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Review
. 2023 May 30:16:1541-1554.
doi: 10.2147/DMSO.S410834. eCollection 2023.

The Association Between Sarcopenia and Diabetes: From Pathophysiology Mechanism to Therapeutic Strategy

Huiling Chen  1   2 , Xiaojing Huang  2 , Meiyuan Dong  2 , Song Wen  2 , Ligang Zhou  2 , Xinlu Yuan  2
Affiliations
Review

The Association Between Sarcopenia and Diabetes: From Pathophysiology Mechanism to Therapeutic Strategy

Huiling Chen et al. Diabetes Metab Syndr Obes. .

Abstract

Diabetes and sarcopenia are emerging as serious public health issues. Sarcopenia, an age-related disorder characterized by loss of skeletal muscle mass and function, is recognized as a new complication in elderly patients with type 2 diabetes mellitus (T2DM). Type 2 diabetes is characterized by insulin resistance, chronic inflammation, accumulation of advanced glycation products and increased oxidative stress, which can negatively affect skeletal muscle mass, strength and function leading to sarcopenia. There is a mutual interrelationship between T2DM and sarcopenia in light of pathophysiology mechanism and long-term outcome. T2DM will accelerate the decline of muscle mass and function, which will in turn lead to glucose metabolism disorders, reduced physical activity and the risk of diabetes. However, the specific mechanism involved has not been thoroughly studied. Therefore, this review aims to explore the pathophysiology and therapeutic strategy related to sarcopenia and diabetes and provide insight for future investigations, which is of great significance for improving the quality of life in the elderly with diabetes and concurrently reducing the incidence of related complications.

Keywords: gut microbiota; inflammation; insulin resistance; sarcopenia; therapeutic strategy; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The converging risk factors between sarcopenia and diabetes. Sarcopenia was variably associated with some risk factors, notably age (marked with*).
Figure 2
Figure 2
The possible mechanism of diabetes and sarcopenia. In diabetes, insulin resistance inhibits protein synthesis pathways leading to decreased muscle mass. The increase of inflammatory cytokines, ROS, Myostatin and Calpain related to diabetes will not only inhibit the protein synthesis pathway, but also increase the protein catabolism pathway, thereby causing further decline in muscle mass. Hyperglycemia causes decrease of WWP1, which leads to increase of KLF15, which further aggravates the protein catabolic pathway and leads to muscle atrophy.
See this image and copyright information in PMC

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