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Sarcopenic Obesity and Risk of Incident Type 2 Diabetes: A Prospective Cohort Study and Landmark Analysis From the UK
Zhongyang Guan1,2, Blossom C M Stephan2, Mario Siervo1,2
1Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
Objective:
To examine whether sarcopenic obesity (SO) is associated with incident type 2 diabetes (T2D) beyond obesity or sarcopenia alone and whether associations differ by sex, age, and transitions in body composition phenotypes over time.
Research Design And Methods:
We studied 479,607 diabetes-free UK Biobank participants. SO was defined using handgrip strength, skeletal muscle mass-to-weight ratio, and fat mass percentage. Cox models estimated hazard ratios (HRs). A landmark analysis (n = 53,107) examined phenotype transitions.
Results:
Over a median follow-up of 14.2 years, T2D developed in 32,948 participants. SO conferred the highest risk (HR 3.54 [95% CI 3.34-3.74]), exceeding obesity alone and sarcopenia alone. Transitioning to SO (HR 2.90 [95% CI 2.07-4.07]) and persistent SO (HR 3.07 [95% CI 1.63-5.79]) both elevated risks.
Conclusions:
SO was associated with higher T2D risk than obesity or sarcopenia alone, supporting integrated assessment of muscle health and adiposity in T2D risk stratification.
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