Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.
Unit of Endocrinology, Diabetology, Dietetics and Clinical Nutrition, Sant Anna Hospital, 22020 San Fermo della Battaglia, Italy.
Nutrients. 2023 Dec 25;16(1):63. doi: 10.3390/nu16010063.
Sarcopenia is an age-related clinical complaint characterized by the progressive deterioration of skeletal muscle mass and strength over time. Type 2 diabetes (T2D) is associated with faster and more relevant skeletal muscle impairment. Both conditions influence each other, leading to negative consequences on glycemic control, cardiovascular risk, general health status, risk of falls, frailty, overall quality of life, and mortality. PubMed/Medline, Scopus, Web of Science, and Google Scholar were searched for research articles, scientific reports, observational studies, clinical trials, narrative and systematic reviews, and meta-analyses to review the evidence on the pathophysiology of di-abetes-induced sarcopenia, its relevance in terms of glucose control and diabetes-related outcomes, and diagnostic and therapeutic challenges. The review comprehensively addresses key elements for the clinical definition and diagnostic criteria of sarcopenia, the pathophysiological correlation be-tween T2D, sarcopenia, and related outcomes, a critical review of the role of antihyperglycemic treatment on skeletal muscle health, and perspectives on the role of specific treatment targeting myokine signaling pathways involved in glucose control and the regulation of skeletal muscle metabolism and trophism. Prompt diagnosis and adequate management, including lifestyle inter-vention, health diet programs, micronutrient supplementation, physical exercise, and pharmaco-logical treatment, are needed to prevent or delay skeletal muscle deterioration in T2D.
肌肉减少症是一种与年龄相关的临床病症，其特征是随着时间的推移，骨骼肌质量和力量逐渐恶化。2 型糖尿病（T2D）与更快和更相关的骨骼肌损伤有关。这两种情况相互影响，导致血糖控制、心血管风险、总体健康状况、跌倒风险、虚弱、整体生活质量和死亡率的负面后果。我们在 PubMed/Medline、Scopus、Web of Science 和 Google Scholar 上搜索了研究文章、科学报告、观察性研究、临床试验、叙述性和系统性综述以及荟萃分析，以综述糖尿病引起的肌肉减少症的病理生理学、其在血糖控制和糖尿病相关结局方面的相关性以及诊断和治疗方面的挑战的证据。本综述全面介绍了肌肉减少症的临床定义和诊断标准的关键要素、T2D、肌肉减少症和相关结局之间的病理生理学相关性、抗高血糖治疗对骨骼肌健康的作用的批判性回顾，以及针对涉及葡萄糖控制和骨骼肌代谢和营养调节的肌因子信号通路的特定治疗在血糖控制中的作用的观点。需要及时诊断和适当管理，包括生活方式干预、健康饮食计划、微量营养素补充、体育锻炼和药物治疗，以预防或延缓 T2D 中的骨骼肌恶化。
