IMPACT OF DIABETES AND SARCOPENIA ON MORTALITY

Abstract

INTRODUCTION
Diabetes mellitus (DM) and sarcopenia are growing public health threats in an aging society. They share common pathophysiological mechanisms and are associated with serious health consequences. We investigated the impact of DM and sarcopenia on all-cause and cardiovascular mortalities in a longitudinal nationwide population-based study.

METHODOLOGY
Subjects who participated in the Korea National Health and Nutrition Examination Survey conducted from 2008 to 2011 with available appendicular skeletal muscle mass data were analyzed. Mortality data up to December 2020 were retrieved from the National Death Registry.

RESULTS
Of the 17,920 subjects, 14,737 (82.2%) had neither DM nor sarcopenia (DM-/SP-), 1,349 (7.5%) had only DM (DM+/ SP-), 1,425 (8.0%) had only sarcopenia (DM-/SP+), and 409 (2·3%) had both DM and sarcopenia (DM+/SP+). Compared to the DM-/SP- group, all-cause mortality was increased, with hazard ratios (HRs) of 1.29 (95% confidence interval [CI]: 0.97–1.73), 1.44 (95% CI: 1.12–1.85), and 1.88 (95% CI: 1.29–2.73) in the DM+/SP-, DM-/SP+, and DM+/SP+ groups, respectively, after adjusting for covariates. The data showed the DM+/SP+ group had the highest risk of overall mortality (p-for-trend = 0.042). Cardiovascular mortality was increased, with HRs of 1.34 (95% CI: 0.79–2.25), 1.39 (95% CI: 0.82–2.36), and 1.98 (95% CI: 1.04–3.77) in the DM+/SP-, DM-/SP+ and DM+/SP+ groups, respectively, compared to DM-/SP- group (p-for-trend 0.037).

CONCLUSION
The coexistence of DM and sarcopenia synergistically increased the risk of all-cause and cardiovascular mortality. Individuals with either disease may require more careful management to prevent the development of the other disease to reduce mortality.