Diabetes and Sarcopenic Obesity: Pathogenesis, Diagnosis, and Treatments

Abstract

Sarcopenic obesity and diabetes are two increasing health problems worldwide, which both share many common risk factors, such as aging, and general obesity. The pathogenesis of sarcopenic obesity includes aging, physical inactivity, malnutrition, low-grade inflammation, insulin resistance, and hormonal changes. Nevertheless, there are two major reasons to cause diabetes: impaired insulin secretion and impaired insulin action. Furthermore, the individual diagnosis of obesity and sarcopenia should be combined to adequately define sarcopenic obesity. Also, the diagnosis of diabetes includes fasting plasma glucose test (FPG), 2-h oral glucose tolerance test (OGTT), glycated hemoglobin (A1C), and random plasma glucose coupled with symptoms. Healthy diet and physical activity are beneficial to both sarcopenic obesity and diabetes, but there are only recommended drugs for diabetes. This review consolidates and discusses the latest research in pathogenesis, diagnosis, and treatments of diabetes and sarcopenic obesity.

Keywords: aging; diabetes; inflammation; insulin resistance; sarcopenic obesity.

Figure 1

This simplified schematic diagram depicts the vicious cycle of unhealthy lifestyle which can eventually lead to diabetes and sarcopenic obesity as well as other adverse metabolic conditions.

Figure 2

This figure illustrates the main mechanism of impaired insulin secretion that glucose toxicity, lipid toxicity, immunoinflammatory response, and oxidative stress lead to β cell damage. ANT, Adenine nucleotide translocator.

Figure 3

This figure illustrates the main mechanism of impaired insulin action that excessive insulin secretion, adipocytes, and inflammatory factors directly affect IR or indirectly interfere the insulin signaling pathway.