ArticleFrontiers in endocrinology2026
Muscle mass and function in patients with type 2 diabetes mellitus: a characteristic analysis based on sex, age, and BMI.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the characteristics and determinants of muscle mass and muscle function in patients with type 2 diabetes mellitus (T2DM), stratified by sex, age, and body mass index (BMI). Methods: This is a retrospective cross-sectional study included 838 T2DM patients treated at the Department of Endocrinology and Metabolism, Nanjing First Hospital. Data on body weight, grip strength, gait speed, and other relevant clinical parameters were collected. Regression analyses and subgroup comparisons were performed according to sex, age, and BMI categories to evaluate the features and associated factors of muscle mass and muscle function in T2DM patients. Results: The prevalence of sarcopenia was slightly higher in female T2DM patients than that in males. Binary logistic regression analysis showed that, in addition to advanced age and low BMI, decreased serum albumin (Alb), elevated alkaline phosphatase, and insulin use were also significant risk factors for sarcopenia in male patients with T2DM. Multivariate analysis showed that in males, decreased skeletal muscle index (SMI) was independently associated with older age, low Alb, low creatinine, and low BMI; in females, it was independently associated with older age, low triglycerides, and low BMI. Regarding handgrip strength, older age and higher HbA1c were associated factors in males, whereas older age and longer diabetes duration were associated factors in females. For gait speed, older age and low albumin were associated factors in males, whereas only older age was significant in females. Age-stratified analyses revealed that in males, SMI and handgrip strength remained stable between ages 40 and 60, then declined significantly after 60; in females, declines were observed from approximately age 50. Gait speed decreased after age 70 in both sexes. BMI-stratified analyses revealed that sarcopenia prevalence increases with lower BMI, particularly in males. In males, low handgrip strength and gait speed rose sharply at BMI <18.5; no such association was observed in females. Conclusion: Older age and low BMI are common risk factors associated with sarcopenia in T2DM patients. In males, monitoring of muscle mass and functional decline is warranted after age 60, particularly in the presence of low serum albumin and low BMI. Preventive awareness and measures should be initiated when females reach age 50.
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