Sarcopenia and atherosclerosis is age-related disorders and its prevalence is common in individuals with type 2 diabetes. Several epidemiologic studies proposed that sarcopenia was associated with central obesity, insulin resistance, and type 2 diabetes. However, there was only few studies for investigating associations between sarcopenia and atherosclerosis. In this study we examined relationships of sarcopenia with carotid intima-media thickness (CIMT) in Korean male patients with type 2 diabetes.
A total of 262 male subjects with type 2 diabetes were enrolled. B-mode ultrasound was used for measuring CIMT. High CIMT was defined as ≥ 75 percentiles of maximum IMT in common carotid artery. Appendicular skeletal muscle mass (ASM) was assessed using dual energy X-ray absorptiometry (DEXA). We defined sarcopenia as follows: ASM (kg)/body mass index (BMI: kg/m2) <0.789.
Patients with sarcopenia were more likely to be elderly and hypertensive, have higher values of BMI, waist circumference (WC), triglycerides (TG), mean CIMT, and maximum CIMT, and have lower values of HDL cholesterol and estimated glomerular filtration rate (eGFR) compared to those without sarcopenia. High CIMT was more common in subjects with sarcopenia than those without sarcopenia (Non-sarcopenic vs. Sarcopenic = 19.9% vs. 40.8%, p=0.001). Maximum CIMT was positively correlated with age, WC, and BMI, but showed negative correlations with HDL and eGFR. ASM/BMI was significantly associated with maximum CIMT (r2=0.074, p<0.001). The odds ratio (OR) of sarcopenia for high CIMT after adjusted for age was 2.286 (95% CI = 1.228-4.252, p<0.01). The OR remained significant after further adjustments for WC, BMI, hypertension, TG, HDL cholesterol, and eGFR (p<0.05).
We showed that sarcopenia was significantly associated with CIMT in Korean male patients with type 2 diabetes independent of age, WC, BMI, hypertension, TG, HDL cholesterol, and eGFR. To explore causal relationships between sarcopenia and atherosclerosis, further studies are needed.

Association of sarcopenia with carotid intima-media thickness in Korean male patients with type 2 diabetes