Association between sarcopenic overweight and left ventricular diastolic dysfunction and remodeling in patients with type 2 diabetes

To the Editor:Left ventricular(LV)hypertrophy and diastolic dysfunction are prevalent in patients with type 2 diabetes mellitus(T2DM)[1]and contribute to an increased rate of cardiovascular events.The multifactorial pathological state may be linked to overweight and obesity.However,the definitions of obesity based on body mass index(BMI)resulted in discrepancies in the impact on cardiometabolic risk in different studies.Thus,the exact association between overweight/obesity and diabetic cardiomyopathy is yet controversial.Sarcopenia,age-related decline in muscle mass and strength,also showed an association with cardiovascular disease.[2]Moreover,individuals with high BMI but low muscle mass may not be noticeable but need to be considered.Studies have demonstrated that sarcopenic overweight and obesity are associated with variable cardiometabolic diseases.Diabetes may coexist with sarcopenia or obesity.However,research on the association between sarcopenia and LV diastolic function,LV remodeling,and the association with sarcopenic overweight and obesity is lacking.This study sought to investigate whether sarcopenia and sarcopenic overweight and obesity are independently related to preclinical LV diastolic dysfunction and LV remodeling in patients with T2DM.