Lipoprotein profile as a predictor of type 2 diabetes with sarcopenia: A cross-sectional study

Purpose This study investigated the relationship between lipoprotein profiles and sarcopenia in patients with type 2 diabetes mellitus (T2DM). The objective is to provide a solid theoretical foundation and treatment strategies for clinical prevention and management of diabetes, particularly in individuals with concurrent sarcopenia. Methods In this study, we selected inpatients aged over 60 years diagnosed with T2DM who were admitted to the Department of Geriatrics at Qinghai University Affiliated Hospital from July 2023 to June 2024 as research subjects. We collected general patient data, including gender, age, ethnicity, height, weight, and calculated body mass index (BMI). Key indices measured included glycated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoproteins A and B (ApoA and ApoB), phospholipids, lipoprotein(a) [Lp(a)], very low-density lipoprotein (VLDL), and free fatty acids (FFA). Additionally, we assessed limb skeletal muscle mass, grip strength, walking speed, and calculated the appendicular skeletal muscle mass index (ASMI). Based on Asian diagnostic criteria for sarcopenia, patients were categorized into a non-sarcopenic group or a group with T2DM combined with sarcopenia. Baseline laboratory data along with ASMI measurements, grip strength assessments, and walking speeds were statistically analyzed for both groups. Results Compared with T2DM patients without sarcopenia, the levels of HbA1c, Lp(a), FFA, serum albumin, TC, TG, HDL-C, ApoA and VLDL in type 2 diabetic patients with sarcopenia were statistically significant (all P  < 0.05). When multivariate adjustments were made for these clinical features, age (OR = 1.18, 95%CI: 1.11–1.25, P  < 0.001), BMI (OR = 0.81, 95%CI: 0.72–0.91, P  < 0.001), ApoA (OR = 0.04, 95%CI: 0.00-0.98, P  = 0.048), Lp(a) > 15.5 mg/dL (OR = 3.27, 95%CI: 1.58–6.80, P  = 0.001) and FFA > 0.48 g/L (OR = 4.06, 95%CI: 1.96–8.43, P  < 0.001) were independent predictors of diabetes mellitus with sarcopenia. ROC curve analysis showed that free fatty acids (AUC = 0.721, 95%CI: 0.660–0.782, P  < 0.001) in T2DM with sarcopenia has good predictive value judgment. Conclusion Age, BMI, ApoA, Lp(a), and FFA were independent predictors of T2DM with sarcopenia. Serum free fatty acids have a good predictive value in the judgment of T2DM complicated with sarcopenia.