Relationship between sarcopenia and type 2 diabetes mellitus among adults with prediabetes: evidence from a prospective cohort study.

Background: The relationship between sarcopenia and type 2 diabetes mellitus (T2DM) among those with prediabetes is largely inconclusive given the heterogeneous findings of previous studies. We aimed to clarify the association between sarcopenia and prediabetes progression to T2DM in adult participants.

Methods: Participants with baseline prediabetes from the UK Biobank cohort were included in this study. Sarcopenia was classified as present or absent based on the criteria from the 2019 European Working Group of Sarcopenia in Older People (EWGSOP2 criteria) including handgrip strength, muscle mass and walking pace. The primary outcome was incident T2DM during follow-up. Multivariable Cox regression model adjusting for sociodemographic factors, lifestyles, comorbidities, and laboratory measures, was used to assess the association between sarcopenia and risk of T2DM.

Results: We included 60,325 participants (mean age: 59.6 years, 54.5% females) with baseline prediabetes for analysis, among whom 9,305 (15.4%) had incident T2DM during a mean follow up of 11.4 years. There were 7,139 (11.8%) participants categorized as having sarcopenia. Those with sarcopenia had a higher cumulative incidence of T2DM than those without (19.3% vs. 14.9%, P < 0.001). Sarcopenia was associated with a 22% increased risk of T2DM when compared with no sarcopenia (hazard ratio [HR] = 1.22, 95% confidence interval [CI]: 1.15-1.30) in the fully adjusted model. This association was more evident in participants with a waist to hip ratio < 0.9 (P-value for interaction < 0.05).

Conclusions: Sarcopenia was associated with increased risk of T2DM in adults with prediabetes. Sarcopenia appears to be a marker for risk of T2DM in people with prediabetes and interventions targeted at preserving and improving muscle health might be another novel potential approach to effectively decelerating prediabetes progression to T2DM.