Association of adiponectin and nutritional indices with sarcopenia in elderly diabetic patients

Objectives To assess the relationship between adiponectin levels, nutritional indices, and sarcopenia in elderly diabetic patients, and to identify metabolic and nutritional biomarkers that distinguish sarcopenic from non-sarcopenic elderly diabetic individuals. Methods This cross-sectional study included 80 diabetic patients aged >60 years, sarcopenic (n=40) and non-sarcopenic (n=40) groups based on Asian Working Group for Sarcopenia criteria. Serum adiponectin, glucose metabolism markers, lipid profiles, and nutritional indices including prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) score were assessed. Results Sarcopenic patients demonstrated significantly higher adiponectin levels (12.8 ± 3.4 vs. 8.4 ± 2.1 μg/mL, p<0.001), representing a 52% increase compared to non-sarcopenic individuals. The sarcopenic group showed impaired insulin sensitivity (QUICKI: 0.31 ± 0.05 vs. 0.36 ± 0.04, p=0.003), elevated atherogenic indices, and reduced nutritional status. All nutritional indices were significantly impaired in the sarcopenic group: PNI (45.2 ± 5.4 vs. 52.4 ± 6.8, p<0.001), GNRI, and CONUT score. Multiple logistic regression identified adiponectin (OR=1.264, 95% CI: 1.062–1.504, p=0.009), age, insulin resistance, and nutritional indices as independent predictors of sarcopenia. Conclusions Elevated adiponectin levels paradoxically associate with sarcopenia in elderly diabetes, suggesting a potential biomarker for muscle wasting. The association between nutritional indices and sarcopenia emphasizes the importance of comprehensive nutritional assessment in elderly diabetic patients.