

  6. Rosenberg IH (2011) Sarcopenia: origins and clinical relevance. Clin Geriatr Med 27:337–339. https://doi.org/10.1016/j.cger.2011.03.003

    Article  PubMed  Google Scholar 

  7. Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European working group on Sarcopenia in older people. Age Ageing 39:412–423. https://doi.org/10.1093/ageing/afq034

    Article  PubMed  PubMed Central  Google Scholar 

  8. Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Sarcopenia: revised European consensus on definition and diagnosis [published correction appears in Age Ageing. Age Ageing 48:16–31. https://doi.org/10.1093/ageing/afy169

    Article  PubMed  Google Scholar 

  9. Chen LK, Liu LK, Woo J et al (2014) Sarcopenia in Asia: consensus report of the Asian working group for Sarcopenia. J Am Med Dir Assoc 15:95–101. https://doi.org/10.1016/j.jamda.2013.11.025

    Article  PubMed  Google Scholar 

  10. Fielding RA, Vellas B, Evans WJ et al (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition prevalence etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 12:249–256. https://doi.org/10.1016/j.jamda.2011.01.003

    Article  PubMed  Google Scholar 

  11. Zanker J, Scott D, Reijnierse EM et al (2019) Establishing an operational definition of sarcopenia in australia and new zealand: delphi method based consensus statement. J Nutr Health Aging 23:105–110. https://doi.org/10.1007/s12603-018-1113-6

    Article  CAS  PubMed  Google Scholar 

  12. Cruz-Jentoft AJ, Sayer AA (2019) Sarcopenia [published correction appears in Lancet. Lancet 393:2636–2646. https://doi.org/10.1016/S0140-6736(19)31138-9

    Article  PubMed  Google Scholar 

  13. Izzo A, Massimino E, Riccardi G et al (2021) A Narrative review on sarcopenia in type 2 diabetes mellitus: prevalence and associated factors. Nutrients. 13:183. https://doi.org/10.3390/nu13010183

    Article  PubMed  PubMed Central  Google Scholar 

  14. Park S, Kim SH, Shin JY (2021) Combined association of skeletal muscle mass and grip strength with cardiovascular diseases in patients with type 2 diabetes. J Diabetes 13:1015–1024. https://doi.org/10.1111/1753-0407.13216

    Article  CAS  PubMed  Google Scholar 

  15. Hamasaki H, Kawashima Y, Katsuyama H et al (2017) Association of handgrip strength with hospitalization, cardiovascular events, and mortality in Japanese patients with type 2 diabetes. Sci Rep 7:7041. https://doi.org/10.1038/s41598-017-07438-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Miyake H, Kanazawa I, Tanaka KI et al (2019) Low skeletal muscle mass is associated with the risk of all-cause mortality in patients with type 2 diabetes mellitus. Ther Adv Endocrinol Metab. https://doi.org/10.1177/2042018819842971

    Article  PubMed  PubMed Central  Google Scholar 

  17. Liu P, Hao Q, Hai S et al (2017) Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis. Maturitas 103:16–22. https://doi.org/10.1016/j.maturitas.2017.04.007

    Article  PubMed  Google Scholar 

  18. Kelley GA, Kelley KS (2017) Is sarcopenia associated with an increased risk of all-cause mortality and functional disability? Exp Gerontol 96:100–103. https://doi.org/10.1016/j.exger.2017.06.008

    Article  PubMed  PubMed Central  Google Scholar 

  19. Beaudart C, Zaaria M, Pasleau F et al (2017) Health outcomes of Sarcopenia: a systematic review and meta-analysis. PLoS One. 12:e0169548. https://doi.org/10.1371/journal.pone.0169548

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Safiri S, Ayubi E (2017) Sarcopenia based on the Asian working Group for Sarcopenia criteria and all-cause mortality risk in older Japanese adults: Methodological issues. Geriatr Gerontol Int 17:1759–1760. https://doi.org/10.1111/ggi.13092

    Article  PubMed  Google Scholar 

  21. Kim JH, Lim S, Choi SH et al (2014) Sarcopenia: an independent predictor of mortality in community-dwelling older Korean men. J Gerontol A Biol Sci Med Sci 69:1244–1252. https://doi.org/10.1093/gerona/glu050

    Article  PubMed  Google Scholar 

  22. Woo J, Leung J, Morley JE (2015) Defining sarcopenia in terms of incident adverse outcomes. J Am Med Dir Assoc 16:247–252. https://doi.org/10.1016/j.jamda.2014.11.013

    Article  PubMed  Google Scholar 

  23. Chen LK, Woo J, Assantachai P et al (2020) Asian working group for sarcopenia: 2019 consensus update on Sarcopenia diagnosis and treatment. J Am Med Dir Assoc 21:300-307.e2. https://doi.org/10.1016/j.jamda.2019.12.012

    Article  PubMed  Google Scholar 

  24. Sun L, Fu J, Mu Z et al (2023) Association between body fat and sarcopenia in older adults with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne). https://doi.org/10.3389/fendo.2023.1094075

    Article  PubMed  PubMed Central  Google Scholar 

  25. Takahashi F, Hashimoto Y, Kaji A et al (2021) Sarcopenia is associated with a risk of mortality in people with type 2 diabetes mellitus. Front Endocrinol (Lausanne). https://doi.org/10.3389/fendo.2021.783363

    Article  PubMed  PubMed Central  Google Scholar 

  26. Young BA, Lin E, Von Korff M et al (2008) Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. Am J Manag Care 14:15–23

    PubMed  PubMed Central  Google Scholar 

  27. McHugh ML (2012) Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 22:276–282

    Article  PubMed  Google Scholar 

  28. Xia L, Zhao R, Wan Q et al (2020) Sarcopenia and adverse health-related outcomes: an umbrella review of meta-analyses of observational studies. Cancer Med 9:7964–7978. https://doi.org/10.1002/cam4.3428

    Article  PubMed  PubMed Central  Google Scholar 

  29. Huang P, Luo K, Xu J et al (2021) Sarcopenia as a risk factor for future hip fracture: a meta-analysis of prospective cohort studies. J Nutr Health Aging 25:183–188. https://doi.org/10.1007/s12603-020-1474-5

    Article  CAS  PubMed  Google Scholar 

  30. Xu J, Wan CS, Ktoris K et al (2022) Sarcopenia is associated with mortality in adults: a systematic review and meta-analysis. Gerontology 68:361–376. https://doi.org/10.1159/000517099

    Article  PubMed  Google Scholar 

  31. Chen X, Cao M, Liu M et al (2022) Association between sarcopenia and cognitive impairment in the older people: a meta-analysis. Eur Geriatr Med 13:771–787. https://doi.org/10.1007/s41999-022-00661-1

    Article  PubMed  Google Scholar 

  32. Petermann-Rocha F, Chen M, Gray SR et al (2020) New versus old guidelines for sarcopenia classification: what is the impact on prevalence and health outcomes? Age Ageing 49:300–304. https://doi.org/10.1093/ageing/afz126

    Article  PubMed  Google Scholar 

  33. Kitamura A, Seino S, Abe T et al (2021) Sarcopenia: prevalence, associated factors, and the risk of mortality and disability in Japanese older adults. J Cachexia Sarcopenia Muscle 12:30–38. https://doi.org/10.1002/jcsm.12651

    Article  PubMed  Google Scholar 

  34. Yu R, Leung J, Woo J (2014) Incremental predictive value of sarcopenia for incident fracture in an elderly Chinese cohort: results from the osteoporotic fractures in Men (MrOs) study. J Am Med Dir Assoc 15:551–558. https://doi.org/10.1016/j.jamda.2014.02.005

    Article  PubMed  Google Scholar 

  35. Wong BW, Thu WPP, Chan YH et al (2023) Association of sarcopenia with important health conditions among community-dwelling Asian women. PLoS One. https://doi.org/10.1371/journal.pone.0281144

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kinoshita K, Satake S, Matsui Y et al (2021) Quantifying muscle mass by adjusting for body mass index is the best for discriminating low strength and function in Japanese older outpatients. J Nutr Health Aging 25:501–506. https://doi.org/10.1007/s12603-020-1557-3

    Article  CAS  PubMed  Google Scholar 

  37. Moon JH, Kim KM, Kim JH et al (2016) Predictive values of the new Sarcopenia index by the foundation for the national institutes of health Sarcopenia project for mortality among older Korean adults. PLoS One. 11:e0166344. https://doi.org/10.1371/journal.pone.0166344

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Studenski SA, Peters KW, Alley DE et al (2014) The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci 69:547–558. https://doi.org/10.1093/gerona/glu010

    Article  PubMed  PubMed Central  Google Scholar 

  39. Motamed N, Ajdarkosh H, Darkahian M et al (2020) 10-year risk of cardiovascular disease and body mass index in association with the obesity paradox. ARYA Atheroscler 16:16–23. https://doi.org/10.22122/arya.v16i1.1581

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We would like to thank the patients and the research team for their participation in this study.

Funding

No funding was received for this paper.

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Author notes

  1. Xin Ye and Fengning Chuan have contributed equally to this work and therefore share first authorship.

Authors and Affiliations

  1. Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Xin Ye, Fengning Chuan, Ying Li, Shuang Kang, Wenqing Tian, Mei Mei, Kun Liao, Lilin Gong & Bo Zhou

  2. Department of Endocrinology, Chongqing University Fuling Hospital, Chongqing, China

    Fengning Chuan

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Contributions

BZ: designed the study, interpreted the data and critically revised the manuscript for important intellectual content. XY, FC, SK, and YL collected the data. WT, KL, MM, LG, and RL assisted with the data collection. XY and FC analysed the data and wrote the paper. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bo Zhou.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

The study protocol conformed to the Declaration of Helsinki and was approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (No. 2021–299).

Human and animal rights

The present study is an observational cohort study with human subjects. All methods in this study were conducted in accordance with the amended Declaration of Helsinki.

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Informed consent was obtained from all participants included in the study.

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Ye, X., Chuan, F., Li, Y. et al. Comparing the prognostic value of the old and new sarcopenia criteria from the Asian Working Group on Sarcopenia in older adults with type 2 diabetes: Which set is more appropriate?. Aging Clin Exp Res 35, 1917–1926 (2023). https://doi.org/10.1007/s40520-023-02473-0

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