Sarcopenia is associated with the risk of albuminuria in patients with type 2 diabetes mellitus (T2DM), and obesity is a risk factor for proteinuria. However, the association between sarcopenic obesity and diabetic nephropathy, including albuminuria, in patients with T2DM has not been reported. The study included 206 men and 163 women with T2DM who participated in the KAMOGAWA-DM cohort, which investigating the natural history of diabetes since 2014. Sarcopenia was defined as having both low skeletal muscle mass index (SMI, kg/m²) (<7.0 kg/m² for men and <5.7 kg/m² for women) and low handgrip strength (<28 kg for men and <18 kg for women). Obesity was diagnosed by the percentage of body fat (>30% for men and >35% for women). The patient was said to have sarcopenic obesity if he/she had both sarcopenia and obesity. Urinary albumin excretion of patients with sarcopenic obesity was higher than that of patients without sarcopenic obesity (median [interquartile range]: 342.0 [41.8–467.5] vs. 21.0 [9.0–75.4] mg/g Cr, p = 0.016). Additionally, sarcopenic obesity was associated with the presence of macroalbuminuria, compared with non-sarcopenic obesity (adjusted odds ratio 6.92 [95% confidence interval:1.63–29.4], p = 0.009). Adjusted odds ratios of sarcopenic obesity, sarcopenia only, and obesity only for the presence of macroalbuminuria were 6.52 (1.47–28.8, p = 0.014), 1.29 (0.45–3.71, p = 0.638), and 0.78 (0.38–1.58, p = 0.482), respectively, compared with neither sarcopenia nor obesity. This study indicated that sarcopenic obesity is associated with albuminuria, especially macroalbuminuria, in Japanese patients with T2DM.

少肌症与 2 型糖尿病 (T2DM) 患者的蛋白尿风险相关，而肥胖是蛋白尿的危险因素。然而，在 T2DM 患者中，肌肉减少性肥胖与糖尿病肾病（包括蛋白尿）之间的关联尚未见报道。该研究纳入了 KAMOGAWA-DM 队列的 206 名男性和 163 名女性 T2DM，该队列研究了自 2014 年以来糖尿病的自然史。肌肉减少症被定义为具有低骨骼肌质量指数 (SMI, kg/m ² ) (<男性7.0 kg/m ²和 <5.7 kg/m ²女性）和低握力（男性<28 kg，女性<18 kg）。肥胖是通过体脂百分比来诊断的（男性>30%，女性>35%）。如果患者同时患有肌肉减少症和肥胖症，则称该患者患有肌肉减少症肥胖症。少肌型肥胖患者的尿白蛋白排泄高于非少肌型肥胖患者（中位数[四分位距]：342.0 [41.8-467.5] vs. 21.0 [9.0-75.4] mg/g Cr，p = 0.016）。此外，与非少肌型肥胖相比，少肌型肥胖与大量白蛋白尿有关（调整优势比 6.92 [95% 置信区间：1.63-29.4]，p= 0.009)。肌肉减少性肥胖、仅肌肉减少症和仅存在大量白蛋白尿的肥胖的调整优势比分别为 6.52 (1.47–28.8, p = 0.014)、1.29 (0.45–3.71, p = 0.638) 和 0.78 (0.38–1.58, p = 0.482），分别与肌肉减少症和肥胖症相比。该研究表明，在日本 T2DM 患者中，肌肉减少性肥胖与白蛋白尿，尤其是大量白蛋白尿有关。