The role of markers of chronic inflammation in the progression of sarcopenic obesity in type 2 diabetes mellitus

The pathogenetic process of sarcopenic obesity (SO) development is multifactorial, the key of them is considered – non-specific systemic inflammation. Objective. to assess the influence of the intensity of the course of chronic inflammation in patients with type 2 diabetes mellitus (T2DM) on the development of SO. Material and methods. The study involved patients with type 2 diabetes (n=83), including 18 men and 65 women aged 68.73 ± 7.17 years, divided into 2 groups: type 1 diabetes mellitus and CO (decreased muscle strength, performance, excess fat mass, decreased appendicular skeletal muscle ratio index (ASMM) to body weight (MT), 2 – type 2 diabetes without CO. The diagnosis of CO was established based on the ESPEN and EASO criteria (2022) and the recommendations of EWGSOP-2019. The following tests were performed: medical history collection, objective examination, anthropometry, SARC-F completion, hand dynamometry, SPPB testing, bioimpedansometry, and laboratory tests (biochemical blood test, tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), oxidation protein products (AOPP), 8-hydroxyguanosine, macrophage inflammatory protein-1α (MIP-1α), 8-isoprostanes, and glutathione). Results. Sodium-glucose cotransporter type 2 inhibitors (iNGLT-2) and glucagon-like peptide-1 receptor agonists (aGPP-1) were more often used by participants in the second group (p < 0.001). TNF-α and MIP-1α levels were found to be higher in individuals with type 2 diabetes and SO, as well as glutathione (p=0.037). Correlation analysis revealed a significant direct relationship between glutathione and fat mass and OT; MIP-1α and HbA1c; TNF-α and ASMM, as well as TNF-α and ASMM/MT (p < 0.05). There was also a noticeable inverse relationship between MIP-1α and fat mass, as well as TNF-α and HbA1c. Conclusion. Pro-inflammatory cytokines play a crucial role in the progression of SO. The selection of pleiotropic therapy, including hypoglycemic therapy, which affects the course of chronic inflammation (iNGLT-2, aGPP-1) will reduce the risk of developing CO in patients with type 2 diabetes