# Determinants and predictive performance of reduced muscle mass in elderly patients with type 2 diabetes: a retrospective study

## TL;DR

This study identifies risk factors for low muscle mass in elderly type 2 diabetes patients and finds BMI is a strong predictor.

## Contribution

The study identifies gender-specific risk factors and shows BMI's strong predictive power for reduced muscle mass in elderly T2DM patients.

## Key findings

- Age, BMI, and DSPN are independently linked to low muscle mass in elderly T2DM patients.
- Insulin use lowers risk in men, while sulfonylurea use increases risk in women.
- BMI has the highest discriminatory ability for identifying reduced muscle mass.

## Abstract

This study aimed to identify risk factors for low muscle mass among elderly patients with type 2 diabetes mellitus (T2DM).

In this cross-sectional study, 521 elderly T2DM patients were enrolled, comprising 253 with low muscle mass and 268 with normal muscle mass. Clinical characteristics were compared between groups and stratified by gender. Binary logistic regression was conducted to identify risk factors for muscle mass reduction. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of relevant factors for low muscle mass.

Patients with reduced muscle mass were older and had lower body mass index (BMI) and waist-to-hip ratio (WHR). Age, BMI, and diabetic sensorimotor polyneuropathy (DSPN) were independently associated with low muscle mass in elderly T2DM patients across both genders. The odds ratios (P < 0.05) were 1.098, 0.590, and 2.334 for males, and 1.063, 0.681, and 3.621 for females, respectively. We also found insulin use was independently associated with a lower risk of low muscle mass in men, whereas sulfonylurea use was associated with a higher risk in women. Among the significant variables, BMI demonstrated the greatest discriminatory ability for identifying reduced muscle mass, with AUCs of 0.815(95%CI:0.763-0.859) in men and 0.763(95%CI:0.705-0.814) in women.

Older age, lower BMI, DSPN, and the use of insulin and sulfonylureas were independently associated with reduced muscle mass in elderly patients with T2DM. BMI demonstrated the strongest discriminative capacity among all significant variables.