Association between sarcopenia and diabetes in community dwelling elderly in the Amazon region - Viver Mais Project

Background: Studies indicate the intrinsic relationship between sarcopenia and diabetes mellitus (DM) pathophysiological mechanisms. Changes in insulin and muscular metabolism are features of diabetic patients and can interact as sarcopenic accelerators. Conversely, sarcopenic patients feature lower glucose tolerance and higher serum insulin levels, predisposing them to DM. Objective: To study the association between sarcopenia and DM in a community-dwelling elderly population of the Amazon region. Methods: Cross-sectional study, performed in Belem, Brazil, with 1078 patients aged above 60 years old from the Viver Mais Project (VMP). The definition of sarcopenia was based in the European Working Group on Sarcopenia in Older People (EWGSOP). Calf circumference > 31 cm was considered normal, muscle strength was discriminated by BMI and measured with the hand grip test, and gait speed < 0.8 m/s configured low performance. DM was diagnosed when reported by the patient or medical form, use of hypoglycemic medications/insulin and in the presence of fasting glucose > 126 mg/dl or glycated hemoglobin (HbA1c) > 6.5% on two occasions. Other medical and socio-demographic data were extracted from medical forms. Results: The frequency of sarcopenia was 9.4%, while DM was present in 36.87% of the patients, and had an increased occurrence in the sarcopenic group. Female sex, advanced age, DM, coronary insufficiency, osteoporosis, body mass index, waist circumference, triglycerides and functionality were associated with sarcopenia. In multivariate analysis, sarcopenia remained strongly associated with DM (OR: 3.208, 95%CI: 1.784-5.769). Conclusion: This study describes strong and independent association between sarcopenia and DM. To further clarify these findings, broader prospective cohorts are necessary.