Journal of Shandong University (Health Sciences) ›› 2021, Vol. 59 ›› Issue (6): 38-44.doi: 10.6040/j.issn.1671-7554.0.2021.0380

Previous Articles     Next Articles

Correlation between diabetic peripheral neuropathy and sarcopenia

ZHENG Fengjie, SONG Yuwen, SUN Aili, PAN Zhe, WANG Dianhui, LOU Nengjun, LYU Li, ZHUANG Xianghua, CHEN Shihong   

  1. Department of Endocrinology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China
  • Published:2021-06-10

RichHTML

21

PDF (PC)

677

Abstract: Objective To investigate the relationship between diabetic peripheral neuropathy(DPN)and sarcopenia in patients with type 2 diabetes mellitus(T2DM). Methods A total of 166 patients with T2DM were selected and divided into sarcopenia group(n=62)and non-sarcopenia group(n=104)according to the skeletal muscle mass index, grip strength and gait speed. Patients with symptoms or signs of DPN and a decrease in nerve conduction were diagnosed as diabetic peripheral neuropathy. Single factor analysis and multivariate Logistic regression analysis were used for statistical processing to compare the differences of clinical characteristics, biochemical indicators and prevalence of diabetic peripheral neuropathy between the two groups. Results The patients in sarcopenia group were older, but the body mass index, alanine aminotransferase level, skeletal muscle mass index, grip strength, and gait speed were lower than those in the non-sarcopenia group(P<0.05). The proportion of DPN and osteoporosis in the sarcopenia group were 83.87% and 70.97%, respectively, which were higher than those in the non-sarcopenia group(P<0.05). Male sex(OR=0.025, 95%CI: 0.004-0.143)and DPN(OR=32.927, 95%CI: 6.169-175.742)were independent risk factors for sarcopenia. Higher body mass index was a protective factor for sarcopenia(OR=0.546, 95%CI: 0.420-0.710). Conclusion DPN is an independent risk factor for sarcopenia in patients with T2DM. For patients with DPN, clinical screening for sarcopenia is recommended.

Key words: Sarcopenia, Diabetic peripheral neuropathy, Type 2 diabetes mellitus, Skeletal muscle mass index, Body mass index

CLC Number: 

  • R589
[1] Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia [J]. J Am Med Dir Assoc, 2011, 12(4): 249-256.
[2] 薛瑜, 王鸥, 邢小平. 肌少症筛查工具[J]. 中华骨质疏松和骨矿盐疾病杂志, 2017, 10(5):483-490. XUE Yu, WANG Ou, XING Xiaoping. Screening tools for sarcopenia [J]. Chinese Journal of Osteoporosis and Bone Mineral Research, 2017, 10(5):483-490.
[3] Wu PY, Huang KS, Chen KM, et al. Exercise, nutrition, and combined exercise and nutrition in older adults with sarcopenia: a systematic review and network meta-analysis[J]. Maturitas, 2021, 145: 38-48. doi: 10.1016/j.maturitas.2020.12.009.
[4] Beaudart C, Sanchez-Rodriguez D, Locquet M, et al. malnutrition as a strong predictor of the onset of sarcopenia [J]. Nutrients, 2019, 11(12):2883
[5] Dhillon RJ, Hasni S. Pathogenesis and management of sarcopenia [J]. Clin Geriatr Med, 2017, 33(1): 17-26.
[6] Albers JW, Pop-Busui R. Diabetic neuropathy: mechanisms, emerging treatments, and subtypes [J]. Curr Neurol Neurosci Rep, 2014, 14(8): 473.
[7] Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation [J]. Diabet Med, 1998, 15(7): 539-553.
[8] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志, 2018, 10(1):64-67. Chinese Diabetes Society. Guidelines for the prevention and control of type 2 diabetes in China(2017 Edition)[J]. Chinese Journal of Diabetes Mellitus, 2018, 10(1):64-67.
[9] Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia [J]. J Am Med Dir Assoc, 2014, 15(2): 95-101.
[10] 中华医学会骨质疏松和骨矿盐疾病分会. 原发性骨质疏松症诊疗指南(2017)[J]. 中华骨质疏松和骨矿盐疾病杂志, 2017, 10(5):413-444. Chinese Society of Osteoporosis and Bone Mineral Research. Guidelines for the diagnosis and management of primary osteoporosis(2017)[J]. Chinese Journal of Osteoporosis and Bone Mineral Research,2017, 10(5):413-444.
[11] CruzJentoft AJ, Sayer AA. Sarcopenia[J]. Lancet, 2019, 393(10191): 2636-2646.
[12] Wong R, Wong H, Zhang N, et al. The relationship between sarcopenia and fragility fracture-a systematic review [J]. Osteoporos Int, 2019, 30(3): 541-553.
[13] Ryan AM, Prado CM, Sullivan ES, et al. Effects of weight loss and sarcopenia on response to chemotherapy, quality of life, and survival [J]. Nutrition, 2019, 67-68: 110539. doi: 10.1016/j.nut.2019.06.020.
[14] 郭衍超,王霓雯,姚颖. 老年肌少症的研究进展[J]. 老年医学与保健, 2020, 26(1):4-8.
[15] Kim TN, Park MS, Yang SJ, et al. Prevalence and determinant factors of sarcopenia in patients with type 2 diabetes: the Korean Sarcopenic Obesity Study(KSOS)[J]. Diabetes Care, 2010, 33(7): 1497-1499.
[16] Yoon JW, Ha YC, Kim KM, et al. Hyperglycemia is associated with impaired muscle quality in older men with diabetes: the Korean longitudinal study on health and aging [J]. Diabetes Metab J, 2016, 40(2): 140-146.
[17] Tajiri Y, Kato T, Nakayama H, et al. Reduction of skeletal muscle, especially in lower limbs, in Japanese type 2 diabetic patients with insulin resistance and cardiovascular risk factors [J]. Metab Syndr Relat Disord, 2010, 8(2): 137-142.
[18] Andreassen CS, Jakobsen J, Ringgaard S, et al. Accelerated atrophy of lower leg and foot muscles - a follow-up study of long-term diabetic polyneuropathy using magnetic resonance imaging(MRI)[J]. Diabetologia, 2009, 52(6): 1182-1191.
[19] Allen MD, Choi IH, Kimpinski K, et al. Motor unit loss and weakness in association with diabetic neuropathy in humans [J]. Muscle Nerve, 2013, 48(2): 298-300.
[20] Resnick HE, Stansberry KB, Harris TB, et al. Diabetes, peripheral neuropathy, and old age disability [J]. Muscle Nerve, 2002, 25(1): 43-50. doi:10.1016/j.giatpost.2017.07.117.
[21] Scarton A, Jonkers I, Guiotto A, et al. Comparison of lower limb muscle strength between diabetic neuropathic and healthy subjects using OpenSim [J]. Gait Posture, 2017, 58: 194-200. doi:10.1016/j.giatpost.2017.07.117.
[22] Oh TJ, Song Y, Moon JH, et al. Diabetic peripheral neuropathy as a risk factor for sarcopenia [J]. Ann Geriatr Med Res, 2019, 23(4): 170-175.
[23] Mege RM, Goudou D, Giaume C, et al. Is intercellular communication via gap junctions required for myoblast fusion? [J]. Cell Adhes Commun, 1994, 2(4): 329-343.
[24] Schiaffino S, Reggiani C. Molecular diversity of myofibrillar proteins: gene regulation and functional significance [J]. Physiol Rev, 1996, 76(2): 371-423.
[25] Allen MD, Kimpinski K, Doherty TJ, et al. Length dependent loss of motor axons and altered motor unit properties in human diabetic polyneuropathy [J]. Clin Neurophysiol, 2014, 125(4): 836-843.
[26] Allen MD, Major B, Kimpinski K, et al. Skeletal muscle morphology and contractile function in relation to muscle denervation in diabetic neuropathy [J]. J Appl Physiol(1985), 2014, 116(5): 545-552.
[27] Langer HT, Afzal S, Kempa S, et al. Nerve damage induced skeletal muscle atrophy is associated with increased accumulation of intramuscular glucose and polyol pathway intermediates [J]. Sci Rep, 2020, 10(1): 1908.
[28] Bohnert KL, Hastings MK, Sinacore DR, et al. Skeletal muscle regeneration in advanced diabetic peripheral neuropathy [J]. Foot Ankle Int, 2020, 41(5): 536-548.
[29] Toosizadeh N, Mohler J, Armstrong DG, et al. The influence of diabetic peripheral neuropathy on local postural muscle and central sensory feedback balance control [J]. PLoS One, 2015, 10(8): e135255. doi: 10.1371/journal.pone.0135255.
[30] Bonewald LF, Kiel DP, Clemens TL, et al. Forum on bone and skeletal muscle interactions: summary of the proceedings of an ASBMR workshop [J]. J Bone Miner Res, 2013, 28(9): 1857-1865.
[31] Chen Q, Zeng J, Chen Y, et al. Efficacy of Xianling Gubao capsule in treating sarco-osteopenia: Protocol for a systematic review and meta-analysis [J]. Medicine(Baltimore), 2019, 98(20): e15672. doi: 10.1097/MD.0000000000015672.
[32] Verschueren S, Gielen E, ONeill TW, et al. Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men [J]. Osteoporos Int, 2013, 24(1): 87-98.
[33] 帅波, 沈霖, 杨艳萍, 等. 武汉地区中老年男性肌肉减少症与骨密度的相关性[J]. 中华骨质疏松和骨矿盐疾病杂志, 2016, 9(3):257-263. SHUAI Bo, SHEN Lin, YANG Yanping, et al. Relationship between sarcopenia and bone mineral density in middle-aged and elderly men in Wuhan area [J]. Chinese Journal of Osteoporosis and Bone Mineral Research, 2016, 9(3):257-263.
[34] Tagliaferri C, Wittrant Y, Davicco MJ, et al. Muscle and bone, two interconnected tissues [J]. Ageing Res Rev, 2015, 21: 55-70. doi: 10.1016/j.arr.2015.03.002.
[35] Cederholm T, Cruz-Jentoft AJ, Maggi S. Sarcopenia and fragility fractures [J]. Eur J Phys Rehabil Med, 2013, 49(1): 111-117.
[36] 张栌尹,莫永珍,欧阳晓俊,等. 住院老年患者肌少症患病率及相关因素分析[J]. 老年医学与保健, 2021, 27(1): 64-67. ZHANG Luyin, MO Yongzhen, OUYANG Xiaojun, et al. Analysis of prevalence and related factors of sarcopenia in hospitalized elderly patients[J]. Geriatrics & Health Care, 2021, 27(1): 64-67.
[37] Rong Y, Bian A, Hu H, et al. Study on relationship between elderly sarcopenia and inflammatory cytokine IL-6, anti-inflammatory cytokine IL-10 [J]. BMC Geriatrics, 2018, 18(1):308..
[38] Moon JS, Yoon JS, Won KC, et al. The role of skeletal muscle in development of nonalcoholic Fatty liver disease [J]. Diabetes Metab J, 2013, 37(4): 278-285.
[39] Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People [J]. Age Ageing, 2010, 39(4): 412-423.
[40] Papadopoulou SK. Sarcopenia: a contemporary health problem among older adult populations [J]. Nutrients, 2020, 12(5):1293.
[41] Verschueren S, Gielen E, ONeill TW, et al. Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men [J]. Osteoporos Int, 2013, 24(1): 87-98.
[42] Vespasiani-Gentilucci U, De Vincentis A, Ferrucci L, et al. Low Alanine aminotransferase levels in the elderly population: frailty, disability, sarcopenia, and teduced survival [J]. J Gerontol A Biol Sci Med Sci, 2018, 73(7): 925-930.
[43] Chung SM, Moon JS, Yoon JS, et al. Low alanine aminotransferase levels predict low muscle strength in older patients with diabetes: a nationwide cross-sectional study in Kore a[J]. Geriatr Gerontol Int, 2020, 20(4): 271-276.
[1] ZHANG Chunhui, WANG Chaoyi, YANG Jinghan, ZHANG Wenxia, KONG Yujia, SHI Fuyan, WANG Suzhen. Association between body mass index and hyperuricemia based on propensity score matching method [J]. Journal of Shandong University (Health Sciences), 2026, 64(4): 100-108.
[2] MENG Xiaomei, HAO Yaping, WANG Liang, YU Xiao, TANG Yuxiao. Correlation between the levels of serum Isthmin1, Gremlin2 and retinopathy in type 2 diabetic patients [J]. Journal of Shandong University (Health Sciences), 2025, 63(9): 102-107.
[3] SHEN Lujia, LU Tianwei, GONG Weiming, ZHAO Yansong, WANG Shukang, YUAN Zhongshang. Application of metabolomic risk score in predicting cardiovascular outcomes in patients with type 2 diabetes mellitus [J]. Journal of Shandong University (Health Sciences), 2025, 63(8): 69-78.
[4] CHEN Yingying, WANG Lu, HU Xifeng, ZHU Gaopei, XUE Fuzhong. A Bayesian network-based risk prediction study of stroke in patients with type 2 diabetes mellitus [J]. Journal of Shandong University (Health Sciences), 2025, 63(8): 94-102.
[5] LIU Kailin, GUO Ying, WANG Zhihao, GENG Chong, WANG Nana. Influence of physiological indicators on parathyroid gland function [J]. Journal of Shandong University (Health Sciences), 2025, 63(6): 100-106.
[6] CHEN Yingyi, YOU Qian, WANG Yi, ZHANG Fan, LI Feng, JI Shuming, XU Haoyuan, RAO Zhiyong. Development and validation of a prediction model for muscle mass loss in office workers [J]. Journal of Shandong University (Health Sciences), 2025, 63(4): 26-35.
[7] WANG Baoxuan, JIAO Jie, ZHANG Houjun, LIU Qi, YU Guanying. Application and perspectives of frailty and sarcopenia assessment in predicting postoperative outcomes of gastrointestinal tumours [J]. Journal of Shandong University (Health Sciences), 2025, 63(4): 51-58.
[8] LIU Wen, FENG Wenjuan, YANG Yang, JI Changli, CHAO Lan. Impact of BMI on cumulative birth rate in patients with normal ovarian response [J]. Journal of Shandong University (Health Sciences), 2024, 62(3): 54-60.
[9] LI Jinquan, GAO Meifang, YAN Fei, DONG Ming. Frequency and risk factors of muscle cramp in 136 cases of type 2 diabetes mellitus [J]. Journal of Shandong University (Health Sciences), 2023, 61(5): 20-24.
[10] HAN Mei, MENG Weijing, TAO Zikun, YANG Xi, XU Yaqi, MU Huaxia, BU Weixiao, WANG Suzhen, SHI Fuyan. Causal mediation analysis with multiple-mediator of hypertension and depression between type 2 diabetes mellitus and cognitive function based on G-computation [J]. Journal of Shandong University (Health Sciences), 2023, 61(10): 101-108.
[11] ZHAO Meiru, ZHU Di, LIU Lin, GUAN Qingbo, ZHANG Xu. Association of 4 simple insulin resistance indicators with the risk of hyperuricemia in 698 patients with type 2 diabetes mellitus [J]. Journal of Shandong University (Health Sciences), 2022, 60(12): 44-51.
[12] LYU Li, JIANG Lu, CHEN Shihong, ZHUANG Xianghua, SONG Yuwen, WANG Dianhui, AN Wenjuan, LI Qian, PAN Zhe. Related factors of osteoporosis in 210 postmenopausal women with type 2 diabetes mellitus [J]. Journal of Shandong University (Health Sciences), 2021, 59(7): 19-25.
[13] LIU Ping, SONG Yuwen, WANG Ping, TIAN Guangwei, ZHENG Fengjie, LYU Li, DU Jiaojiao, ZHANG Jing, ZHUANG Xianghua, CHEN Shihong. Correlation between vitamin D deficiency and depression in patients with type 2 diabetes mellitus [J]. Journal of Shandong University (Health Sciences), 2021, 59(6): 51-56.
[14] LIU Xiaofei, LIANG Ying, ZHANG Congxi, WANG Juan, PAN Yun, XU Jiawei, CHANG Chun, DONG Liang. Association of serum leptin with induced sputum eosinophils in 92 asthmatic patients [J]. Journal of Shandong University (Health Sciences), 2020, 1(9): 27-33.
[15] WANG Yuyu, GAO Li, CHEN Shaohua. Association between cognitive impairment and thyroid function after acute ischemic stroke in 94 patients with type 2 diabetes mellitus [J]. Journal of Shandong University (Health Sciences), 2020, 58(5): 56-61.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd