BMJ open · 2026
Sarcopenia in Indian adults with type 2 diabetes: a systematic review and meta-analysis of prevalence and associated factors.
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Raj Shobhit, Suvarna Renuka, Thunga Girish, B S Varashree, Shetty Sahana
Аннотация
OBJECTIVES: To determine the pooled prevalence of sarcopenia phenotypes and synthesise the evidence on factors associated with sarcopenia among adults with type 2 diabetes mellitus (T2DM) in India.
DESIGN: Systematic review and meta-analysis.
DATA SOURCES: PubMed, Embase, Scopus and Web of Science were searched from inception to 14 January 2026, supplemented by reference list and citation searching.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Cross-sectional studies of Indian adults (≥18 years) with T2DM reporting sarcopenia prevalence using Asian Working Group for Sarcopenia (AWGS) diagnostic criteria.
DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened and extracted data. Methodological quality was assessed using the Joanna Briggs Institute prevalence checklist. Proportions were logit-transformed and pooled using random-effects models with Hartung-Knapp CIs and prediction intervals. Associated factors were synthesised narratively within a tiered framework separating adjusted from unadjusted ORs.
RESULTS: Seven studies (n=1359) were included. Pooled confirmed sarcopenia prevalence (AWGS 2019, k=6) was 27.4% (95% Hartung-Knapp CI 18.9% to 37.9%) but highly imprecise: I²=91.7% and the 95% prediction interval ran from 6.9% to 65.6%. Subgroup analysis showed 20.2% for dual-energy X-ray absorptiometry versus 31.7% for bioelectrical impedance analysis (Qbetween p=0.011). Severe sarcopenia was 11.0% (k=5) and sarcopenic obesity 25.2% (k=4); possible sarcopenia (65.6%, k=3; I²=98.6%) was too heterogeneous to interpret. In the two studies reporting adjusted estimates, hypertension (both studies) and diabetes duration ≥10 years (one study) were positively but imprecisely associated with sarcopenia. Certainty was very low for all prevalence outcomes (Grading of Recommendations Assessment, Development and Evaluation (GRADE)).
CONCLUSIONS: Sarcopenia appears common among Indian adults with T2DM, at approximately one in four, but certainty is very low and the plausible prevalence in a new cohort spans roughly 7% to 66%. These estimates are not a sufficient basis for a screening recommendation, but justify greater clinical awareness and, above all, community-based, dual-energy X-ray absorptiometry-standardised prospective studies, including from South India.
PROSPERO REGISTRATION NUMBER: CRD420251251024.
DESIGN: Systematic review and meta-analysis.
DATA SOURCES: PubMed, Embase, Scopus and Web of Science were searched from inception to 14 January 2026, supplemented by reference list and citation searching.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Cross-sectional studies of Indian adults (≥18 years) with T2DM reporting sarcopenia prevalence using Asian Working Group for Sarcopenia (AWGS) diagnostic criteria.
DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened and extracted data. Methodological quality was assessed using the Joanna Briggs Institute prevalence checklist. Proportions were logit-transformed and pooled using random-effects models with Hartung-Knapp CIs and prediction intervals. Associated factors were synthesised narratively within a tiered framework separating adjusted from unadjusted ORs.
RESULTS: Seven studies (n=1359) were included. Pooled confirmed sarcopenia prevalence (AWGS 2019, k=6) was 27.4% (95% Hartung-Knapp CI 18.9% to 37.9%) but highly imprecise: I²=91.7% and the 95% prediction interval ran from 6.9% to 65.6%. Subgroup analysis showed 20.2% for dual-energy X-ray absorptiometry versus 31.7% for bioelectrical impedance analysis (Qbetween p=0.011). Severe sarcopenia was 11.0% (k=5) and sarcopenic obesity 25.2% (k=4); possible sarcopenia (65.6%, k=3; I²=98.6%) was too heterogeneous to interpret. In the two studies reporting adjusted estimates, hypertension (both studies) and diabetes duration ≥10 years (one study) were positively but imprecisely associated with sarcopenia. Certainty was very low for all prevalence outcomes (Grading of Recommendations Assessment, Development and Evaluation (GRADE)).
CONCLUSIONS: Sarcopenia appears common among Indian adults with T2DM, at approximately one in four, but certainty is very low and the plausible prevalence in a new cohort spans roughly 7% to 66%. These estimates are not a sufficient basis for a screening recommendation, but justify greater clinical awareness and, above all, community-based, dual-energy X-ray absorptiometry-standardised prospective studies, including from South India.
PROSPERO REGISTRATION NUMBER: CRD420251251024.