Triumvirate: Osteoporosis, presarcopenia, and type 2 diabetes mellitus
Abstract. Type 2 diabetes mellitus (DM) and sarcopenia are classified under the age-associated diseases that share common pathogenetic mechanisms. Metabolic disturbances inherent in both DM and sarcopenia can cause changes in bone tissue microarchitecture.Obedkov R.N., Dedov E.I., Kokorin V.A., Pshennikova I.G.
The aim: to study the prevalence of bone mineral density disorders (osteopenia/osteoporosis) in case of DM and to determine their contribution to the development of presarcopenia in older diabetic patients.
Material and methods. A cross-sectional study was performed among patients over 60 years of age hospitalized in the Department of endocrinology of the V.M. Buyanov City Clinical Hospital of the Department of Healthcare of Moscow, due to DM decompensation. SARC-F questionnaire was used to verify sarcopenia syndrome. Patients with a score of 4 or more were included in the main phase of the study to identify sarcopenia according to the EWGSOP 2 consensus. X-ray densitometry (DXA) was used to diagnose bone mineral density disorders.
Results. The study included 147 participants—35 male and 112 female (mean age 70 ± 8 years). Presarcopenia was diagnosed in 87 (59%) patients. Among patients with presarcopenia, DXA revealed normal bone tissue in 45 (51.7%) participants, osteopenia in 40 (46%), and osteoporosis in 2 (2.3%) patients with presarcopenia. Older age group patients with presarcopenia had decreased T-score and BMD of the left femoral neck, as well as T-score and BMD of the right femoral neck. Comparatively to male individuals, females with presarcopenia had a decreased T-score at the L1–L4 level and at the right femoral neck.
Conclusion. The combination of presarcopenia and decreased bone mineral density in patients with type 2 diabetes mellitus is accompanied by more pronounced manifestations, which must be taken into account when managing patients from older age groups.
Keywords
presarcopenia
osteoporosis
osteopenia
osteosarcopenia
type 2 diabetes mellitus in elderly patients
References
1. Kirk B, Al Saedi A, Duque G. Osteosarcopenia: A case of geroscience. Aging Med (Milton). 2019;2(3):147–56.
PMID: 31942528. PMCID: PMC6880711. https://doi.org/10.1002/agm2.12080
2. Демидова Т.Ю., Плахотняя В.М. Сахарный диабет и остеопороз: патогенетическая связь и современные принципы лечения. Медицинский совет. 2021;(7):96–107. (Demidova TYu, Plakhotnyaya VM. Diabetes mellitus and osteoporosis: Pathogenetic relationship and current principles of treatment. Meditsinskiy sovet = Medical Council. 2021;(7):96–107 (In Russ.)).
EDN: FYJJVX. https://doi.org/10.21518/2079-701X-2021-7-96-107
3. Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB et al. Sarcopenia: An undiagnosed condition in older adults. Current consensus definition: Prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249–56.
PMID: 21527165. PMCID: PMC3377163. https://doi.org/10.1016/j.jamda.2011.01.003
4. Белая Ж.Е., Белова К.Ю., Бирюкова Е.В., Дедов И.И., Дзеранова Л.К., Драпкина О.М. с соавт. Федеральные клинические рекомендации по диагностике, лечению и профилактике остеопороза. Остеопороз и остеопатии. 2021;24(2):4–47. (Belaya ZhE, Belova KYu. Biryukova EV, Dedov II, Dzeranova LK, Drapkina OM et al. Federal clinical guidelines for diagnosis, treatment and prevention of osteoporosis. Osteoporoz i osteopatii = Osteoporosis and Bone Diseases. 2021;24(2):4–47 (In Russ.)).
EDN: TUONYE. https://doi.org/10.14341/osteo12930
5. Бочарова К.А., Рукавишникова С.А., Осипов К.В., Шадрин К.А., Одегнал А.А., Курносенко В.Ю. Cаркопения в системе долговременного ухода. Современные проблемы здравоохранения и медицинской статистики. 2021;(2):12–26. (Bocharova KA, Rukavishnikova SA, Osipov KV, Shadrin KA, Odehnal AA, Kurnosenko VYu. Sarcopenia in the long-term care system. Sovremennyye problemy zdravookhraneniya i meditsinskoy statistiki = Modern Problems of Healthcare and Medical Statistics. 2021;(2):12–26 (In Russ.)).
EDN: UNVQYZ. https://doi.org/10.24412/2312-2935-2021-2-12-26
6. Аметов А.С., Пуговкина Я.В. Гомеостаз глюкозы и метаболическая гибкость у здоровых людей. Эндокринология: новости, мнения, обучение. 2020;9(4):12–22. (Ametov AS, Pugovkina YaV. Glucose homeostasis and metabolic flexibility in healthy people. Endokrinologiya: novosti, mneniya, obucheniye = Endocrinology: News, Opinions, Training. 2020;9(4):12–22 (In Russ.)).
EDN: LANHYC. https://doi.org/10.33029/2304-9529-2020-9-4-12-22
7. Izzo A, Massimino E, Riccardi G, Della Pepa G. A narrative review on sarcopenia in type 2 diabetes mellitus: Prevalence and associated factors. Nutrients. 2021;13(1):183.
PMID: 33435310. PMCID: PMC7826709. https://doi.org/10.3390/nu13010183
8. Liccini A, Malmstrom TK. Frailty and sarcopenia as predictors of adverse health outcomes in persons with diabetes mellitus. J Am Med Dir Assoc. 2016;17(9):846–51.
PMID: 27569712. https://doi.org/10.1016/j.jamda.2016.07.007
9. Объедков Р.Н., Дедов Е.И., Пшенникова И.Г. Роль биоимпедансного статуса в диагностике пресаркопении у пациентов пожилого и старческого возраста с сахарным диабетом 2-го типа. Consilium Medicum. 2025;27(4):246–251. (Obyedkov RN, Dedov EI, Pshennikova IG. The role of bioimpedance status in the diagnosis of presarcopenia in elderly and elderly patients with type 2 diabetes mellitus. Consilium Medicum. 2025;27(4):246–251 (In Russ.)).
EDN: OQJFZQ. https://doi.org/10.26442/20751753.2025.4.203313
10. Clynes MA, Gregson CL, Bruyere O, Cooper C, Dennison EM. Osteosarcopenia: Where osteoporosis and sarcopenia collide. Rheumatology. 2021:60(2):529–37.
PMID: 33276373. https://doi.org/10.1093/rheumatology/keaa755
11. Reid IR. Fat and bone. Arch Biochem Biophys. 2010;503(1):20–27.
PMID: 20599663. https://doi.org/10.1016/j.abb.2010.06.027
12. Kawao N, Kaji H. Interactions between muscle tissues and bone metabolism. J Cell Biochem. 2015;116(5):687–95.
PMID: 25521430. https://doi.org/10.1002/jcb.25040
13. Curtis E, Litwic A, Cooper C, Dennison E. Determinants of muscle and bone aging. J Cell Physiol. 2015;230(11):2618–25.
PMID: 25820482. PMCID: PMC4530476. https://doi.org/10.1002/jcp.25001
14. Polito A, Barnaba L, Ciarapica D, Azzini E. Osteosarcopenia: A narrative review on clinical studies. Int J Mol Sci. 2022;23(10):5591.
PMID: 35628399. PMCID: PMC9147376. https://doi.org/10.3390/ijms23105591
15. Yang Q, Zhang Z, He P, Mao X, Jing X, Hu Y et al. LC/MS-based untargeted lipidomics reveals lipid signatures of sarcopenia. Int J Mol Sci. 2024;25(16):8793.
PMID: 39201479. PMCID: PMC11354784. https://doi.org/10.3390/ijms25168793
16. Anagnostis P, Florentin M, Livadas S, Lambrinoudaki I, Goulis DG. Bone health in patients with dyslipidemias: An underestimated aspect. Int J Mol Sci. 2022;23(3):1639.
PMID: 35163560. PMCID: PMC8835770. https://doi.org/10.3390/ijms23031639
About the Authors
Ruslan N. Obedkov, MD, general practitioner of the Department of therapy, Volokolamsk Hospital. Address: 143600, Moscow region, Volokolamsk, 41 Rizhskoe Highway.E-mail: rn.obedkov98@gmail.com
ORCID: https://orcid.org/0000-0002-8689-6623
Evgeny I. Dedov, MD, Dr. Sci. (Medicine), professor of the Department of hospital therapy named after academician G.I. Storozhakov of the Institute of Clinical Medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia (Pirogov University); rheumatologist at V.M. Buyanov City Clinical Hospital of the Department of Healthcare of Moscow. Address: 117513, Moscow, 1 Ostrovityanova St.
E-mail: dedov-e-i@yandex.ru
ORCID: https://orcid.org/0000-0002-9118-3708. Scopus ID: 57204854667. SPIN-code: 8724-4940
Valentin A. Kokorin, MD, Dr. Sci. (Medicine), head of the Department of hospital therapy with courses in endocrinology, hematology, and clinical laboratory diagnostics of the Medical institute, RUDN University; professor of the Department of hospital therapy named after academician P.E. Lukomsky of the Institute of clinical medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia (Pirogov University). Address: 117198, Moscow, 6 Miklukho-Maklaya St.
E-mail: kokorin_va@pfur.ru
ORCID: https://orcid.org/0000-0001-8614-6542. Scopus ID: 56053021100. SPIN-code: 9772-2288
Irina G. Pshennikova, MD, endocrinologist, head of the Department of endocrinology of V.M. Buyanov City Clinical Hospital of the Department of Healthcare of Moscow, assistant at the Department of endocrinology, Russian Biotechnological University (ROSBIOTEKH). Address: 115516, Moscow, 26 Bakinskaya St.
E-mail: irinapshennikova@yandex.ru
ORCID: https://orcid.org/0009-0005-0776-0955
Similar Articles
