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Ji CH, Huang XQ, Li Y, Muheremu A, Luo ZH, Dong ZH. The Relationship between physical activity, nutritional status, and sarcopenia in community- dwelling older adults with type 2 diabetes: a cross-sectional study. BMC Geriatr 2024; 24:506. [PMID: 38849763 PMCID: PMC11157920 DOI: 10.1186/s12877-024-05038-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 05/02/2024] [Indexed: 06/09/2024] Open
Abstract
AIM This study was conducted in Urumqi, Xinjiang, to assess the prevalence of sarcopenia and to determine the relationship between physical activity, nutritional status, and sarcopenia among community-dwelling patients with type 2 diabetes mellitus. METHODS Four hundred eight cases of older people patients with type 2 diabetes mellitus in the community in Urumqi, Xinjiang, from May to August 2022 were selected for a cross-sectional on-site survey, and general information questionnaires, clinical information surveys, physical function measurements, and criteria developed by the Asian sarcopenia working group in 2019 were selected for diagnosis of sarcopenia, and unifactorial and multifactorial binary Logistic regression were applied to analyze the influencing factors of T2DM combined with sarcopenia in patients with sarcopenia. RESULTS Among the 408 patients, 84 (20.6%) had sarcopenia, with a prevalence of 12.6%, 32.1%, and 51.9% in those aged 60-70, 71- 80, and 81 or older respectively. The prevalence increased significantly with age. Adjusting for variables, the study found that FFM of the Left Leg (OR: 0.710, 95% CI: 0.612-0.804, P = 0.024), FFM of the Right Arm (OR: 0.710, 95% CI: 0.612-0.804, P < 0.001), Age (OR: 1.246, 95% CI: 1.031-1.505, P = 0.023), Fasting Blood Glucose (OR: 1.649, 95% CI: 1.066-2.550, P = 0.025), and Post-Prandial Blood Glucose (OR: 1.455, 95% CI: 0.999-2.118, P = 0.025) were independent associated factors. An increase in MNA score (OR: 0.398, 95% CI: 0.244-0.6500, P < 0.001), ASMI (OR: 0.000, 95% CI: 0.00-0.01, P < 0.001) walking energy expenditure (MET-min) (OR: 0.998, 95% CI: 0.996-0.999, P = 0.001) reduced the prevalence of sarcopenia. CONCLUSION This study shows that increased age, increased skeletal muscle mass index, decreased right arm FFM, increased postprandial glucose, increased MNA scores, and increased walking energy expenditure (MET-min) were associated with type 2 diabetes with sarcopenia.
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Affiliation(s)
| | | | - Yue Li
- The Third People's Hospital of Chengdu, Chengdu, 610014, China
| | | | - Zhao-Hui Luo
- The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830002, China.
| | - Zheng-Hui Dong
- The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830002, China.
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Sohi YH, Golestani A, Panahi G, Tabatabaei-Malazy O, Khalagi K, Fahimfar N, Ostovar A, Sanjari M, Larijani B, Nabipour I. The association between anti-diabetic agents and osteoporosis, sarcopenia, and osteosarcopenia among Iranian older adults; Bushehr Elderly Health (BEH) program. Daru 2024; 32:145-159. [PMID: 38133840 PMCID: PMC11087384 DOI: 10.1007/s40199-023-00497-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Various risk factors are mentioned for osteoporosis, sarcopenia, and osteosarcopenia. Our aim is to assess the impacts of anti-diabetic drugs on these disorders. METHODS To perform this study, the participants' data was extracted from the Bushehr Elderly Health (BEH) program in Iran. Afterward, the data were categorized into three subgroups: osteoporosis, sarcopenia, and osteosarcopenia, based on WHO and European Working Group on Sarcopenia in Older People (EWGSOP-2) working group definitions. Demographic characteristics, anthropometric measures, past medical history, and current medications were recorded. Pearson chi-squared and simple/multiple logistic regression using Python (3.11.4) and R (4.3.1) programming software assessed the association between anti-diabetic agents and these bone disorders. RESULTS Out of 1995 participants, 820, 848, and 404 had osteoporosis, sarcopenia, or osteosarcopenia, respectively. Among all types of anti-diabetic drugs, a significant protective association between osteoporosis and consumption of second-generation sulfonylureas was found; Adjusted Odd Ratio (AOR) = 0.65 ([95% CI: 0.45-0.94], p-value = 0.023). No associations were found between sarcopenia and consumption of anti-diabetic agents. A significant association was observed between using Meglitinides and the risk of osteosarcopenia; AOR = 4.98 ([95% CI: 1.5-16.55], p-value = 0.009). CONCLUSION In conclusion, a protective association between consumption of second-generation sulfonylureas and osteoporosis was found. Moreover, a positive association was found between the consumption of meglitinides and osteosarcopenia. However, to support these findings, further studies are recommended.
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Affiliation(s)
- Yasmin Heydarzadeh Sohi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Golestani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghodratollah Panahi
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
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de Luis Román D, Gómez JC, García-Almeida JM, Vallo FG, Rolo GG, Gómez JJL, Tarazona-Santabalbina FJ, Sanz-Paris A. Diabetic Sarcopenia. A proposed muscle screening protocol in people with diabetes : Expert document. Rev Endocr Metab Disord 2024:10.1007/s11154-023-09871-9. [PMID: 38315411 DOI: 10.1007/s11154-023-09871-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVES To propose the grounds for "diabetic sarcopenia" as a new comorbidity of diabetes, and to establish a muscle screening algorithm proposal to facilitate its diagnosis and staging in clinical practice. METHOD A qualitative expert opinion study was carried out using the nominal technique. A literature search was performed with the terms "screening" or "diagnostic criteria" and "muscle loss" or "sarcopenia" and "diabetes" that was sent to a multidisciplinary group of 7 experts who, in a face-to-face meeting, discussed various aspects of the screening algorithm. RESULTS The hallmark of diabetic sarcopenia (DS) is muscle mass atrophy characteristic of people with diabetes mellitus (DM) in contrast to the histological and physiological normality of muscle mass. The target population to be screened was defined as patients with DM with a SARC-F questionnaire > 4, glycosylated haemoglobin (HbA1C) ≥ 8.0%, more than 5 years since onset of DM, taking sulfonylureas, glinides and sodium/glucose cotransporter inhibitors (SGLT2), as well as presence of chronic complications of diabetes or clinical suspicion of sarcopenia. Diagnosis was based on the presence of criteria of low muscle strength (probable sarcopenia) and low muscle mass (confirmed sarcopenia) using methods available in any clinical consultation room, such as dynamometry, the chair stand test, and Body Mass Index (BMI)-adjusted calf circumference. DS was classified into 4 stages: Stage I corresponds to sarcopenic patients with no other diabetes complication, and Stage II corresponds to patients with some type of involvement. Within Stage II are three sublevels (a, b and c). Stage IIa refers to individuals with sarcopenic diabetes and some diabetes-specific impairment, IIb to sarcopenia with functional impairment, and IIc to sarcopenia with diabetes complications and changes in function measured using standard tests Conclusion: Diabetic sarcopenia has a significant impact on function and quality of life in people with type 2 diabetes mellitus (T2DM), and it is important to give it the same attention as all other traditionally described complications of T2DM. This document aims to establish the foundation for protocolising the screening and diagnosis of diabetic sarcopenia in a manner that is simple and accessible for all levels of healthcare.
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Affiliation(s)
- Daniel de Luis Román
- Center Investigación of Endocrinology and Nutrition, University of Valladolid, Valladolid, Spain.
| | | | - José Manuel García-Almeida
- Clinical Management Unit of Endocrinology and Nutrition, Virgen de la Victoria Clinical Hospital, Málaga, Spain
| | | | | | - Juan José López Gómez
- Endocrinology and Nutrition Department, University Clinical Hospital of Valladolid, Valladolid, Spain
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Tack W, De Cock AM, Dirinck EL, Bastijns S, Ariën F, Perkisas S. Pathophysiological interactions between sarcopenia and type 2 diabetes: A two-way street influencing diagnosis and therapeutic options. Diabetes Obes Metab 2024; 26:407-416. [PMID: 37854007 DOI: 10.1111/dom.15321] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Abstract
This review will try to elucidate the interconnected pathophysiology of sarcopenia and type 2 diabetes (T2D) and will try to identify a common pathway to explain their development. To this end, the PubMed and Scopus databases were searched for articles published about the underlying pathophysiology, diagnosis and treatment of both sarcopenia and T2D. The medical subject heading (MeSH) terms 'sarcopenia' AND 'diabetes mellitus' AND ('physiopathology' OR 'diagnosis' OR 'therapeutics' OR 'aetiology' OR 'causality') were used. After screening, 32 papers were included. It was evident that sarcopenia and T2D share multiple pathophysiological mechanisms. Common changes in muscle architecture consist of a shift in myocyte composition, increased myosteatosis and a decreased capacity for muscle regeneration. Further, both diseases are linked to an imbalance in myokine and sex hormone production. Chronic low-grade inflammation and increased levels of oxidative stress are also known pathophysiological contributors. In the future, research efforts should be directed towards discovering common checkpoints in the development of T2D and sarcopenia as possible shared therapeutic targets for both diseases. Current treatment for T2D with biguanides, incretins and insulin may already convey a protective effect on the development of sarcopenia. Furthermore, attention should be given to early diagnosis of sarcopenia within the population of people with T2D, given the sizeable physical and medical burden it encompasses. A combination of simple diagnostic techniques could be used at regular diabetes check-ups to identify sarcopenia at an early stage and start lifestyle modifications and treatment as soon as possible.
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Affiliation(s)
- Wouter Tack
- ZNA (ZiekenhuisNetwerk Antwerpen), University Center for Geriatrics, Antwerp, Belgium
| | - Anne-Marie De Cock
- ZNA (ZiekenhuisNetwerk Antwerpen), University Center for Geriatrics, Antwerp, Belgium
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Eveline Lia Dirinck
- Department of Endocrinology, Diabetology and Metabolism, Anwerp University Hospital, Edegem, Belgium
| | - Sophie Bastijns
- ZNA (ZiekenhuisNetwerk Antwerpen), University Center for Geriatrics, Antwerp, Belgium
| | - Femke Ariën
- ZNA (ZiekenhuisNetwerk Antwerpen), University Center for Geriatrics, Antwerp, Belgium
| | - Stany Perkisas
- ZNA (ZiekenhuisNetwerk Antwerpen), University Center for Geriatrics, Antwerp, Belgium
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
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Kuzuya M. Drug-related sarcopenia as a secondary sarcopenia. Geriatr Gerontol Int 2024; 24:195-203. [PMID: 38158766 DOI: 10.1111/ggi.14770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024]
Abstract
Sarcopenia has a significant impact on falls, physical function, activities of daily living, and quality of life in older adults, and its prevention and treatment are becoming increasingly important as the global population ages. In addition to primary age-related sarcopenia, activity-related sarcopenia, disease-related sarcopenia, and nutrition-related sarcopenia have been proposed as secondary sarcopenia. Polypharmacy and potentially inappropriate medication based on multiple diseases cause health problems in older patients. In some cases, drugs used for therapeutic or preventive purposes act on skeletal muscle as adverse drug reactions and induce sarcopenia. Although sarcopenia caused by these adverse drug reactions may be more common in older patients, in particular those taking many medications, drug-related sarcopenia has not yet received much attention. This review summarizes drugs that may induce sarcopenia and emphasizes the importance of drug-related sarcopenia as a secondary sarcopenia. Geriatr Gerontol Int 2024; 24: 195-203.
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Affiliation(s)
- Masafumi Kuzuya
- Meitetsu Hospital, Nagoya, Japan
- Professor Emeritus Nagoya University, Nagoya, Japan
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Kim HJ, Jung DW, Williams DR. Age Is Just a Number: Progress and Obstacles in the Discovery of New Candidate Drugs for Sarcopenia. Cells 2023; 12:2608. [PMID: 37998343 PMCID: PMC10670210 DOI: 10.3390/cells12222608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
Sarcopenia is a disease characterized by the progressive loss of skeletal muscle mass and function that occurs with aging. The progression of sarcopenia is correlated with the onset of physical disability, the inability to live independently, and increased mortality. Due to global increases in lifespan and demographic aging in developed countries, sarcopenia has become a major socioeconomic burden. Clinical therapies for sarcopenia are based on physical therapy and nutritional support, although these may suffer from low adherence and variable outcomes. There are currently no clinically approved drugs for sarcopenia. Consequently, there is a large amount of pre-clinical research focusing on discovering new candidate drugs and novel targets. In this review, recent progress in this research will be discussed, along with the challenges that may preclude successful translational research in the clinic. The types of drugs examined include mitochondria-targeting compounds, anti-diabetes agents, small molecules that target non-coding RNAs, protein therapeutics, natural products, and repositioning candidates. In light of the large number of drugs and targets being reported, it can be envisioned that clinically approved pharmaceuticals to prevent the progression or even mitigate sarcopenia may be within reach.
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Affiliation(s)
| | - Da-Woon Jung
- New Drug Targets Laboratory, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea;
| | - Darren Reece Williams
- New Drug Targets Laboratory, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea;
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Liu L, Wang R, Gao J, Yan J, Zhang J, Zhang Z, Liu J, Lin H, Rao S, Yao X, Wu W, Bian H, Wang X, Guo S, Gao X, Yan H. Insulin Glargine is More Suitable Than Exenatide in Preventing Muscle Loss in Non-Obese Type 2 Diabetic Patients with NAFLD. Exp Clin Endocrinol Diabetes 2023; 131:583-588. [PMID: 37524110 PMCID: PMC10645484 DOI: 10.1055/a-2145-1004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/28/2023] [Indexed: 08/02/2023]
Abstract
AIM This study investigated the effects of insulin glargine and exenatide on the muscle mass of patients with newly diagnosed type 2 diabetes (T2DM) and nonalcoholic fatty liver disease (NAFLD). METHODS We performed a post-hoc analysis of our previously study, a 24-week randomized controlled multicenter clinical trial (ClinicalTrials.gov, NCT02303730). Seventy-six patients were randomly assigned 1:1 to receive insulin glargine or exenatide treatment. The changes in psoas muscle area (PMA) (mm2) were obtained with the cross-sectional Dixonfat magnetic resonance images at the fourth lumber vertebra. RESULTS There were no significant differences in age, BMI, gender, and PMA in insulin glargine and exenatide groups at baseline. After treatment, PMA tended to increase by 13.13 (-215.52, 280.80) mm2 in the insulin glargine group and decrease by 149.09 (322.90-56.39) mm2 in the exenatide group (both p>0.05). Subgroup analysis showed a 560.64 (77.88, 1043.40) (mm2) increase of PMA in the insulin group relative to the Exenatide group in patients with BMI<28 kg/m2 (p0.031) after adjusting for gender, age, and research center. Interaction analysis showed an interaction between BMI and treatment (p0.009). However, no interaction was observed among subgroups with a BMI≥28 kg/m2 or with different genders and ages. CONCLUSION Compared to exenatide, insulin glargine can relativity increase PMA in patients with T2DM having BMI<28 kg/m2 and NAFLD.
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Affiliation(s)
- Lin Liu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Ruwen Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai,
China
| | - Jian Gao
- Department of Nutrition, Zhongshan Hospital, Fudan
University
- Center of Clinical Epidemiology and Evidence-based Medicine, Fudan
University
| | - Jianhua Yan
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of
Medicine and Health Sciences, Shanghai, China
| | - Jingtian Zhang
- Department of Nutrition, Zhongshan Hospital, Fudan
University
| | - Zhitian Zhang
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
| | - Jiaojiao Liu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
| | - Huandong Lin
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Shengxiang Rao
- Department of Radiology, Zhongshan Hospital, Fudan University,
Shanghai, China
| | - Xiuzhong Yao
- Department of Radiology, Zhongshan Hospital, Fudan University,
Shanghai, China
| | - Weiyun Wu
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan
University, Shanghai, China
| | - Hua Bian
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Xiangyu Wang
- Department of Nutrition, Zhongshan Hospital, Fudan
University
| | - Shanshan Guo
- School of Kinesiology, Shanghai University of Sport, Shanghai,
China
- School of Life Sciences, Fudan University, Shanghai,
China
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Hongmei Yan
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
- Department of Endocrinology and Metabolism, Wusong Branch of Zhongshan
Hospital, Fudan University, Shanghai, China.
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Abstract
Introduction Objectives: an expert report is presented on the situation of loss of muscle mass in people with type 2 diabetes mellitus (T2DM), with a proposal of what the clinical approach to this comorbidity should be, based on the evidence from the literature and clinical experience. Method: a qualitative expert opinion study was carried out using the nominal approach. A literature search on diabetes and muscle was made and submitted to a multidisciplinary group of 7 experts who through a face-to-face meeting discussed different aspects of the role of muscle mass in T2DM. Results: muscle mass must be taken into account in the clinical context of patients with T2DM. It has an enormous impact on patient function and quality of life, and is as important as adequate metabolic control of T2DM. Conclusions: in addition to drug therapy and diet adjustments, aerobic and strength activities are essential for maintaining muscle mass and function in diabetic patients. In concrete situations, artificial oral supplementation specific for muscle care could improve the situation of malnutrition and low muscle mass. Measures such as the walking speed test, chair test, or the SARC-F questionnaire, together with the Barthel index, constitute a first step to diagnose relevant impairment requiring intervention in patients with T2DM. This document seeks to answer some questions about the importance, assessment, and control of muscle mass in T2DM.
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The Bidirectional Relationship between Periodontal Disease and Diabetes Mellitus-A Review. Diagnostics (Basel) 2023; 13:diagnostics13040681. [PMID: 36832168 PMCID: PMC9954907 DOI: 10.3390/diagnostics13040681] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Periodontitis is a chronic inflammatory disease caused by the presence of a bacterial biofilm known as dental plaque. This biofilm affects the supporting apparatus of the teeth, especially the periodontal ligaments and the bone surrounding the teeth. Periodontal disease and diabetes seem to be interrelated and in a bidirectional relationship, and have been increasingly studied in recent decades. For example, diabetes mellitus has a detrimental effect on periodontal disease, increasing its prevalence, extent, and severity. In turn, periodontitis negatively affects glycemic control and the course of diabetes. This review aims to present the most recently discovered factors that contribute to the pathogenesis, therapy, and prophylaxis of these two diseases. Specifically, the article focuses on microvascular complications, oral microbiota, pro- and anti-inflammatory factors in diabetes, and periodontal disease. As presented in this review, these two diseases require specific/ complementary therapeutic solutions when they occur in association, with new clinical trials and epidemiological research being necessary for better control of this interdependent pathogenic topic.
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The Promotion of Migration and Myogenic Differentiation in Skeletal Muscle Cells by Quercetin and Underlying Mechanisms. Nutrients 2022; 14:nu14194106. [PMID: 36235757 PMCID: PMC9572605 DOI: 10.3390/nu14194106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Aging and muscle disorders frequently cause a decrease in myoblast migration and differentiation, leading to losses in skeletal muscle function and regeneration. Several studies have reported that natural flavonoids can stimulate muscle development. Quercetin, one such flavonoid found in many vegetables and fruits, has been used to promote muscle development. In this study, we investigated the effect of quercetin on migration and differentiation, two processes critical to muscle regeneration. We found that quercetin induced the migration and differentiation of mouse C2C12 cells. These results indicated quercetin could induce myogenic differentiation at the early stage through activated p-IGF-1R. The molecular mechanisms of quercetin include the promotion of myogenic differentiation via activated transcription factors STAT3 and the AKT signaling pathway. In addition, we demonstrated that AKT activation is required for quercetin induction of myogenic differentiation to occur. In addition, quercetin was found to promote myoblast migration by regulating the ITGB1 signaling pathway and activating phosphorylation of FAK and paxillin. In conclusion, quercetin can potentially be used to induce migration and differentiation and thus improve muscle regeneration.
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11
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Kumar R, García-Compeán D, Maji T. Hepatogenous diabetes: Knowledge, evidence, and skepticism. World J Hepatol 2022; 14:1291-1306. [PMID: 36158904 PMCID: PMC9376767 DOI: 10.4254/wjh.v14.i7.1291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/27/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
The diabetogenic potential of liver cirrhosis (LC) has been known for a long time, and the name "hepatogenous diabetes" (HD) was coined in 1906 to define the condition. Diabetes mellitus (DM) that develops as a consequence of LC is referred to as HD. In patients with LC, the prevalence rates of HD have been reported to vary from 21% to 57%. The pathophysiological basis of HD seems to involve insulin resistance (IR) and pancreatic β-cell dysfunction. The neurohormonal changes, endotoxemia, and chronic inflammation of LC initially create IR; however, the toxic effects eventually lead to β-cell dysfunction, which marks the transition from impaired glucose tolerance to HD. In addition, a number of factors, including sarcopenia, sarcopenic obesity, gut dysbiosis, and hyperammonemia, have recently been linked to impaired glucose metabolism in LC. DM is associated with complications and poor outcomes in patients with LC, although the individual impact of each type 2 DM and HD is unknown due to a lack of categorization of diabetes in most published research. In fact, there is much skepticism within scientific organizations over the recognition of HD as a separate disease and a consequence of LC. Currently, T2DM and HD are being treated in a similar manner although no standardized guidelines are available. The different pathophysiological basis of HD may have an impact on treatment options. This review article discusses the existence of HD as a distinct entity with high prevalence rates, a strong pathophysiological basis, clinical and therapeutic implications, as well as widespread skepticism and knowledge gaps.
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Affiliation(s)
- Ramesh Kumar
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
| | - Diego García-Compeán
- Department of Gastroenterology, University Hospital, Universidad Autónoma de Nuevo León, México, Monterrey 64700, México
| | - Tanmoy Maji
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
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Sanz-Cánovas J, López-Sampalo A, Cobos-Palacios L, Ricci M, Hernández-Negrín H, Mancebo-Sevilla JJ, Álvarez-Recio E, López-Carmona MD, Pérez-Belmonte LM, Gómez-Huelgas R, Bernal-López MR. Management of Type 2 Diabetes Mellitus in Elderly Patients with Frailty and/or Sarcopenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148677. [PMID: 35886528 PMCID: PMC9318510 DOI: 10.3390/ijerph19148677] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 02/04/2023]
Abstract
The life expectancy of the population is increasing worldwide due to improvements in the prevention, diagnosis, and treatment of diseases. This favors a higher prevalence of type 2 diabetes mellitus (T2DM) in the elderly. Sarcopenia and frailty are also frequently present in aging. These three entities share common mechanisms such as insulin resistance, chronic inflammation, and mitochondrial dysfunction. The coexistence of these situations worsens the prognosis of elderly patients. In this paper, we review the main measures for the prevention and management of sarcopenia and/or frailty in elderly patients with T2DM.
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Affiliation(s)
- Jaime Sanz-Cánovas
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
| | - Almudena López-Sampalo
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
| | - Lidia Cobos-Palacios
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
| | - Michele Ricci
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
| | - Halbert Hernández-Negrín
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
| | - Juan José Mancebo-Sevilla
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
| | - Elena Álvarez-Recio
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
| | - María Dolores López-Carmona
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
| | - Luis Miguel Pérez-Belmonte
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
| | - Ricardo Gómez-Huelgas
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (R.G.-H.); (M.R.B.-L.); Tel.: +34-951291169 (R.G.-H.); +34-951290346 (M.R.B.-L.)
| | - Maria Rosa Bernal-López
- Unidad de Gestión Clínica de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga (UMA), 29010 Málaga, Spain; (J.S.-C.); (A.L.-S.); (L.C.-P.); (M.R.); (H.H.-N.); (J.J.M.-S.); (E.Á.-R.); (M.D.L.-C.); (L.M.P.-B.)
- Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29590 Málaga, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (R.G.-H.); (M.R.B.-L.); Tel.: +34-951291169 (R.G.-H.); +34-951290346 (M.R.B.-L.)
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13
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Merchant RA, Soong JTY, Morley JE. Gender Differences in Body Composition in Pre-Frail Older Adults With Diabetes Mellitus. Front Endocrinol (Lausanne) 2022; 13:795594. [PMID: 35242108 PMCID: PMC8885520 DOI: 10.3389/fendo.2022.795594] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/12/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND & AIMS Ageing is a risk factor for diabetes mellitus (DM) and frailty. It is associated with body composition changes including increase in fat mass (FM), central fat distribution, decrease in fat free mass (FFM) and skeletal muscle which are risk factors for DM. This study aims to evaluate gender differences in body composition in pre-frail diabetics and association with physical performance, cognitive function and perceived health. In addition, we aim to explore the association of obesity, sarcopenia, sarcopenic obesity, and body composition in pre-frail older adults to DM status. METHODS Cross-sectional study of 192 pre-frail community dwelling older adults (≥ 65 years). Data was collected on demographics, physical function, cognition, frailty, sarcopenia, perceived health and body composition using the InBody S10. Univariate and multivariate logistic regression were undertaken to explore the association of sarcopenic obesity, obesity, sarcopenia and body composition measures to DM status. RESULTS There were insignificant within-gender differences for physical function, cognition and body composition, except for a higher prevalence of obesity defined by body mass index (BMI) and body fat percentage (BF%), increased fat mass index(FMI) and fat free mass index(FFMI) in females with DM. There were significant between-gender differences for those with DM where females overall had lower education levels, lower perceived health, higher prevalence of depression and low mental vitality, lower overall physical function (low short physical performance battery scores, low gait speed and hand grip strength), lower cognitive scores, lower muscle mass and muscle quality with higher FMI, FM/FFM and visceral fat area(VFA). BMI, VFA>100 cm2, FMI and FFMI were found to be independently associated with DM status after multivariable adjustment. CONCLUSION Within pre-frail DM vs non-DM, there were insignificant differences in body composition, physical function, cognition and perceived health within gender except for FMI, BF% and FFMI in females. There were significant differences between gender in pre-frail DM in muscle mass, quality, functional, cognitive and mental status. Further longitudinal studies are required to understand the pathogenesis, trajectory of DM and protective role of oral hypoglycemics in pre-frail older adults.
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Affiliation(s)
- Reshma Aziz Merchant
- Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - John Tshon Yit Soong
- Department of Medicine, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Advanced Internal Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St Louis, MO, United States
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14
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Zhang X, Zhao Y, Chen S, Shao H. Anti-diabetic drugs and sarcopenia: emerging links, mechanistic insights, and clinical implications. J Cachexia Sarcopenia Muscle 2021; 12:1368-1379. [PMID: 34676695 PMCID: PMC8718027 DOI: 10.1002/jcsm.12838] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/14/2021] [Accepted: 09/20/2021] [Indexed: 12/21/2022] Open
Abstract
Sarcopenia, characterized by loss of skeletal muscle mass, quality, and strength, has become a common hallmark of ageing and many chronic diseases. Diabetes mellitus patients have a higher prevalence of sarcopenia, which greatly aggravates the metabolic disturbance and compromises treatment response. Preclinical and clinical studies have shown differential impacts of anti-diabetic drugs on skeletal muscle mass, strength, and performance, highlighting the importance of rational therapeutic regimen from the perspective of sarcopenia risk. In this review, we provide an update on the regulation of muscle mass and quality by major anti-diabetic drugs, focusing primarily on emerging data from clinical studies. We also discuss the underlying mechanisms and clinical implications for optimal selection of anti-diabetic drugs to reduce the risk of sarcopenia. In view of the lifelong use of anti-diabetic drugs, we propose that a better understanding of the sarcopenia risk and interventional strategies is worthy of attention in future studies.
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Affiliation(s)
- Xueli Zhang
- Department of Pharmacy, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Yi Zhao
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Shuobing Chen
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Hua Shao
- Department of Pharmacy, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
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15
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Wang P, Liu Y, Zhang T, Yin C, Kang SY, Kim SJ, Park YK, Jung HW. Effects of Root Extract of Morinda officinalis in Mice with High-Fat-Diet/Streptozotocin-Induced Diabetes and C2C12 Myoblast Differentiation. ACS OMEGA 2021; 6:26959-26968. [PMID: 34693116 PMCID: PMC8529596 DOI: 10.1021/acsomega.1c03372] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/29/2021] [Indexed: 05/15/2023]
Abstract
Type 2 diabetes is the most common type of diabetes and causes a decline in muscle quality. In this study, we investigated the effects of the root extract of Morinda officinalis (MORE) on skeletal muscle damage in mice with high-fat-diet (HFD)/streptozotocin (STZ)-induced diabetes and the expression of myogenic and biogenesis regulatory proteins in C2C12 myoblast differentiation. An in vivo model comprised C57BL/6N mice fed HFD for 8 weeks, followed by a single injection of STZ at 120 mg/kg. MORE was administered at 100 and 200 mg/kg once daily (p.o.) for 4 weeks. The changes in body weight, calorie intake, and serum levels of glucose, insulin, total cholesterol (TCHO), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), aspartate transaminase (AST), and alanine aminotransferase (ALT) were investigated in diabetic mice. The histological changes in the gastrocnemius muscle were observed by H&E staining, and then the myofiber size was measured. The expression of the myogenic (MHC, myogenin, and MyoD) and biogenesis (PGC-1α, SIRT1, NRF1, and TFAM) regulatory proteins was examined in the muscle tissues and differentiated C2C12 myoblasts by Western blot, respectively. The administration of MORE at 200 mg/kg in mice with HFD/STZ-induced diabetes significantly reduced weight gains, calorie intake, insulin resistance, and serum levels of glucose, TCHO, LDL-C, AST, and ALT. MORE administration at 100 and 200 mg/kg significantly increased serum insulin and HDL-C levels in diabetic mice. In addition, MORE significantly increased the expression of MHC, myogenin, MyoD, PGC-1α, SIRT1, NRF1, and TFAM in muscle tissues as well as increased the myofiber size in diabetic mice. In C2C12 myoblast differentiation, MORE treatment at 0.5, 1, and 2 mg/mL significantly increased the expression of myogenic and biogenesis regulatory proteins in a dose-dependent manner. MORE improves diabetes symptoms in mice with HFD/STZ-induced diabetes by improving muscle function. This suggests that MORE could be used to prevent or treat diabetes along with muscle disorders.
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Affiliation(s)
- Piao Wang
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Yi Liu
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Tong Zhang
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Cheng Yin
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Seok Yong Kang
- Korean
Medicine R&D Center, Dongguk University, 38066 Gyeongju, Korea
| | - Su Jin Kim
- Department
of Anesthesiology and Pain Medicine, College of Medicine, Dongguk University, 38066 Gyeongju, Korea
| | - Yong-Ki Park
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
- Korean
Medicine R&D Center, Dongguk University, 38066 Gyeongju, Korea
| | - Hyo Won Jung
- Department
of Herbology, College of Korean Medicine, Dongguk University, 38066 Gyeongju, Korea
- Korean
Medicine R&D Center, Dongguk University, 38066 Gyeongju, Korea
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16
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Myopathy Associated With Statins and SGLT2 - A Review of Literature. Curr Probl Cardiol 2020; 46:100765. [PMID: 33385749 DOI: 10.1016/j.cpcardiol.2020.100765] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022]
Abstract
Drug-induced myopathy is a well-described clinical entity characterized by muscle damage leading to symptoms ranging from myalgias to rhabdomyolysis and acute kidney injury. Many pharmacotherapies are known to precipitate myopathic symptoms. Recent case reports suggest a potential relationship between the use of sodium/glucose cotransport 2 (SGLT2) inhibitors and onset of myopathy. The pathogenesis of this has yet to be elucidated. The relevance of this association is augmented by the recent popularity of SGLT2 inhibitors as well as the tendency for them to be prescribed alongside statins. This study reviewed the literature on the incidence and mechanism of drug-induced myopathy in patients with type 2 diabetes mellitus who are taking SGLT2 inhibitors with and without the use of statins.
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