The study covered in this summary was published on Research Square as a preprint that has not yet been peer reviewed.
Key Takeaways
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Chinese researchers developed and validated a new, alternative sarcopenia risk score to identify in Chinese clinical practice functionally independent adults with type 2 diabetes who are at high risk of having sarcopenia and who may be candidates for intervention to prevent further physical disability.
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The new sarcopenia risk score had high diagnostic accuracy and good discrimination ability and was able to both identify sarcopenia and predict incident sarcopenia in Chinese adult patients with type 2 diabetes who were at least 50 years old.
Why This Matters
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Routine medical screening to detect sarcopenia before the onset of physical disability could enhance delivery of potentially effective interventions to people with a high risk for incident sarcopenia as well as those with early-stage sarcopenia who may otherwise be hard to identify. People with sarcopenia are generally unaware of their condition until the gradual reduction in muscle mass and function becomes very serious and leads to physical and functional disability.
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The new, alternative sarcopenia risk score is suitable for the detection of sarcopenia in people with type 2 diabetes when body composition cannot be examined. It avoids x-ray exposure and is more practical and inexpensive than assessments that rely on CT, MRI, or dual-energy x-ray absorptiometry. The authors said that it was not difficult to acquire the variables required to calculate the new, alternative sarcopenia risk score. A brief screening tool for sarcopenia that does not depend on many instruments is ideal.
Study Design
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The data came from a multicenter, cross-sectional study run at nine randomly selected hospitals in Beijing from January 2016 to March 2018. The study was designed to estimate the prevalence of sarcopenia among adults who were at least 50 years old and had been diagnosed with type 2 diabetes.
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The researchers collected extensive clinical measurements and questionnaire data from 1125 adults with type 2 diabetes. Patients were randomly divided into two groups: an exploratory population with 298 men and 258 women, and a validation population with 288 men and 281 women.
Key Results
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In multivariable analysis in the exploratory population, variables significantly associated with sarcopenia were age, male sex, body mass index, glycosylated hemoglobin level, insulin treatment, daily caloric intake, and the proportion of calories supplied by protein.
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In an area-under-the-curve analysis, these variables accounted for about 81% of the cases of sarcopenia in the exploratory population and about 84% in the validation population.
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The prevalence of sarcopenia was higher in the exploratory population — 14.8% in men, 4.3% in women — compared with the validation population — 10.8% in men, 3.6% in women — but these differences were not significant.
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The risk score showed sensitivity and specificity values of 74.5% and 78.0% for all individuals.
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Positive predictive and negative predictive values were 20.6% and 97.0% for all individuals.
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A total of 151 (27.2%) participants in the exploratory population had a risk score of at least 11, and 41 of these people (27.2%) had sarcopenia.
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In the validation population, at a score threshold of at least 11, sensitivity and specificity were 80.5% and 72.2% for all individuals, and the positive predictive and negative predictive values were 27.2% and 96.5%, respectively.
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A total of 136 (23.9%) individuals in the validation population had a risk score of at least 11 points, and 28 (20.6%) had sarcopenia.
Limitations
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The exploratory and validation populations had similar characteristics. Further validation in diverse populations is needed.
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The findings might not be generalizable to populations that don’t have diabetes, those with different racial or ethnic characteristics, or those in countries other than China.
Disclosures
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The study received no commercial funding.
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None of the authors had disclosures.
This is a summary of a preprint research study, “A New, Alternative Risk Score for Sarcopenia in Chinese Patients with Type 2 Diabetes Mellitus,” by researchers at several institutions in China, published on Research Square, and provided to you by Medscape. The study has not yet been peer reviewed. The full text of the study can be found on researchsquare.com.
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