Abstract
Our understanding of skeletal muscle has undergone significant changes in recent years. It has been established that muscle tissue is a powerful endocrine organ, actively involved in regulating metabolic processes in other organs and tissues. Skeletal muscle is the largest organ in the human body. Muscle contraction causes a biomechanical response and also releases anti-inflammatory cytokines in response to this contraction, and this opens up new paradigms of skeletal muscle being an endocrine organ, through contraction stimulating the production and release of myokines and adipomyokines, which can influence other organs and systems. Sarcopenia is a progressive age-related decrease in the mass and functional capacity of skeletal muscle, which is associated with an increased risk of developing disability, falls, and metabolic disorders. An important role in the pathogenesis of this condition is played by an imbalance of myokines – signaling molecules secreted by muscle tissue. The results of recent epidemiological studies indicate that patients with type 2 diabetes mellitus (T2DM) are characterized, along with chronic complications, by loss of muscle tissue – sarcopenia. T2DM is a chronic disease that is a global pandemic affecting hundreds of millions of people worldwide, and its prevalence continues to increase. According to the World Health Organization, almost 422 million people worldwide suffer from diabetes mellitus. According to the 11th edition of the International Diabetes Federation Atlas, the number of people with T2DM among the Ukrainian population aged 20 to 79 years will increase to 2.1 million by 2050. According to the new American Diabetes Association guidelines for
the treatment of diabetes, sarcopenia is associated with T2DM and diagnostic testing for this complication is recommended in this category of patients. Sarcopenia is now officially recognized as a disease in the International Classification of Diseases (ICD-10: M62). An imbalance between myokines, in particular irisin, myostatin, interleukins-6 and fibroblast growth factor 21, contributes to the development of sarcopenia, deterioration of glucose metabolism and increased insulin resistance. The article summarizes current data on the role of myokine imbalance in the pathogenesis of sarcopenia in DM, examines possible molecular mechanisms of interaction and promising areas of therapeutic correction.
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