Wang Xuanyu, Bai Yan, Zhang Fan, Que Huafa
Department of Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No. 725, Wanping South Road, Xuhui District, Shanghai, China.
Department of Endocrine, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No. 725, Wanping South Road, Xuhui District, Shanghai, China.
Eur J Med Res. 2025 Mar 4;30(1):151. doi: 10.1186/s40001-025-02405-w.
Sarcopenia, characterized by loss of muscle mass and strength, has been linked to various health outcomes, including diabetes mellitus. This study aims to investigate the association of sarcopenia index, based on serum creatinine and cystatin C levels, with incident diabetes mellitus in middle-aged and older adults in China.
This study extracted data from 2015 to 2020 China Health and Retirement Longitudinal Study (CHARLS), including age ≥ 45-year adults without diabetes mellitus at baseline. Sarcopenia index was calculated based on serum creatinine and cystatin C levels, and incident diabetes mellitus was assessed through follow-up surveys. Cox proportional hazards regression models were used to analyze the association between sarcopenia index and incident diabetes mellitus, adjusting for potential confounders, with hazard ratio (HR) with 95% confidence interval (95% CI) reported.
During a mean follow-up period of 5.0 years, a total of 501 new cases of diabetes were recorded. A total of 7718 participants were included in the analysis. The median age was 60 years, and 46.2% were male. During a mean follow-up period of 5.0 years, 501 cases of incident diabetes mellitus were identified. After adjusting for covariates, Compared with participants in the lowest quartile, the corresponding diabetes HRs (95% CIs) for participants in the second, third, and fourth quartiles were 0.930 (95% CI 0.724-1.193; P = 0.567); 0.892 (95% CI 0.685-1.162; P = 0.398), 0.869 (95% CI 0.657-1.150; P = 0.327). Restricted cubic spline curves revealed that incident rate decreased with increase in sarcopenia index.
This study provides national longitudinal evidence in China on the association of sarcopenia index, based on serum creatinine and cystatin C levels, with incident diabetes mellitus in middle-aged and older adults. Our findings suggest that sarcopenia index may be a useful biomarker for predicting the risk of diabetes mellitus in this population.
肌肉减少症以肌肉质量和力量丧失为特征，与包括糖尿病在内的多种健康结局相关。本研究旨在探讨基于血清肌酐和胱抑素C水平的肌肉减少症指数与中国中老年人群新发糖尿病之间的关联。
本研究从2015年至2020年中国健康与养老追踪调查（CHARLS）中提取数据，纳入基线时年龄≥45岁且无糖尿病的成年人。根据血清肌酐和胱抑素C水平计算肌肉减少症指数，并通过随访调查评估新发糖尿病情况。采用Cox比例风险回归模型分析肌肉减少症指数与新发糖尿病之间的关联，并对潜在混杂因素进行校正，报告风险比（HR）及95%置信区间（95%CI）。
在平均5.0年的随访期内，共记录到501例新发糖尿病病例。分析共纳入7718名参与者。中位年龄为60岁，男性占46.2%。在平均5.0年的随访期内，识别出501例新发糖尿病病例。校正协变量后，与最低四分位数组的参与者相比，第二、第三和第四四分位数组参与者相应的糖尿病HR（95%CI）分别为0.930（95%CI 0.724-1.193；P = 0.567）；0.892（95%CI 0.685-1.162；P = 0.398），0.869（95%CI 0.657-1.150；P = 0.327）。限制立方样条曲线显示，随着肌肉减少症指数升高，发病率降低。
本研究为中国提供了关于基于血清肌酐和胱抑素C水平的肌肉减少症指数与中老年人群新发糖尿病之间关联的全国性纵向证据。我们的研究结果表明，肌肉减少症指数可能是预测该人群糖尿病风险的一个有用生物标志物。
