Lou Yiling, Xie Yulin, Jiang Qingqing, Huang Shen, Wang Xiaohan, Wang Linlin, Wang Hengchang, Cao Shiyi
School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Diabetes Obes Metab. 2025 Jan;27(1):291-299. doi: 10.1111/dom.16016. Epub 2024 Oct 21.
To investigate the effect of sarcopenic obesity on the progression of glycaemic status in middle-aged and older adults without diabetes.
This research involved 4637 participants without diabetes from the China Health and Retirement Longitudinal Study 2011-2015. Sarcopenic obesity at baseline was evaluated based on the Asian Working Group for Sarcopenia 2019 criteria. According to the American Diabetes Association criteria, we used fasting plasma glucose and glycated haemoglobin to define glycaemic status. Cox proportional hazard models were applied to obtain adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).
The mean age of included participants was 58.98 ± 8.82 years, and 45.35% were men. During 18,497 person-years of follow-up, 1743 (37.59%) cases with glycaemic status progression were identified. Compared with participants without sarcopenia and obesity, participants with sarcopenic obesity, but not sarcopenia only or obesity only, exhibited a higher risk of progression from normoglycaemia to diabetes (HR = 2.11; 95% CI: 1.10-4.04). Moreover, participants with sarcopenic obesity (HR = 1.65; 95% CI: 1.04-2.63), sarcopenia only (HR = 1.78; 95% CI: 1.11-2.86), or obesity only (HR = 2.00; 95% CI: 1.29-3.12) had increased the risk of progression from prediabetes to diabetes.
The effect of sarcopenic obesity on the progression of glycaemic status based on fasting plasma glucose and glycated haemoglobin may be more pronounced than that of sarcopenia only or obesity only.
探讨肌少性肥胖对无糖尿病的中老年人血糖状态进展的影响。
本研究纳入了中国健康与养老追踪调查2011 - 2015年的4637名无糖尿病参与者。根据2019年亚洲肌少症工作组标准评估基线时的肌少性肥胖。根据美国糖尿病协会标准，我们使用空腹血糖和糖化血红蛋白来定义血糖状态。应用Cox比例风险模型获得调整后的风险比（HR）和95%置信区间（CI）。
纳入参与者的平均年龄为58.98±8.82岁，男性占45.35%。在18497人年的随访期间，共识别出1743例（37.59%）血糖状态进展的病例。与无肌少症和肥胖的参与者相比，患有肌少性肥胖而非仅肌少症或仅肥胖的参与者从正常血糖进展为糖尿病的风险更高（HR = 2.11；95% CI：1.10 - 4.04）。此外，患有肌少性肥胖（HR = 1.65；95% CI：1.04 - 2.63）、仅肌少症（HR = 1.78；95% CI：1.11 - 2.86）或仅肥胖（HR = 2.00；95% CI：1.29 - 3.12）的参与者从糖尿病前期进展为糖尿病的风险增加。
基于空腹血糖和糖化血红蛋白，肌少性肥胖对血糖状态进展的影响可能比仅肌少症或仅肥胖更为显著。
