Sarcopenic obesity evaluated by dual energy X-ray absorptiometry, rather than sarcopenia or obesity alone, is associated with the macrovascular but not microvascular complications in patients with type 2 diabetes

Abstract

Abstract Objective: The prevalence of Sarcopenic obesity (SO) is increasing, particularly with a rising trend observed in patients diagnosed with Type 2 diabetes (T2D). However, the association between SO and diabetic complications remains unclear when compared to sarcopenia or obesity alone. This study aimed to investigate the associations between sarcopenia, obesity, SO, and diabetes complications in patients with T2D. Methods: A retrospective study was conducted including 2387 hospitalized patients with T2D. Data associated with demographic characteristics, biochemical parameters, diabetic complications, and body composition from electronic health records were collected. The participants were categorized as normal (nonsarcopenia nonobesity), sarcopenia, obesity, and SO groups according to the body compositions evaluated by dual-energy X-ray absorptiometry. Multiple logistic regression models were applied to assess the associations between body composition and complications of diabetes. Results: After adjustment for potential confounders, compared with patients in normal group, the odds ratios (95% CIs) of macrovascular complications of diabetes were 0.64 (95% CI, 0.29-1.42) for those in sarcopenia group, 1.05 (95% CI, 0.56-1.97) in obesity group, and 2.45 (95% CI, 1.18-5.09) in SO group, respectively; the odds ratios (95% CIs) of microvascular complications of diabetes was 0.95 (95% CI, 0.58-1.55) for those in sarcopenia group, 0.80 (95% CI, 0.53-1.22) in obesity group, and 1.21 (95% CI, 0.69-2.11) in SO group, respectively. Conclusion: According to our findings, SO, rather than sarcopenia or obesity alone, was significantly associated with a higher prevalence of macrovascular complications, in hospitalized patients with T2DM. This association was not observed for diabetic microvascular complications.