Skeletal muscle alterations in type 2 diabetes mellitus with and without dyslipidemia

Background Diabetic dyslipidemia, a common comorbidity in people with type 2 diabetes, has been reported to be associated with adverse metabolic outcomes. Skeletal muscle is a key organ impacted by metabolic disorders; however, the specific effects of diabetic dyslipidemia on skeletal muscle mass, strength, and performance remain unclear. The aim of this study was to assess the skeletal muscle alterations of people with type 2 diabetes with and without dyslipidemia. Methods This retrospective study included 144 participants (mean age 51.3 +/- 7.1 years; 103 female, 41 male) aged 40-65 years. Body composition was assessed using bioelectrical impedance analysis (BIA), muscle strength via dynamometer, and functional capacity with the 6-minute walk test (6MWT). To minimize the confounding effect of longer diabetes duration in the diabetic dyslipidemia group, propensity score matching (PSM) was performed using a 1:1 nearest-neighbor method. All analyses were performed on matched groups. ROC analysis was conducted for variables showing significant differences. Results After PSM, people with diabetic dyslipidemia showed significantly lower skeletal muscle mass and skeletal muscle index (SMI), higher body fat percentage, and reduced 6MWD compared to those with diabetes alone (p < 0.05). In women with diabetic dyslipidemia, handgrip strength was significantly lower. ROC analysis revealed moderate predictive value for skeletal muscle mass (AUC = 0.682), SMI (AUC = 0.654), and 6MWD (AUC = 0.628). Conclusion This study demonstrated that people with diabetic dyslipidemia had lower skeletal muscle mass, SMI, and decreased physical performance compared to people with diabetes alone, even after matching for diabetes duration. These findings demonstrate early sarcopenic and dynapenic changes and highlight the need to consider skeletal muscle health and lipid abnormalities together in diabetes management.