Midlife and late-life diabetes and sarcopenia in a general older Japanese population: The Hisayama Study

Abstract

Aims/introduction: To investigate the association between midlife or late-life diabetes and the development of sarcopenia in an older Japanese population.

Materials and methods: A total of 824 Japanese residents aged 65 to 84 years without sarcopenia were followed up from 2012 to 2017. Sarcopenia was determined following the Asian Working Group for Sarcopenia definition. The time of diabetes diagnosis was classified as midlife or late-life diabetes by the age at first diagnosis of diabetes (< 65 or ≥ 65 years) based on annual health checkups data over the past 24 years. The duration of diabetes was categorized into three groups of < 10, 10-15, and > 15 years. The odds ratios of incident sarcopenia according to the diabetic status were estimated using a logistic regression analysis.

Results: During follow-up, 47 subjects developed sarcopenia. The multivariable-adjusted odds ratio for incident sarcopenia was significantly greater in subjects with diabetes at baseline than in those without it (odds ratio 2.51, 95% confidence interval 1.26-5.00). Subjects with midlife diabetes had a significantly greater risk of incident sarcopenia, whereas no significant association between late-life diabetes and incident sarcopenia was observed. With a longer duration of diabetes, the risk of incident sarcopenia increased significantly (P for trend = 0.002).

Conclusions: The present study suggests that midlife diabetes and a longer duration of diabetes are significant risk factors for incident sarcopenia in the older population. Preventing diabetes in midlife may reduce the risk of the development of sarcopenia in later life.

Keywords: Diabetes; Prospective cohort study; Sarcopenia.

Figure 1

Flow chart of the study sample selection.

Figure 2

Multivariable‐adjusted odds ratios for the development of sarcopenia by the duration of diabetes. Values on each bar are shown as odds ratios (95% confidence intervals). Odds ratios were adjusted for age, sex, body mass index, education level, hypertension, estimated glomerular filtration rate, dementia, activities of daily living disability, history of cardiovascular disease or cancer, history of fracture, regular exercise habits, current smoking, current drinking, total energy intake, and number of health checkup visits between 1988 and 2012. *P < 0.01 vs. no diabetes.

Figure 3

Multivariable‐adjusted odds ratios for the development of sarcopenia by the age at first diagnosis of diabetes. Values on each bar are shown as odds ratios (95% confidence intervals). Odds ratios were adjusted for age, sex, body mass index, education level, hypertension, estimated glomerular filtration rate, dementia, activities of daily living disability, history of cardiovascular disease or cancer, history of fracture, regular exercise habits, current smoking, current drinking, total energy intake, and number of health checkup visits between 1988 and 2012. *P < 0.01 vs. no diabetes.