Sarcopenic obesity is associated with a faster decline in renal function in people with type 2 diabetes.

Aim: To evaluate the association between sarcopenic obesity and the decline in estimated GFR in people with type 2 diabetes. Methods: We enrolled 745 people with type 2 diabetes (mean age 64.6 years, 53.6% men). Body composition was evaluated using dual‐energy X‑ray absorptiometry. Skeletal muscle index, calculated as appendicular non‐fat mass (kg) divided by height squared (m2), was used to determine sarcopenia. Sarcopenic obesity was defined as the coexistence of sarcopenia and a ratio of android to gynoid fat mass greater than the median values in each gender. The association of sarcopenic obesity both with the annual rate of decline in estimated GFR and a >30% decline in estimated GFR was evaluated using multivariate linear regression models and Cox proportional hazard models, respectively. Results: Participants with sarcopenic obesity were at an increased risk of a high annual rate of decline in estimated GFR, even after adjustment for the confounding variables (standardized β = −0.228, P <0.001). Sarcopenic obesity was also significantly associated with risk of a >30% decline in estimated GFR (hazard ratio 4.52, 95% CI 2.16–9.47; P < 0.01) in multivariate model. Conclusions: Sarcopenic obesity evaluated by dual energy X‑ray absorptiometry is associated with a faster decline in renal function in people with type 2 diabetes. What's new?: People with sarcopenic obesity, defined as the coexistence of sarcopenia and obesity, were reported to have an extremely high risk of metabolic abnormalities including insulin resistance, metabolic syndrome and diabetes; however, the impact of sarcopenic obesity on decline in renal function has not been fully established.This study demonstrated that sarcopenic obesity was significantly associated with a high annual rate of estimated GFR (eGFR) decline and a >30% decline in eGFR in both men and women with type 2 diabetes. [ABSTRACT FROM AUTHOR]