Diabetes Mellitus · Jul 26, 2026
Sarcopenia in postmenopausal patients with type 1 diabetes mellitus: characteristics of functional, laboratory, and instrumental indicators
By Pushkareva A, Belaya ZE, Шамхалова МШ et al.
BACKGROUND . Patients with type 1 diabetes mellitus (T1DM) are prone to earlier development of sarcopenia due to insulin deficiency, hyperglycemia, oxidative stress, and mitochondrial dysfunction. A pressing challenge in the management of these patients is the search for standardized diagnostic tools for the timely detection and monitoring of sarcopenia. OBJECTIVE . Comparative assessment of laboratory serum myokine levels in relation to muscle mass, strength, and function in postmenopausal women with type 1 diabetes and controls without diabetes. MATERIALS AND METHODS . A single-center, cross-sectional comparative study was conducted in women with type 1 diabetes (n=40) and a control group (n=40) aged 50–75 years. The SARC-F questionnaire, laboratory parameters (myostatin, follistatin, cystatin C, lipocalin 2, IGF-1), muscle mass (iDXA densitometry), strength (wrist dynamometry), and function (short-form exercise battery) were assessed. Statistical processing was performed in Statistica 14.0.0.15, IBM SPSS Statistics 23 using the Mann-Whitney, Fisher, and Spearman correlation tests. RESULTS . The age of the patients was 60 [56;64] years in the T1DM group and 64 [60;66] years in the control group (p=0.029). Glycated hemoglobin (HbA 1c ) in the T1DM group was 8.0% [7.6;9.3] with a diabetes duration of 26 [13;42] years. The myostatin level was significantly higher in T1DM 52.73 [46.45;58.26] mg/ml versus 21.46 [19.07;24.74] in the control (p < 0.001) and positively correlated with HbA 1c (r=0.544, p < 0.001), but not with muscle strength and mass. HbA1c negatively correlated with the time it took to get up from a chair 5 times. No differences were found in the levels of follistatin, lipocalin 2, cystatin C. Wrist dynamometry strength and walking speed were lower in the T1DM group with a tendency to statistical significance. The median IGF-1 was lower in diabetes (92.7 vs. 114.1 ng/ml, p=0.014) and positively correlated with muscle strength (r=0.472, p < 0.001). The sarcopenia index negatively correlated with muscle strength (r=-0.402, p=0.021) and positively with HbA 1c (r=0.514, p=0.035). Severe sarcopenia (according to EWGSOP2) was diagnosed in only one patient with T1DM, whose myostatin level did not differ from the range of patients without sarcopenia. CONCLUSION . Thus, patients with type 1 diabetes have higher myostatin levels, which correlates with with the level of HbA 1c . Low functional capacity in patients with type 1 diabetes is associated with HbA 1c levels, but is not directly related to myostatin levels.