A New, Alternative Risk Score for Sarcopenia in Chinese Patients with Type 2 Diabetes Mellitus

Abstract

Abstract Objective To develop a new, alternative sarcopenia risk score to screen for sarcopenia in type 2 diabetes patients in China and to demonstrate its validity. Research design and methods : The data for this study came from a multicenter, cross-sectional study that had been designed to estimate the prevalence of sarcopenia among adults with type 2 diabetes and had been conducted in several hospitals in Beijing, China. A total of 1125 participants were randomly divided into two groups: an exploratory population and a validation population. A multivariable logistic regression model using the backward stepwise likelihood ratio method to estimate the probability of sarcopenia was fitted with candidate variables in the exploratory population. A new, alternative sarcopenia risk score was developed based on the multivariable model. The internal and external validations were performed in the exploratory and validation populations. The study was registered at Chinese Clinical Trial Registry (ChiCTR-EOC-15006901). Results The new, alternative sarcopenia risk score included seven variables: age, sex, BMI, glycosylated hemoglobin, insulin treatment or not, total caloric intake per day, and the proportion of calorie supplied by protein. The score ranged from − 9 to 23. The area under the receiver operating characteristic (ROC) curve of the risk score for the prediction of sarcopenia in type 2 diabetes patients was 0.812 (95% CI 0.748–0.877) and 0.841 (95% CI 0.785–0.897) in the exploratory and validation populations, respectively. At the optimal cutoff value of 11, the sensitivity and specificity of the score for the prediction of sarcopenia were 74.5% and 78.0% in the exploratory population and 80.5% and 72.2% in the validation population, respectively. The Hosmer-Lemeshow goodness-of-fit test showed a good calibration with the risk score in external validation (χ2 = 1.687, P = 0.989). Conclusions The new, alternative sarcopenia risk score appears to be an effective screening tool for the identification of sarcopenia in Chinese patients with type 2 diabetes in clinical practice.