Risk Factors for Sarcopenia in the Elderly with Type 2 Diabetes Mellitus and the Effect of Metformin

Aims. Sarcopenia is a common condition in older individuals, especially in the elderly with type 2 diabetes mellitus (T2DM). The aim of the present study was to examine the risk factors for sarcopenia in elderly individuals with T2DM and the effects of metformin. Methods. A total of 1732 elderly with T2DM were recruited to this cross-sectional observational study, and we analyzed the data using logistic regression analyses. Skeletal muscle mass, grip strength, and usual gait speed were measured to diagnose sarcopenia according to the criteria of the Asian Working Group for Sarcopenia, combined with expert consensus on sarcopenia in China. Results. The overall prevalence of sarcopenia was 10.37% of the participants. In the multivariate analysis, sex, age, educational level, and BMI were risk factors for sarcopenia, with women more likely to develop sarcopenia relative to men ( $\text{OR}=2.539$ , 95% $\text{CI}=1.475$ –4.371; $P<0.05$ ). We observed that sarcopenia increased with age and decreased with increasing BMI and educational level ( $P<0.05$ ). Participants who took metformin alone or combined with other drugs exhibited a lower risk for sarcopenia than those who took no medication ( $\text{OR}=0.510$ , 95% $\text{CI}=0.288$ –0.904 and $\text{OR}=0.398$ , 95% $\text{CI}=0.225$ –0.702, respectively; $P<0.05$ ). Conclusions. We showed that being female and at an older age, lower educational level, and lower BMI were risk factors for sarcopenia in elderly T2DM and that metformin acted as a protective agent against sarcopenia in these patients.