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Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship.

ABSTRACT: The incidence and prevalence of metabolic and musculoskeletal diseases are increasing. Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, inflammation, advanced glycation end-product accumulation and increased oxidative stress. These characteristics can negatively affect various aspects of muscle health, including muscle mass, strength, quality and function through impairments in protein metabolism, vascular and mitochondrial dysfunction, and cell death. Sarcopenia is a term used to describe the age-related loss in skeletal muscle mass and function and has been implicated as both a cause and consequence of T2DM. Sarcopenia may contribute to the development and progression of T2DM through altered glucose disposal due to low muscle mass, and also increased localized inflammation, which can arise through inter- and intramuscular adipose tissue accumulation. Lifestyle modifications are important for improving and maintaining mobility and metabolic health in individuals with T2DM and sarcopenia. However, evidence for the most effective and feasible exercise and dietary interventions in this population is lacking. In this review, we discuss the current literature highlighting the bidirectional relationship between T2DM and sarcopenia, highlight current research gaps and treatments, and provide recommendations for future research.

SUBMITTER: Mesinovic J

PROVIDER: S-EPMC6630094 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship.

Mesinovic Jakub J Zengin Ayse A De Courten Barbora B Ebeling Peter R PR Scott David D

Diabetes, metabolic syndrome and obesity : targets and therapy 20190708

The incidence and prevalence of metabolic and musculoskeletal diseases are increasing. Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, inflammation, advanced glycation end-product accumulation and increased oxidative stress. These characteristics can negatively affect various aspects of muscle health, including muscle mass, strength, quality and function through impairments in protein metabolism, vascular and mitochondrial dysfunction, and cell death. Sarcopenia is a term ...[more]

PMID: 31372016

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Project description:BackgroundSarcopenia is characterized by the age-associated loss of skeletal muscle mass and strength that develops progressively and plays an important role in the disability of the elderly. It has received growing attention over the last decade and has been implicated as both a cause and consequence of type 2 diabetes mellitus (T2DM). The existence of T2DM could increase the risk of developing sarcopenia through multiple mechanisms including advanced glycation end-product accumulation. Meanwhile, sarcopenia would alter glucose disposal and may contribute to the development and progression of T2DM due to reduced muscle mass.MethodsWe implemented transcriptomic analysis of skeletal muscle biopsy specimens in sarcopenia patients and proliferating myoblasts or differentiated myotubes from individuals with T2DM. Related microarray data were selected from Gene Expression Omnibus (GEO) to screen the genes, which were differentially expressed for sarcopenia and T2DM. Multiple combinatorial statistical methods and bioinformatics tools were used to analyze the common DEGs. Meanwhile, functional enrichment analysis was also carried out. Furthermore, we constructed the protein-protein interaction (PPI), as well as transcription factor (TF)-gene interactions network and TF-miRNA coregulatory network. Finally, based on the common DEGs, drug compounds were speculated using the Drug Signatures database (DSigDB).ResultsA total of 1765 and 2155 DEGs of sarcopenia and T2DM were screened, respectively. 15 common genes (LXN, CIB2, PEA15, KANK2, FGD1, NMRK1, PLCB1, SEMA4G, ADARB1, UPF3A, CSTB, COL3A1, CD99, ETV3, FJX1) correlated with sarcopenia and T2DM simultaneously were then identified, and 3 genes (UPF3A, CSTB and PEA15) of them were regarded as hub genes. Functional enrichment analysis revealed several shared pathways between two diseases. In addition, according to the TF-gene interactions network and TF-miRNA coregulatory network, part of TF and miRNA may be identified as key regulator in sarcopenia and T2DM at the same time (e.g., CREM and miR-155). Notably, drug compounds for T2DM and sarcopenia were also suggested, such as coenzyme Q10.ConclusionThis study revealed that sarcopenia and T2DM may share similar pathogenesis and provided new biological targets and ideas for early diagnosis and effective treatment of sarcopenia and T2DM.

Project description:BackgroundThe prevalence of sarcopenia is high in older people with type 2 diabetes mellitus (T2DM) and is now considered a critical problem in the healthcare sector. However, the preferred screening tool for identifying sarcopenia remains unknown. Thus, the aim of this study was to ensure that the diagnostic values of the SARC-F (strength, assisting with walking, rising from a chair, climbing stairs, and falling) and SARC-CalF (SARC and calf circumference) scales were compared with five reference diagnostic criteria for sarcopenia.MethodsThis was a cross-sectional study. Patients diagnosed with diabetes were treated at the First Affiliated Hospital of Wenzhou Medical University. Appendicular skeletal muscle mass, muscle strength, and physical performance were assessed using dual-energy X-ray absorptiometry, handgrip strength, and gait speed assessment. Five diagnostic criteria for sarcopenia (Asian Working Group for Sarcopenia, International Working Group on Sarcopenia, Foundation for the National Institutes of Health, Sarcopenia Project, Society on Sarcopenia Cachexia and Wasting Disorders, and European Working Group on Sarcopenia in Older People criteria) were utilized. Sensitivity and specificity analyses were performed on the SARC-CalF and SARC-F scales. The diagnostic precision of both instruments was determined using the receiver-operating characteristic (ROC) curves and area under the ROC curves (AUC).ResultsThis study included 689 subjects (459 men and 230 women) with a mean age of 58.1 ± 13.2 years. In accordance with the five reference diagnostic parameters, the prevalence of sarcopenia was between 4.5 and 19.2%. In addition, the range of sensitivity of SARC-F and SARC-CalF ranged from 61.4 to 67.4 and 82.6 to 91.8%, respectively. Concurrently, the specificity ranged from 63.1 to 67.3 and 51.5 to 61.2%, respectively. Overall, AUC values for SARC-CalF were higher than those for SARC-F, regardless of the diagnostic standard, sex, or age.ConclusionThe results of this study suggest that SARC-CalF significantly enhances the sensitivity and overall diagnosis of SARC-F. SARC-CalF appears to be an optimal screening tool for sarcopenia in adults with T2DM.

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Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship.

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Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship.

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