Sarcopenia as a predictor of negative health outcomes in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.

BACKGROUND: Sarcopenia represents a considerable public health issue and is associated with increased mortality and complication rates in patients with type 2 diabetes mellitus (T2DM). Existing evidence regarding adverse outcomes in patients with T2DM and sarcopenia is currently scattered and limited, and comprehensive evidence is lacking. METHODS: A comprehensive search of Embase, PubMed, Scopus, and Web of Science was conducted to identify relevant studies that assessed the impact of sarcopenia on mortality, cardiovascular disease (CVD), and complications in individuals with T2DM. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale and the Joanna Briggs Institute Critical Appraisal tool. The pooled hazard ratios and odds ratios, along with their corresponding 95% confidence intervals for mortality, CVD, and complication estimates, were analyzed. RESULTS: Fifteen studies were included in the meta-analysis. The overall risk of bias across the studies was low. Patients with T2DM and sarcopenia had a considerably elevated risk of mortality, with a pooled hazard ratio of 1.72 (95% CI = 1.28-2.32). Similarly, sarcopenia was associated with an increased hazard ratio for CVD of 1.94 (95% CI = 1.67-2.25). Furthermore, sarcopenia was associated with an elevated risk of developing diabetic complications, as evidenced by a hazard ratio of 1.12 (95% CI = 1.09-1.15) and an odds ratio of 2.49 (95% CI = 1.53-4.05). CONCLUSIONS: Sarcopenia is predictive of adverse outcomes, including mortality, CVD, and diabetic complications, in patients with T2DM. Our findings underscore the clinical imperative for integrating sarcopenia assessment into routine T2DM management to facilitate early risk stratification.