Prevalence, risk factors and adverse health outcomes of osteosarcopenia in middle-aged and older adults with type 2 diabetes mellitus-a scoping review.

Osteoporosis and sarcopenia are increasingly recognised as important complications of type 2 diabetes mellitus (T2D). As both conditions share common pathophysiological mechanisms, they can coexist in the same individual. The coexistence of osteoporosis and sarcopenia, known as osteosarcopenia (OS), is an emerging geriatric syndrome. Compared with its individual components, OS has received much less attention. The overall objective of this scoping review was to summarise the existing literature on the prevalence, risk factors, biomarkers, and adverse health outcomes associated with OS in adults with T2D aged ≥ 40. A search was conducted in eight online databases (Ovid MEDLINE®, Embase (Ovid), PubMed, CINAHL, Cochrane Library, Web of Science, Scopus and PsycINFO) and grey literature sources for relevant articles published in English up to 31 July 2024. A total of ten articles reporting findings from nine distinct studies (7 cross-sectional, 2 case-control) were included. Despite significant heterogeneity in its definition, OS was shown to be prevalent in T2D. The risk of OS was increased in individuals with T2D who had poor β-cell function, low body mass index, and smaller waist circumference. Insulin resistance, duration of T2D, glycaemic control, and metformin, sulfonylurea and insulin use were not shown to be significant risk factors. Osteocalcin was a potentially useful biomarker of OS in T2D, and OS may be associated with falls and leg fractures in T2D. In conclusion, this scoping review revealed a paucity of information about OS in T2D. Longitudinal studies with comprehensive phenotyping are required to address the many knowledge gaps.