Importance of Assessing Sarcopenia in Patients with Type 2 Diabetes Mellitus Based on Body Fat Percentage Measured by Dual-Energy X-Ray Absorptiometry in Different Genders

Background: Growing evidence indicates that there is a close relationship between type 2 diabetes mellitus (T2DM) and sarcopenia, and T2DM patients are often accompanied by obesity. However, research exploring the connection between body fat percentage (BFP) and sarcopenia is currently limited. Methods: This was a cross-sectional study that included 676 patients with T2DM over 50 years old. The appendicular skeletal muscle mass index (ASMI), handgrip strength, and 5-time chair stand test (5-TCST) were measured, and sarcopenia was diagnosed according to the Asian Working Group on Sarcopenia (AWGS). Spearman's coefficient was used to evaluate the correlation of BFP and body mass index (BMI) with the diagnostic elements of sarcopenia, and BFP and other relevant covariates were included in the binary logistic regression model. The subgroup performed an interaction test for statistically significant population baseline information. Results: The prevalence of sarcopenia was 18.0% in males and 11.6% in females. Spearman correlation analysis showed that BFP was positively correlated with ASMI in women ( R =0.107, P =0.029), but not in men. BFP was negatively correlated with grip strength (male: R = − 0.187, P =0.003; female: R =− 0.108, P =0.029). There was a positive correlation between BFP and 5-TCST (male: R =0.199, P =0.001; female: R =0.144, P =0.003). After adjusting for confounding factors, BFP was an independent risk factor for sarcopenia (men, OR: 1.33, 95% CI: 1.15– 1.54; women, OR: 1.26, 95% CI: 1.13– 1.41). This correlation was generally consistent, as demonstrated in further subgroup analyses. Conclusion: High BFP was significantly associated with sarcopenia risk, and this association was independent of gender, age, and BMI. Keywords: body fat percentage, diabetes, sarcopenia, body mass index, obesity