The skeletal muscle mass index is a predictor for all-cause mortality in US adults with type 2 diabetes or pre-diabetes

Abstract

Aims: To investigate the relationship between the skeletal muscle mass index (SMI) with all-cause mortality in patients with type 2 diabetes mellitus (T2DM) or pre-diabetes (pre-DM) among American adults.

Methods: This study included 3684 patients with T2DM or pre-DM from the National Health and Nutrition Examination Survey 2011-2018.

Results: Our study revealed an inverse J-shaped relationship between the SMI with all-cause mortality in US adults with T2DM or pre-DM. We determined the inflection points for all-cause mortality in patients with T2DM or pre-DM were 9.07 kg/m² in males and 7.82 kg/m² in females. In men, the all-cause mortality decreased by approximately 72 % (HR, 0.28; 95 % CI, 0.09-0.93) for each unit increased in the SMI below the inflection point. In women, all-cause mortality was reduced by 60 % (HR, 0.40; 95 % CI, 0.16-0.91) for each unit increased in SMI below the threshold. A reverse J-shaped SMI-mortality association emerged in patients with T2DM, contrasting with a U-shaped pattern in pre-DM individuals.

Conclusions: An inverse J-shaped association was observed between the SMI with all-cause mortality in in US adults with T2DM or pre-DM. SMI is a valuable tool for predicting all-cause mortality in patients with T2DM or pre-DM.

Keywords: Mortality; NHANES; Pre-diabetes; Sarcopenia; Skeletal muscle mass index; Type 2 diabetes mellitus.