Bidirectional association between sarcopenia and diabetes: A prospective cohort study in middle-aged and elderly adults.

BACKGROUND AND AIMS: Sarcopenia and diabetes are prevalent diseases among middle-aged and elderly population. This study aimed to investigate the bidirectional association between sarcopenia and diabetes.

METHODS

This study comprised two longitudinal analyses. In cohort 1, the association between baseline diabetes and the risk of new-onset sarcopenia was assessed. In cohort 2, the association between baseline sarcopenia and the risk of new-onset diabetes was examined. Multivariate logistic regression models were used to calculate odds ratios (OR) and 95 % confidence intervals (95 % CI). Cross-lagged panel analysis was used to further validate their bidirectional associations.

RESULTS

Significant bidirectional associations were observed between sarcopenia and diabetes in both cross-sectional and longitudinal analyses (P < 0.05). After four years of follow-up, low handgrip strength (OR: 2.31, 95 % CI: 1.74-3.08) and appendicular skeletal muscle mass index (ASM/Ht2) (OR: 1.25, 95 % CI: 1.20-1.30) were associated with an increased risk of diabetes. Conversely, elevated fasting plasma glucose (FPG) (OR: 1.52, 95 % CI: 1.17-1.96) and glycated hemoglobin A1c (HbA1c) (OR: 1.35, 95 % CI: 1.05-1.73) were associated with a higher risk of sarcopenia. Cross-lagged analysis further confirmed their bidirectional longitudinal association.

CONCLUSIONS

This study identified significant longitudinal bidirectional association between sarcopenia and diabetes, highlighting that each condition serves as a risk factor for the other. Clinically, early assessments of handgrip strength and ASM/Ht2 may aid in diabetes prevention, while monitoring FPG and HbA1c could help reduce the risk of sarcopenia.