Differences of Plasma Metabolites in Sarcopenia Among Individualswith Type 2 Diabetes: A Cross-Sectional Study

Introduction: The objective of this study is to characterize plasma metabolites and identify potential clinical indicators of sarcopenia in individuals with Type 2 Diabetes (T2D). Methods: This cross-sectional, observational study included 122 individuals with T2D recruited from a university hospital clinic between October 2022 and December 2023. Demographic and health data were obtained through questionnaires and electronic health records. Plasma metabolites were analyzed using liquid chromatography-mass spectrometry. Predictive probability of the identified metabolite was assessed using the Receiver Operating Characteristic-Area Under the Curve (ROC-AUC). Statistical analyses were conducted with SPSS version 29 and R version 4.4.2. Results: We identified 23 metabolites, including 21 that were unique to individuals with sarcopenia compared with the general population. Plasma 4-Hydroxyproline and homocysteine levels were significantly different between the sarcopenia and non-sarcopenia groups, as defined by the Asian Working Group for Sarcopenia criteria. A model combining 4-Hydroxyproline, age, body mass index, and educational levels achieved an ROC-AUC of 0.825 (95% CI: 0.726-0.923) for predicting sarcopenia. Discussion: The metabolic features of sarcopenic status are distinctive among individuals with T2D compared to the general population. Plasma 4-Hydroxyproline and Homocysteine are clinical indicators in sarcopenia in T2D. Conclusions: Individuals with T2D and sarcopenia exhibit distinct metabolite profiles compared with the general population. Plasma 4-Hydroxyproline and homocysteine may serve as clinical indicators for sarcopenia in T2D. Further studies are needed to validate these findings and assess their potential as diagnostic and therapeutic targets.