Irisin is a predictor of sarcopenic obesity in type 2 diabetes mellitus: a cross-sectional study
Kurutas, Ergul B.
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CitationOguz, A., Sahin, M., Tuzun, D., Kurutas, E. B., Ulgen, C., Bozkus, O., & Gul, K. (2021). Irisin is a predictor of sarcopenic obesity in type 2 diabetes mellitus: A cross-sectional study. Medicine, 100(26), e26529. https://doi.org/10.1097/MD.0000000000026529
Abstract We aimed to evaluate sarcopenia and sarcopenic obesity (SO) in patients with type 2 diabetes mellitus (T2DM), possible relationships with serum irisin and myostatin levels, and the effect of glycemic control on SO. Ninety T2DM patients were included in this a cross-sectional study. Sarcopenia was determined by evaluating muscle mass (bioelectrical impedance analysis), muscle strength (HGS), and gait speed (GS). Patients with muscle mass loss with functionally reduced muscle strength and/or performance were considered sarcopenic. In addition, participants were divided into 3 groups according to the FM (fat mass)/FFM (fat-free mass) ratio [group 1:5th-50th percentiles; group 2:50th-95th percentiles and group 3: ≥95 percentiles (sarcopenic obese)]. Irisin, myostatin levels and metabolic parameters were measured in all patients. The prevalence of sarcopenia and SO was 25.6% and 35.6%, respectively. Irisin levels were lower in sarcopenic patients, while glycosylated hemoglobin (A1c), body mass index (BMI), FM, and FM index were higher (P<.05). From group 1 to group 3, BMI, FM, FM index, GS, myostatin, and A1c increased, and muscle mass percentage, HGS, and irisin decreased (P<.05). A positive correlation was found between FM/FFM and myostatin and a negative correlation between FM/FFM and irisin (r=0.303, P=.004 vs. r= 0.491, P<.001). Irisin remained an important predictor of SO, even after adjusting for confounding variables (OR:1.105; 95% CI:0.965–1.338, P=.002). The optimal cut-off value for irisin to predict SO was 9.49 ng/mL (specificity=78.1%, sensitivity=75.8%). In addition, A1c was an independent risk factor for SO development (OR:1.358, P=.055). This study showed that low irisin levels (<9.49ng/mL) and poor glycemic control in T2DM patients were an independent risk factor, especially for SO. Abbreviations: A1c = Glycosylated hemoglobin, ALT = Alanine aminotransferase, ASM = Appendicular skeletal muscle mass, BIA = Bioelectrical empedans analysis, BMI = Body mass index, CC = Calf circumference, CI = Confidence Interval, Cr = Creatinine, CV = Coefficients of variability, ELISA = Enzyme-linked immunosorbent assay, FFM = Fat-free mass, FFMI = Fat-free mass index, FM = Fat mass, FMI = Fat mass index, GS = Gait speed, HC = Hip circumference, HDL-C = High density lipoprotein, HGS = Hand-grip strength, HPLC = High-pressure liquid chromatography, IR = Insulin resistance, LDL-C = Low density lipoprotein, MAC = Mid-arm circumference, OR = Odds Ratio, ROC = Receiver operating characteristic, SD = Standard deviation, SMI = Skeletal muscle index, SO = Sarcopenic obesity, T2DM = Type 2 diabetes mellitus, TG = Triglyceride, Total-C = Total cholesterol, WC = Waist circumference, WHR = Waist-to-hip ratio