White matter alterations linked to sarcopaenia in elderly diabetic patients

In older adults with diabetes mellitus (DM), alterations in the white matter are also linked to the prevalence of sarcopaenia, a recent study reports.

The study included 284 elderly adults (median age, 79 years; 64.1 percent female) presenting to frailty clinic. Diffusion tensor imaging (DTI) was performed to measure fractional anisotropy (FA) and mean diffusivity (MD), as markers of white matter integrity. Sarcopaenia was assessed according to grip strength, walking speed, and skeletal muscle index (SMI).

More than half (58.5 percent) of the patients had DM and showed higher median glycated haemoglobin and dyslipidaemia prevalence, as well as lower low- and high-density lipoprotein cholesterol levels. SMI was slightly and nonsignificantly higher in diabetic men and women.

Diabetic patients with sacropaenia and lowered SMI showed alterations in more white matter tracts than those without diabetes. The most significant changes occurred in the left anterior thalamic radiation (lATR) and right inferior frontoccipital fasciculus (rIFOF) tracts.

Stepwise binomial logistic regression analysis showed that in diabetic patients, the FA values of the lATR and rIFOF were significantly correlated with sarcopaenia, even after controlling for confounders such as physical activity, glycated haemoglobin, age, sex, and C-reactive protein levels, among others. No such link was reported for nondiabetic participants.

“[W]e found that a loss of white matter integrity in the lATR and rIFOF is strongly associated with the prevalence of sarcopaenia in older patients with diabetes,” said researchers, “which suggests an important role for these tracts in the occurrence of sarcopaenia in older adults with diabetes mellitus.”

“Further longitudinal studies are needed to clarify whether alterations to these tracts could be improved by exercise or dietary interventions to protect against sarcopaenia,” they added.