TIP 2 DIYABETLI BIREYLERDE SARKOPENIK İNDEKS VE BU INDEKSIN YAŞ, KLINIK VE METABOLIK PARAMETRELERLE OLAN İLIŞKISI: RETROSPEKTIF KESITSEL BIR ÇALIŞMA

Yıl 2025, Cilt: 3 Sayı: 1, 25 - 34, 01.03.2025

Ayse Naciye Erbakan , Hacer Hicran Mutlu

Öz

Background: This study aimed to evaluate the sarcopenic index (SI) in individuals with type 2 diabetes and assess its associations with various factors including age, diabetes duration, sex, NT-proBNP, and FIB-4 score.
Methods: This retrospective cross-sectional study included patients with type 2 diabetes who attended the Diabetes Clinic between September 1, 2023, and April 30, 2024. The sarcopenic index was calculated using the creatinine-to-cystatin C ratio, and participants were categorized into three groups based on their SI values. Correlation and multiple regression analyses were conducted to examine relationships between SI and age, diabetes duration, HbA1c, eGFR, NT-proBNP, and FIB-4 score.
Results: The study included 839 patients with type 2 diabetes (54% female). The median age was 63.0 years (IQR: 14.0), and the median diabetes duration was found 10.0 years in females (IQR: 12) and 10.0 years in males (IQR: 10.0) (p = 0.009). The mean sarcopenic index was 0.8 ± 0.1 in males and 0.7 ± 0.1 in females (p < 0.001). SI showed a significant negative correlation with age and diabetes duration (p < 0.001). A negative correlation between NT-proBNP and SI was also observed.
Conclusion: The sarcopenic index was generally low in individuals with type 2 diabetes and was associated with age, diabetes duration, gender, and NT-proBNP levels. The probability of lower SI association with increased risk of sarcopenia and overall morbidity and mortality risk, highlights the need for early interventions, particularly in older individuals with a longer history of diabetes.

Anahtar Kelimeler

Type 2 diabetes, sarcopenia, metabolic parameters

Kaynakça

• 1. Kashani KB, Frazee EN, Kukrálová L, Sarvottam K, Herasevich V, Young PM, et al. Evaluating muscle mass by using markers of kidney function: development of the sarcopenia index. Critical care medicine. 2017;45(1):e23-e9.
• 2. Schmeusser B, Ali A, Patil DH, Midenberg E, Nabavizadeh R, Ogan K, Master VA. Creatinine to cystatin C ratio and mortality in renal cell carcinoma. American Society of Clinical Oncology; 2023.
• 3. Hyun YY, Lee K-B, Kim H, Kim Y, Chung W, Park HC, et al. Serum creatinine to cystatin C ratio and clinical outcomes in adults with non-dialysis chronic kidney disease. Frontiers in Nutrition. 2022;9:996674.
• 4. Hirai K, Tanaka A, Homma T, Goto Y, Akimoto K, Uno T, et al. Serum creatinine/cystatin C ratio as a surrogate marker for sarcopenia in patients with chronic obstructive pulmonary disease. Clinical nutrition. 2021;40(3):1274-80.
• 5. Tabara Y, Okada Y, Ochi M, Ohyagi Y, Igase M. Association of creatinine-to-cystatin C ratio with myosteatosis and physical performance in older adults: the Japan Shimanami Health Promoting Program. Journal of the American Medical Directors Association. 2021;22(11):2366-72. e3.
• 6. Sim M, Dalla Via J, Scott D, Lim WH, Hodgson JM, Zhu K, et al. Creatinine to cystatin C ratio, a biomarker of sarcopenia measures and falls risk in community-dwelling older women. The Journals of Gerontology: Series A. 2022;77(7):1389-97.
• 7. Qiu S, Cai X, Xie B, Yuan Y, Sun Z, Wu T. Normalized creatinine-to-cystatin C ratio and risk of diabetes in middle-aged and older adults: the China health and retirement longitudinal study. Diabetes & metabolism journal. 2022;46(3):476-85.
• 8. Qiu S, Cai X, Yuan Y, Xie B, Sun Z, Wu T. Changes in creatinine‐to‐cystatin C ratio over 4 years, risk of diabetes, and cardiometabolic control: The China Health and Retirement Longitudinal Study. Journal of Diabetes. 2021;13(12):1025-33.
• 9. Osaka T, Hamaguchi M, Hashimoto Y, Ushigome E, Tanaka M, Yamazaki M, Fukui M. Decreased the creatinine to cystatin C ratio is a surrogate marker of sarcopenia in patients with type 2 diabetes. Diabetes research and clinical practice. 2018;139:52-8.
• 10. Inker LA, Eneanya ND, Coresh J, Tighiouart H, Wang D, Sang Y, et al. New creatinine-and cystatin C–based equations to estimate GFR without race. New England Journal of Medicine. 2021;385(19):1737-49.
• 11. Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006;43(6):1317-25.
• 12. Barreto EF, Poyant JO, Coville HH, Dierkhising RA, Kennedy CC, Gajic O, et al. Validation of the sarcopenia index to assess muscle mass in the critically ill: a novel application of kidney function markers. Clinical Nutrition. 2019;38(3):1362-7.
• 13. Süleymanlar G, Utaş C, Arinsoy T, Ateş K, Altun B, Altiparmak MR, et al. A population-based survey of Chronic REnal Disease In Turkey—the CREDIT study. Nephrology Dialysis Transplantation. 2011;26(6):1862-71.
• 14. Groesbeck D, Ko A, Parekh R, Selvin E, Schwartz GJ, Coresh J, Furth S. Age, gender, and race effects on cystatin C levels in US adolescents. Clinical Journal of the American Society of Nephrology. 2008;3(6):1777-85.
• 15. Knight EL, Verhave JC, Spiegelman D, Hillege HL, De Zeeuw D, Curhan GC, De Jong PE. Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney international. 2004;65(4):1416-21.
• 16. Weinert LS, Prates AB, do Amaral FB, Vaccaro MZ, Camargo JL, Silveiro SP. Gender does not influence cystatin C concentrations in healthy volunteers. Clinical chemistry and laboratory medicine. 2010;48(3):405-8.
• 17. Mindikoglu AL, Opekun AR, Mitch WE, Magder LS, Christenson RH, Dowling TC, et al. Cystatin C is a gender-neutral glomerular filtration rate biomarker in patients with cirrhosis. Digestive diseases and sciences. 2018;63:665-75.
• 18. Kandasamy Y, Smith R, Wright IM. Measuring cystatin C to determine renal function in neonates. Pediatric Critical Care Medicine. 2013;14(3):318-22.
• 19. Vallianou NG, Georgousopoulou E, Evangelopoulos AA, Bountziouka V, Bonou MS, Vogiatzakis ED, et al. Inverse relationship between adherence to the mediterranean diet and serum cystatin C Levels. Central European Journal of Public Health. 2017;25(3):240-4.
• 20. Merriwether EN, Host HH, Sinacore DR. Sarcopenic indices in community-dwelling older adults. Journal of geriatric physical therapy. 2012;35(3):118-25.
• 21. Wen X, Wang M, Jiang C-M, Zhang Y-M. Are current definitions of sarcopenia applicable for older Chinese adults? The journal of nutrition, health & aging. 2011;15:847-51.
• 22. Sobestiansky S, Michaelsson K, Cederholm T. Sarcopenia prevalence and associations with mortality and hospitalisation by various sarcopenia definitions in 85–89 year old community-dwelling men: a report from the ULSAM study. BMC geriatrics. 2019;19:1-13.
• 23. Wen CY, Lien ASY, Jiang YD. Sarcopenia in elderly diabetes. Journal of Diabetes Investigation. 2022;13(6):944.
• 24. Trierweiler H, Kisielewicz G, Hoffmann Jonasson T, Rasmussen Petterle R, Aguiar Moreira C, Zeghbi Cochenski Borba V. Sarcopenia: a chronic complication of type 2 diabetes mellitus. Diabetology & metabolic syndrome. 2018;10:1-9.
• 25. Qiao Y-S, Chai Y-H, Gong H-J, Zhuldyz Z, Stehouwer CD, Zhou J-B, Simó R. The association between diabetes mellitus and risk of sarcopenia: accumulated evidences from observational studies. Frontiers in Endocrinology. 2021;12:782391.
• 26. Yogesh M, Mody M, Makwana N, Rabadiya S, Patel J, Shah S. The Hidden Battle Within: Shedding Light on the Co-existence of Sarcopenia and Sarcopenic Obesity among Participants with Type 2 Diabetes in a Tertiary Care Hospital, Gujarat. Indian Journal of Endocrinology and Metabolism. 2024;28(1):80-5.
• 27. Risch M, Risch L, Purde M-T, Renz H, Ambühl P, Szucs T, Tomonaga Y. Association of the cystatin C/creatinine ratio with the renally cleared hormones parathyroid hormone (PTH) and brain natriuretic peptide (BNP) in primary care patients: a cross-sectional study. Scandinavian journal of clinical and laboratory investigation. 2016;76(5):379-85.
• 28. Linzbach S, Samigullin A, Yilmaz S, Tsioga M, Zeiher AM, Spyridopoulos I. Role of N-terminal pro-brain natriuretic peptide and cystatin C to estimate renal function in patients with and without heart failure. The American journal of cardiology. 2009;103(8):1128-33.
• 29. Ai Y, Xu R, Liu L. The prevalence and risk factors of sarcopenia in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetology & Metabolic Syndrome. 2021;13:1-12.
• 30. Hiromine Y, Noso S, Rakugi H, Sugimoto K, Takata Y, Katsuya T, et al. Poor glycemic control rather than types of diabetes is a risk factor for sarcopenia in diabetes mellitus: The MUSCLES‐DM study. Journal of diabetes investigation. 2022;13(11):1881-8.
• 31. Alfaro-Alvarado FA, Rosas-Barrientos JV, Ocharan-Hernández ME, Díaz-Chiguer D, Vargas-De-León C. Association between Sarcopenia and Poor Glycemic Control in Older Adults with Type 2 Diabetes Mellitus. Diseases. 2023;11(4):175.
• 32. Sugimoto K, Ikegami H, Takata Y, Katsuya T, Fukuda M, Akasaka H, et al. Glycemic control and insulin improve muscle mass and gait speed in type 2 diabetes: the MUSCLES-DM study. Journal of the American Medical Directors Association. 2021;22(4):834-8. e1.