Sarcopenia and muscle dysfunction in young adults with type 1 diabetes mellitus: associations with bone mineral...

To evaluate bone mineral density (BMD), body composition, muscle strength, physical performance, and the prevalence of sarcopenia in young adults with type 1 diabetes mellitus (T1DM), and to explore clinical, metabolic, and skeletal correlates associated with sarcopenia.

A cross-sectional study that evaluated BMD, body composition, muscle strength, and physical performance in 42 young adults with T1DM compared with 42 age- and sex-matched non-diabetic controls. DXA was used to assess areal and volumetric BMD, as well as whole-body composition, while muscle strength and function were evaluated using handgrip strength, gait speed, sit-to-stand, and timed up-and-go tests. Sarcopenia was defined following EWGSOP2 criteria.

Areal and volumetric BMD values did not differ between groups at the lumbar spine, femoral neck, or total hip, suggesting preserved BMD in this young population. Body composition, including appendicular skeletal muscle mass index, was also similar between groups. In contrast, the T1DM group displayed significantly reduced muscle strength and impaired physical performance across multiple functional tests. Sarcopenia was diagnosed in 23.8% of T1DM participants, whereas no cases were identified in controls (OR 23.3). Within the T1DM group, participants with sarcopenia exhibited lower femoral BMD and cortical surface BMD than those without sarcopenia.

Young adults with T1DM exhibit a high prevalence of sarcopenia and impaired muscle function despite preserved BMD and muscle mass. Among individuals with T1DM, sarcopenia was associated with lower femoral BMD and cortical surface BMD, supporting the importance of early musculoskeletal assessment in diabetes care.