Clinical characteristics of Sarcopenic obesity in Japanese people with type 2 diabetes: A post hoc analysis of the sub‐cohort iDIAMOND study

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AIMS/INTRODUCTION: Sarcopenic obesity, defined by reduced muscle mass and strength with excess adiposity, is poorly characterized in Japanese individuals with type 2 diabetes (T2D). This post hoc analysis assessed its prevalence and associations with physical quality of life (QOL), walking ability, and falls. MATERIALS AND METHODS: This post hoc cross-sectional analysis used sub-cohort data from the Impact of Diabetes Mellitus on Dynapenia (iDIAMOND) study, conducted across seven medical centers. The study included 930 individuals aged 40-75 years (527 with T2D and 403 without diabetes [non-D]). Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria, defined as low grip strength and/or slow gait speed with low skeletal muscle mass index. Sarcopenic obesity was diagnosed using the Japanese Working Group on Sarcopenic Obesity criteria, defined as high body mass index (BMI) or waist circumference combined with low grip strength, low skeletal muscle mass relative to BMI, and high body fat percentage. Participants meeting neither criterion were classified as robust. RESULTS: Among participants aged 40-75 years, sarcopenic obesity was observed in 4.9% of those with T2D and 0.5% of non-D individuals (P < 0.001). In the T2D group, sarcopenic obesity was associated with lower physical QOL, reduced physical activity, slow gait speed, and a high incidence of falls compared with the robust group. Multivariate logistic regression identified advanced age, high BMI, and reduced physical activity as independent correlates of sarcopenic obesity. CONCLUSIONS: Sarcopenic obesity is more prevalent in individuals with T2D and is associated with impaired physical QOL, reduced walking ability, and increased falls.

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