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.
Kim et al. (2026) studied this question.