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This study examined the correlation between sarcopenia and the incidence of CVD, including stroke, heart failure (HF), and myocardial infarction (MI), in individuals with type 2 diabetes (T2D). Sarcopenia was associated with a twofold increase in the risk of incident CVD in the minimally adjusted model. After adjustment, the risk of CVD was 89% higher in individuals with sarcopenia. Furthermore, individuals with sarcopenia were at a higher risk of developing stroke, HF, and MI (HR, 1.90, 2.59, and 1.56, respectively). Except for the association with MI, these associations were independent of BMI. People with sarcopenia were likely to experience a similar incidence of CVD, stroke, and HF 12 to 15 years earlier than those without sarcopenia.
This study suggests that sarcopenia may increase the risk of developing CVD in people with T2D, which may occur earlier than in those without sarcopenia. Therefore, screening for and prevention of sarcopenia in patients with T2D can be a helpful approach to prevent the complications of CVD.
To investigate the association of sarcopenia with cardiovascular disease (CVD) incidence in people with type 2 diabetes.
MATERIALS AND METHODS
A prospective cohort study with 11 974 White European UK Biobank participants with type 2 diabetes, aged 40-70 years, included. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People as either non-sarcopenic or sarcopenic. Outcomes included CVD, stroke, heart failure (HF) and myocardial infarction (MI). The association between sarcopenia and the incidence of outcomes was investigated using Cox proportional hazard models adjusted for sociodemographic and lifestyle factors. The rate advancement period was used to estimate the time period by which CVD is advanced because of sarcopenia.
Over a median follow-up of 10.7 years, 1957 participants developed CVDs: 373 had a stroke, 307 had an MI and 742 developed HF. Compared with non-sarcopenia, those with sarcopenia had higher risks of CVD (HR 1.89 [95% CI 1.61; 2.21]), HF (HR 2.59 [95% CI 2.12; 3.18]), stroke (HR 1.90 [95% CI 1.38; 2.63]), and MI (HR 1.56 [95% CI 1.04; 2.33]) after adjustment for all covariates. Those with sarcopenia had CVD incidence rates equivalent to those without sarcopenia who were 14.5 years older. Similar results were found for stroke, HF and MI.
In people with type 2 diabetes, sarcopenia increased the risk of developing CVD, which might occur earlier than in those without sarcopenia. Therefore, sarcopenia screening and prevention in patients with type 2 diabetes may be useful to prevent the complications of CVD.