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Possible sarcopenia risk and future diabetes development in Chinese adults: a 10-year prospective cohort study

Year: 2026

Type: article

Abstract: Although a bidirectional association between diabetes and sarcopenia has been reported, the role of possible sarcopenia in the development of diabetes among middle-aged and older adults remains unclear. This study aimed to examine the association between possible sarcopenia and the risk of new-onset diabetes in this population. This study employed a population-based cohort design using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS). The study population included participants aged 45 years and older who were free of diabetes at the baseline survey (2011) and were followed through 2020. Sarcopenia status was determined based on the 2019 diagnostic algorithm of the Asian Working Group for Sarcopenia (AWGS), and participants were categorized into two groups: non-sarcopenia or possible sarcopenia. The association between possible sarcopenia and the risk of new-onset diabetes was analyzed using the Cox proportional hazards regression model. A total of 9791 CHARLS participants were included in the analysis according to predefined inclusion and exclusion criteria, with a mean age of 58.15 years. Compared with non-sarcopenic individuals, those with possible sarcopenia exhibited a significantly higher risk of developing incident diabetes(HR = 1.16,95% CI1.04-1.31). Subgroup analyses revealed that stratified by gender, the association between possible sarcopenia and incident diabetes was not statistically significant in either men (HR = 1.17, 95% CI: 0.99–1.39) or women (HR = 1.00, 95% CI: 0.87–1.16). Stratified by age, the association was statistically significant in individuals under 65 years (HR = 1.14, 95% CI: 1.01–1.29), but not in those aged 65 years and older (HR = 1.14, 95% CI: 0.90–1.43). Furthermore, possible sarcopenia was associated with elevated diabetes risk in participants with BMI < 24 (HR = 1.36, 95% CI: 1.15–1.61) but not in those with BMI ≥ 24 (HR = 0.98, 95% CI: 0.85–1.13). This study suggests an independent positive association between baseline possible sarcopenia and increased risk of incident diabetes in middle-aged and older adults. This finding indicates that muscle strength assessment may have potential value for diabetes risk stratification, although further research is needed to validate its effectiveness and cost-effectiveness as a community screening tool. This is an observational cohort study using existing public data, not a clinical trial. Therefore, trial registration is not applicable.

Source: BMC Public Health

DOI: 10.1186/s12889-026-28993-8