Ann Geriatr Med Res.  2019 Dec;23(4):170-175. 10.4235/agmr.19.0039.

Diabetic Peripheral Neuropathy as a Risk Factor for Sarcopenia

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. janghak@snu.ac.kr
  • 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

BACKGROUND
Diabetic peripheral neuropathy (DPN) is prevalent in patients with type 2 diabetes, and its prevalence increases with age. A previous study demonstrated the association between DPN and muscle dysfunction; however, there are limited data on the association between DPN and sarcopenia.
METHODS
We enrolled patients with type 2 diabetes and measured hand grip strength (HGS), lean body mass using a bio-impedance analysis, and gait speed using a 4-m walking test. Sarcopenia was diagnosed according to the criteria from the Asian Working Group for Sarcopenia. We also performed various examinations of neuropathy, including both small- and large-fiber neuropathy.
RESULTS
Among 170 participants (mean age, 61.5±6.6 years), 24 (14.1%) were diagnosed with sarcopenia. The Michigan Neuropathy Screening Instrument Questionnaire (MNSI-Q) scores were higher in patients with sarcopenia than in those without sarcopenia (2.7±1.3 vs. 2.4±1.3; p=0.008). However, other neuropathy examination results were not significantly associated with sarcopenia. The MNSI-Q score was negatively associated with HGS, with an odds ratio (OR) of 1.367 (95% confidence interval [CI], 1.122-1.667) in predicting the presence of sarcopenia. After adjusting for sex, body mass index, and diabetes duration, the MNSI-Q score was associated with the presence of sarcopenia (adjusted OR=1.310; 95% CI, 1.041-1.647).
CONCLUSION
In this population with type 2 diabetes, patients with sarcopenia had higher neuropathy questionnaire scores than those without sarcopenia. Therefore, active screening for sarcopenia should be performed in subjects with DPN.

Keyword

Sarcopenia; Diabetic neuropathy; Skeletal muscle; Muscle strength

MeSH Terms

Asian Continental Ancestry Group
Body Mass Index
Diabetic Neuropathies
Gait
Hand
Hand Strength
Humans
Mass Screening
Michigan
Muscle Strength
Muscle, Skeletal
Odds Ratio
Peripheral Nervous System Diseases*
Prevalence
Risk Factors*
Sarcopenia*
Walking
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