Sarcopenia index as a predictor of ventricular arrhythmia risk in patients with type 2 diabetes mellitus: a longitudinal study

Abstract

Objective: The correlation between sarcopenia and diabetes mellitus (DM) holds considerable importance. The prognosis of ventricular arrhythmias in individuals with type 2 diabetes mellitus complicated by sarcopenia remains uncertain. Methods: A retrospective analysis was conducted on patients with DM who underwent implantable cardioverter defibrillator (ICD) implantation at Fuwai Hospital. Sarcopenia status was assessed using the biomarker sarcopenia index(SI). Patients were divided into low SI (less than 81.33, n = 74) and high SI (greater than 81.33, n = 158) groups according to the best cut-off value. The primary endpoint was the occurrence of ventricular arrhythmias. Secondary endpoint was appropriate shock therapy. Results: A total of 232 patients who met the inclusion criteria were included. The average follow-up period was 25.85 ± 16.13 months. During the follow-up, a total of 69 cases (29.7%) of ventricular arrhythmias and 31 cases (13.4%) of appropriate shock therapy were recorded. ROC analysis showed that SI had a good predictive value for ventricular arrhythmias (AUC 0.807, cut point value 81.33, sensitivity 66.7%, specificity 82.8%). The lower SI groups had an increased proportion of ventricular arrhythmias (62.2% vs. 14.6%, P < 0.001) and appropriate shock therapy (28.4% vs. 6.3%, P < 0.001) during follow-up. The KM curve showed significantly increased risk of ventricular arrhythmias (log-rank P < 0.001) and appropriate shock (log-rank P < 0.001) in the lower SI group. Multivariate analysis showed that low SI was an independent risk factor for ventricular arrhythmias (hazard ratio (HR) 5.318, 95% confidence interval (CI): 3.198–8.841, P < 0.001), and appropriate shock (hazard ratio (HR) 5.765, 95% confidence interval (CI): 2.689–12.361, P < 0.001). Conclusions: In diabetic patients, SI has a high prediction value for the occurrence of ventricular arrhythmia, and is anticipated to serve as a prognostic indicator for the likelihood of sudden cardiac death in this patient population.