Dynapenic abdominal obesity: an important hallmark of metabaging in patients with type 2 diabetes.

PURPOSE: The purpose of this study was to identify high-risk individuals through screening for dynapenic abdominal obesity (DAO) to better mitigate adverse outcomes among type 2 diabetes (T2D) patients in the future.

METHODS

This study included 530 middle-aged and older T2D patients. Demographics, nutritional and inflammatory indicators, diabetes-related features, hand grip strength (GS), and body composition were collected. Subjects were grouped by GS and estimated visceral adipose tissue area (eVATA): dynapenia/abdominal obesity (D/AO), nondynapenia/abdominal obesity (N/AO), dynapenia/nonobesity (D/N), and nondynapenia/nonobesity (N/N). Multilevel logistic and linear regression were used to analyze factors influencing DAO and its relationship with vertebral fractures, respectively.

RESULTS

Compared with the N/N group, D/AO group patients were older and had a higher high-sensitivity C-reactive protein (hsCRP) level, homeostasis model assessment of insulin resistance (HOMA-IR), and Diabetes Complications Severity Index (DCSI). Regarding body composition and physical performance, subjects with DAO had a greater percentage of total body fat, a lower ratio of appendicular skeletal muscle mass to weight, a higher lumbar spine T score, and a slower gait speed. The risk factors for DAO included greater age and DCSI. Further regression analysis revealed a positive correlation between DAO and the Spinal Deformity Index (B [95% CI], 0.672 [0.005, 1.339]; P = 0.048).

CONCLUSIONS

Among middle-aged and older patients with T2D, DAO is quite common, showing a unique feature related to aging and disease. Identifying DAO may provide new hope for screening high-risk individuals with T2D in terms of functionality and health outcomes.