Biochemical markers in the prediction of sarcopenia in type 2 diabetes mellitus

Abstract

Purpose: analysis of biochemical markers in type 2 diabetes mellitus (DM) to predict sarcopenia. Materials and methods: the study included 46 patients with type 2 diabetes, divided into 4 groups: comparison, presarcopenia (probable sarcopenia), sarcopenia, control. The following studies were carried out: evaluation of a set of short tests for assessing physical performance - Short Physical Performance Battery (SPPB); wrist dynamometry; SARC-F questionnaire; bioimpedansometry with determination of skeletal muscle mass (SMM), appendicular mass index (ASM/m2); biochemical parameters were analyzed: creatinine, cystatin C, α1-proteinase inhibitor (α1-PI); α2-macroglobulin (α2-MG); elastase-like proteinases (El); trypsin-like proteinases (Tr).

Results: Patients with sarcopenia showed a decrease in ASM/m². The content of cystatin C increased in all analyzed groups. Probable sarcopenia is characterized by a negative correlation between the activity of elastase and trypsin-like proteinases with dynamometry and the SPPB test. In patients with sarcopenia, there is a positive correlation between elastase-like proteinases and the SPPB test. In individuals with type 2 diabetes and probable sarcopenia, muscle strength and performance depend negatively on the activity of α1-PI and positively on the activity of α2-MG. In sarcopenia, proteinase inhibitor activity was negatively correlated with muscle performance. A negative correlation between elastase-like proteinases and the parameters of hand dynamometry, SPPB test, and walking speed was determined for presarcopenia, while for sarcopenia it was positive. Presarcopenia and sarcopenia are characterized by a negative correlation between α1-PI and Tr in relation to the above parameters. The activity of proteinases increases in patients with a body mass index (BMI)˃ 25 kg/m² and thyroid pathology. In patients with arterial hypertension, there is a significant imbalance with high activity of elastase-like proteinases against the background of decreased activity of α1 PI. The activity of El and Tr is lower in patients with type 2 diabetes taking metformin.

Conclusion: Additionally, as part of screening for probable sarcopenia and sarcopenia in patients with type 2 diabetes, one can use the determination of laboratory parameters (cystatin C, α1-PI, α2-MG, El, Tr), as well as standard ones - dynamometry, bioimpedansometry, SPPB test. To adequately interpret biochemical parameters, it is necessary to take into account BMI, concomitant diseases and the characteristics of glucose-lowering therapy.