The Paradoxical Relationship Among Diabetes Mellitus, Osteoporosis and Sarcopenia: The PARADOS Study

Tülay Tiftik; Murat Kara; Cevriye Mülkoğlu; İrem Çiftçi; Ömer Faruk Çelik; Mahmut Esad Durmuş; Özgür Kara; Şerife Mehlika Kuşkonmaz; Hakan Genç; Bayram Kaymak; Levent Özçakar

doi:10.1016/j.clnesp.2024.12.009

The Paradoxical Relationship Among Diabetes Mellitus, Osteoporosis and Sarcopenia: The PARADOS Study

Clin Nutr ESPEN. 2024 Dec 10:65:258-263. doi: 10.1016/j.clnesp.2024.12.009. Online ahead of print.

Affiliations

¹ Department of Physical and Rehabilitation Medicine, Ankara Education and Research Hospital, Ankara, Turkey. Electronic address: drttiftik@gmail.com.
² Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.
³ Department of Physical and Rehabilitation Medicine, Ankara Education and Research Hospital, Ankara, Turkey.
⁴ Department of Internal Medicine, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
⁵ Department of Endocrinology and Metabolism, Ankara Education and Research Hospital, Ankara, Turkey.

PMID: 39667559
DOI: 10.1016/j.clnesp.2024.12.009

Abstract

Introduction: Type 2 diabetes mellitus (DM), osteoporosis (OP) and sarcopenia are major public health problems related with higher fall/fracture risks, morbidity and mortality. Due to the lack of a comprehensive analysis among OP, sarcopenia and DM; we aimed to explore the relationships between DM and the aforementioned conditions in postmenopausal women.

Methods: This cross-sectional study included postmenopausal women who consecutively admitted to the Departments of Physical & Rehabilitation Medicine, and Endocrinology and Metabolism. Demographic data, nutrition/cognition status and frailty scores of the participants were recorded. Sarcopenia-related parameters including, anterior thigh muscle thickness, handgrip strength, chair stand test, gait speed, and one-leg stand test (OLST) were measured. ISarcoPRM algorithm was used for the diagnosis of sarcopenia.

Results: A total of 444 postmenopausal women were consecutively enrolled. DM patients (N = 158) had higher frequency of sarcopenia (23.4 % vs. 12.9 %), but lower frequency of OP (33.5 % vs. 50.7 %) than controls (both p < 0.01). As regards regression analyses; menopause duration was positively (OR: 1.054, 95 % CI 1.030-1.077), but weight (OR: 0.957, 95 % CI 0.940-0.975) and DM (OR: 0.477, 95 % CI 0.310-0.733) were negatively related with OP (all p < 0.001). On the other hand, age (OR: 1.094, 95 % CI 1.056-1.133), body mass index (OR: 1.131, 95 % CI 1.067-1.198), and DM (OR: 1.887, 95 % CI 1.107-3.218) were positively related with sarcopenia (all p < 0.05). In addition, age (β = -0.355, p < 0.001), body mass index (β = -0.108, p = 0.021) and DM (β = -0.209, p < 0.001) were negatively related with OLST values.

Conclusion: DM has paradoxical associations with bone mass and muscle mass/function. Although it has negative relationship with OP (about two times lower odds), it has positive relationship with sarcopenia (about two times higher odds).

Keywords: Bone; Function; Hyperglycemia; Insulin; Muscle.