Table 2.
General characteristics of participants with type 2 diabetes mellitus in the subgroups accordingly to sarcopenia, GNRI, and CONUT.
| Sarcopenia – | Sarcopenia + | GNRI < 105 | GNRI ≥105 | CONUT < 2 | CONUT ≥2 | ||||
|---|---|---|---|---|---|---|---|---|---|
| Parameters | n = 438 | n = 41 | P | n = 111 | n = 368 | P | n = 210 | n = 135 | P |
| Age, years | 70 [60, 75] | 80 [74, 86] | < 0.001 | 73 [70, 79] | 69 [59, 75] | < 0.001 | 68 [57, 74] | 72 [63, 79] | 0.003 |
| Men, n (%) | 243 (55.5) | 21 (51.2) | 0.600 | 65 (58.6) | 199 (54.1) | 0.405 | 105 (50.0) | 78 (57.8) | 0.158 |
| Duration of diabetes, years | 16 [11, 22] | 21 [14, 28] | 0.013 | 18 [11, 26] | 16 [11, 22] | 0.041 | 15 [9, 21] | 18 [12, 24] | 0.006 |
| Anthropometry | |||||||||
| Body weight, kg | 66.6 [58.1, 79.5] | 51.8 [46.7, 56.7] | < 0.001 | 53.3 [47.7, 58.9] | 69.4 [60.9, 81.9] | < 0.001 | 67.4 [57.6, 82.9] | 63.6 [54.5, 77.1] | 0.016 |
| BMI, kg/m2 | 25.7 [22.8, 29.6] | 22.0 [20.5, 23.9] | < 0.001 | 20.9 [19.8, 21.9] | 27.1 [24.3, 30.8] | < 0.001 | 26.5 [23.3, 31.0] | 25.3 [21.9, 28.3] | 0.011 |
| Systolic blood pressure, mmHg | 132 ± 17 | 130 ± 19 | 0.550 | 131 [118, 142] | 132 [121, 143] | 0.133 | 133 ± 18 | 133 ± 16 | 0.764 |
| Diastolic blood pressure, mmHg | 74 ± 12 | 67 ± 10 | < 0.001 | 71 [64, 79] | 74 [67, 82] | 0.005 | 74 ± 12 | 74 ± 11 | 0.673 |
| Nutritional indices | |||||||||
| GNRI | 112 [106, 120] | 101 [96, 106] | < 0.001 | 100 [96, 102] | 115 [110, 122] | < 0.001 | 114 [106, 122] | 109 [102, 115] | < 0.001 |
| Range | 85–167 | 87–118 | 85–104 | 105–167 | 93–166 | 85–167 | |||
| GNRI < 98, n (%) | 30 (6.8) | 13 (31.7) | < 0.001 | 43 (38.7) | 0 (0) | < 0.001 | 15 (7.1) | 20 (14.8) | 0.021 |
| GNRI < 105, n (%) | 85 (19.4) | 26 (63.4) | < 0.001 | 43 (20.5) | 38 (28.1) | 0.101 | |||
| CONUT, points | 1.0 [0.0, 2.0] | 1.0 [1.0, 3.0] | 0.281 | 1.0 [0.5, 2.5] | 1.0 [1.0, 2.0] | 0.107 | 1.0 [0.0, 1.0] | 2.0 [2.0, 3.0] | < 0.001 |
| Range | 0–6 | 0–4 | 0–6 | 0–5 | 0–1 | 2–6 | |||
| CONUT ≥ 2, n (%) | 122 (38.7) | 13 (43.3) | 0.622 | 38 (46.9) | 97 (36.7) | 0.101 | |||
| Indices for sarcopenia | |||||||||
| Skeletal muscle index, kg/m2 | 7.2 [6.4, 8.0] | 5.6 [5.3, 6.4] | < 0.001 | 6.3 [5.6, 6.9] | 7.4 [6.5, 8.1] | < 0.001 | 7.2 [6.3, 8.1] | 7.0 [6.2, 7.9] | 0.277 |
| Handgrip strength, kg | 31.5 [24.0, 39.5] | 17.5 [14.5, 22.3] | < 0.001 | 26.0 [19.0, 33.0] | 31.5 [23.5, 40.4] | < 0.001 | 29.3 [22.0, 40.0] | 29.0 [22.5, 37.5] | 0.679 |
| Walking speed, m/s | 1.54 [1.43, 1.82] | 1.25 [1.11, 1.43] | < 0.001 | 1.54 [1.33, 1.67] | 1.54 [1.33, 1.82] | 0.286 | 1.54 [1.33, 1.67] | 1.54 [1.33, 1.67] | 0.747 |
| Low SMI, n (%) | 59 (13.5) | 41 (100) | < 0.001 | 24 (55.8) | 76 (17.4) | < 0.001 | 36 (17.1) | 33 (24.4) | 0.098 |
| Low handgrip, n (%) | 44 (10.0) | 41 (100) | < 0.001 | 33 (29.7) | 52 (14.1) | < 0.001 | 35 (16.7) | 31 (23.0) | 0.147 |
| Low walking speed, n (%) | 16 (3.7) | 6 (14.6) | 0.001 | 5 (4.5) | 17 (4.6) | 0.960 | 10 (4.8) | 7 (5.2) | 0.859 |
| Sarcopenia, n (%) | 0 (0) | 41 (100) | 26 (23.4) | 15 (4.1) | < 0.001 | 17 (8.1) | 13 (9.6) | 0.622 | |
| Comorbidities | |||||||||
| Retinopathy, n (%) | 119 (27.2) | 11 (26.8) | 0.120 | 35 (31.5) | 95 (25.9) | 0.241 | 55 (26.2) | 37 (27.4) | 0.803 |
| eGFR < 60 ml/min/1.73m2, n (%) | 191 (43.6) | 21 (51.2) | 0.348 | 49 (44.1) | 163 (44.4) | 0.960 | 84 (40.0) | 70 (51.9) | 0.031 |
| Hypertension, n (%) | 370 (84.5) | 33 (80.5) | 0.504 | 80 (72.1) | 323 (87.7) | < 0.001 | 177 (84.3) | 117 (86.7) | 0.543 |
| Dyslipidemia, n (%) | 374 (85.4) | 35 (85.4) | 0.997 | 78 (70.3) | 331 (89.9) | < 0.001 | 182 (86.7) | 113 (83.7) | 0.445 |
| Coronary heart disease, n (%) | 68 (15.5) | 6 (14.6) | 0.880 | 11 (9.9) | 63 (17.1) | 0.065 | 25 (11.9) | 23 (17.0) | 0.179 |
| Stroke, n (%) | 33 (7.5) | 7 (17.1) | 0.035 | 8 (7.2) | 32 (8.7) | 0.619 | 17 (8.1) | 11 (8.1) | 0.986 |
| Life habits | |||||||||
| Regular walking, n (%) | 111 (25.5) | 7 (17.5) | 0.265 | 27 (24.8) | 91 (24.8) | 0.996 | 46 (22.1) | 25 (18.7) | 0.441 |
| Current or ex-smoking, n (%) | 235 (53.7) | 19 (46.3) | 0.370 | 19 (46.3) | 235 (53.7) | 0.370 | 114 (54.3) | 67 (49.6) | 0.398 |
| Current or ex-drinking, n (%) | 190 (43.4) | 14 (34.1) | 0.253 | 14 (34.1) | 190 (43.4) | 0.253 | 82 (39.0) | 60 (44.4) | 0.320 |
| Blood measurements | |||||||||
| Albumin, g/dL | 4.3 [4.1, 4.5] | 4.0 [3.8, 4.3] | < 0.001 | 4.1 [3.8, 4.2] | 4.3 [4.1, 4.5] | < 0.001 | 4.3 [4.1, 4.5] | 4.2 [3.9, 4.4] | 0.004 |
| AST, U/L | 21 [17, 28] | 21 [18, 26] | 0.779 | 21 [17, 27] | 21 [17, 28] | 0.683 | 20 [17, 28] | 22 [18, 29] | 0.057 |
| ALT, U/L | 19 [14, 29] | 16 [13, 23] | 0.064 | 16 [11, 23] | 20 [14, 31] | < 0.001 | 19 [14, 30] | 18 [12, 30] | 0.172 |
| Fasting plasma glucose, mg/dL | 131 [118, 154] | 130 [117, 150] | 0.842 | 129 [114, 151] | 132 [118, 154] | 0.223 | 131 [117, 154] | 132 [120, 155] | 0.658 |
| Glycated hemoglobin, % | 6.9 [6.4, 7.5] | 6.8 [6.3, 7.4] | 0.429 | 6.8 [6.4, 7.4] | 6.9 [6.4, 7.5] | 0.747 | 6.9 [6.4, 7.6] | 6.9 [6.4, 7.4] | 0.172 |
| LDL-cholesterol, mg/dL | 102 [84, 119] | 86 [78, 107] | 0.024 | 97 [81, 114] | 102 [83, 120] | 0.105 | 110 [94, 129] | 87 [75, 103] | < 0.001 |
| HDL cholesterol, mg/dL | 54 [46, 62] | 51 [43, 71] | 0.940 | 55 [44, 70] | 53 [46, 62] | 0.097 | 56 [46, 64] | 50 [44, 62] | 0.011 |
| Triglycerides, mg/dL | 104 [73, 154] | 105 [70, 147] | 0.531 | 82 [60, 129] | 109 [78, 160] | < 0.001 | 117 [84, 179] | 90 [66, 132] | < 0.001 |
| Creatinine, mg/dl | 0.84 [0.69, 1.01] | 0.80 [0.68, 0.97] | 0.409 | 0.83 [0.68, 1.03] | 0.83 [0.69, 0.99] | 0.898 | 0.82 [0.67, 1.00] | 0.84 [0.71, 1.06] | 0.117 |
| eGFR, ml/min/1.73 m2 | 63.3 [51.1, 76.2] | 59.9 [49.7, 73.6] | 0.491 | 62.7 ± 19.7 | 63.3 ± 17.8 | 0.663 | 64.9 [50.9, 77.6] | 59.5 [48.8, 74.9] | 0.092 |
| Glucose-lowering drugs | |||||||||
| Insulin, n (%) | 121 (27.6) | 11 (26.8) | 0.913 | 43 (38.7) | 89 (24.2) | 0.003 | 53 (25.2) | 45 (33.3) | 0.104 |
| GLP-1 receptor agonist, n (%) | 34 (7.8) | 0 (0) | 0.064 | 4 (3.6) | 30 (8.2) | 0.102 | 15 (7.1) | 9 (6.7) | 0.865 |
| Sulfonylurea, n (%) | 43 (9.8) | 6 (14.6) | 0.330 | 12 (10.8) | 37 (10.1) | 0.818 | 25 (11.9) | 11 (8.1) | 0.265 |
| Glinide, n (%) | 106 (24.2) | 12 (29.3) | 0.471 | 33 (29.7) | 85 (23.1) | 0.155 | 46 (21.9) | 31 (23.0) | 0.818 |
| Biguanide, n (%) | 221 (50.5) | 18 (43.9) | 0.422 | 46 (41.4) | 193 (52.4) | 0.042 | 104 (49.5) | 62 (45.9) | 0.514 |
| DPP4 inhibitor, n (%) | 268 (61.2) | 26 (63.4) | 0.779 | 67 (60.4) | 227 (61.7) | 0.802 | 123 (58.6) | 84 (62.2) | 0.499 |
| Pioglitazone, n (%) | 137 (31.3) | 10 (24.4) | 0.360 | 17 (15.3) | 130 (35.7) | < 0.001 | 64 (30.5) | 43 (31.9) | 0.787 |
| α-glucosidase inhibitor, n (%) | 79 (18.0) | 11 (26.8) | 0.168 | 29 (26.1) | 61 (16.6) | 0.024 | 40 (19.0) | 17 (12.6) | 0.115 |
| SGLT2 inhibitor, n (%) | 94 (21.5) | 6 (14.6) | 0.304 | 15 (13.5) | 85 (23.1) | 0.029 | 47 (22.4) | 27 (20.0) | 0.599 |
| Nutritional intake | |||||||||
| Total energy intake (kcal/day) | 2,012 [1,802–2,243] | 1,926 [1,781–2,184] | 0.157 | 2,039 [1,796–2,228] | 1,997 [1,799–2,240] | 0.941 | 1,951 [1,787–2,210] | 2,031 [1,800–2,278] | 0.187 |
| Total protein intake (g/day) | 78.2 [70.5–85.3] | 76.9 [68.3–83.8] | 0.323 | 78.7 [70.9–85.3] | 77.7 [70.2–85.2] | 0.549 | 77.0 [69.3–84.3] | 79.0 [70.6–85.4] | 0.133 |
| Total fat intake (g/day) | 58.2 [54.8–63.6] | 57.3 [54.1–62.9] | 0.404 | 59.3 [54.8–63.8] | 58.0 [54.7–63.6] | 0.639 | 57.3 [51.9–−54.8] | 59.2 [55.3–63.7] | 0.090 |
| Total carbohydrate intake (g/day) | 260 [245–296] | 250 [241–292] | 0.170 | 257 [243–297] | 260 [245–295] | 0.700 | 255 [242–293] | 262 [246–302] | 0.165 |
| Protein energy (%) | 15.4 [15.1–15.8] | 15.5 [15.2–15.7] | 0.756 | 15.5 [15.1–15.9] | 15.4 [15.1–15.8] | 0.220 | 15.4 [15.1–15.7] | 15.3 [15.1–15.8] | 0.843 |
| Fat energy (%) | 27.0 [25.6–27.5] | 27.3 [25.9–27.6] | 0.172 | 27.2 [25.7–27.6] | 27.0 [25.6–27.5] | 0.616 | 27.2 [25.6–27.5] | 27.0 [25.5–27.5] | 0.956 |
| Carbohydrate energy (%) | 53.7 [52.0–55.0] | 53.5 [51.8–54.6] | 0.359 | 53.6 [51.2–54.7] | 53.7 [52.0–55.0] | 0.234 | 53.8 [52.4–55.0] | 53.7 [51.9–54.8] | 0.492 |
Data are expressed as median [25%, 75%], Mean ± SD, or number (%). GNRI, geriatric nutritional risk index; CONUT, controlling nutritional status; P, provability; BMI, body mass index; SMI, skeletal mass index; AST, aspartate aminotransferase; ALT, alanine aminotransferase; LDL, low-density lipoprotein; HDL, high-density lipoprotein; eGFR: estimated glomerular filtration rate; GLP-1, glucagon-like peptide-1; SGLT2,sodium-glucose cotransporter 2.