Abstract
The causal relationship between low muscle mass and development of chronic kidney disease (CKD) is uncertain in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association between low muscle mass or sarcopenic obesity and the risk of incident CKD in patients with T2DM. A total of 3,123 patients with T2DM with preserved renal function were followed up for incident CKD. Skeletal muscle mass was estimated from bioelectrical impedance analysis. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73m2. Sarcopenic obesity was defined as the coexistence of sarcopenia and abdominal obesity. During 8.9 years of follow-up, 530 (17.0%) patients developed incident CKD. When subjects were divided into three groups based on sex-specific tertiles, lower muscle mass was not associated with an increased risk of incident CKD after adjustment for risk factors. However, when patients were divided into four groups according to the presence of sarcopenia and obesity, sarcopenic obesity was associated with an increased risk of incident CKD (adjusted hazard ratio 1.77; 95% confidence interval 1.24-2.51; p=0.001) compared to the other groups. Sarcopenic obesity, but not low muscle mass alone, may increase the risk of CKD in patients with T2DM.
Effect of Low Skeletal Muscle Mass and Sarcopenic Obesity on Chronic Kidney Disease in Patients with Type 2 Diabetes