INTERRELATIONSHIPS BETWEEN SARCOPENIC OBESITY, VITAMIN D STATUS, AND INSULIN RESISTANCE IN BULGARIAN POSTMENOPAUSAL WOMEN WITH TYPE 2 DIABETES MELLITUS

Authors

DOI:

https://doi.org/10.18623/rvd.v23.6719

Keywords:

Sarcopenic Obesity, Vitamin D, Insulin Resistance, Type 2 Diabetes Mellitus, Postmenopausal Women

Abstract

Background: Sarcopenic obesity is increasingly recognized as a complex metabolic condition characterized by the coexistence of excess adiposity and reduced skeletal muscle mass and function. Postmenopausal women are particularly vulnerable to sarcopenic obesity due to hormonal alterations, chronic low-grade inflammation, vitamin D deficiency, and insulin resistance. However, limited data are available regarding the interrelationships between sarcopenic obesity, vitamin D status, and metabolic dysfunction in Bulgarian postmenopausal women with type 2 diabetes mellitus (T2DM). Aim: The present study aimed to investigate the associations between sarcopenic obesity, serum vitamin D concentrations, and insulin resistance in Bulgarian postmenopausal women with T2DM. Materials and Methods: A cross-sectional observational study was conducted at Medical Center Prime Clinic during the period from January 2024 to December 2025. A total of 240 postmenopausal women aged 50-75 years were enrolled, including 120 women with T2DM and 120 apparently healthy postmenopausal controls. Anthropometric measurements, body composition parameters, handgrip strength, fasting glucose, insulin, glycated hemoglobin (HbA1c), lipid profile, inflammatory biomarkers, and serum 25-hydroxyvitamin D [25(OH)D] concentrations were evaluated. Insulin resistance was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Results: Women with T2DM demonstrated significantly higher body mass index, waist circumference, fasting glucose, HbA1c, HOMA-IR, and hsCRP levels compared with controls (p<0.001). In contrast, serum 25(OH)D concentrations, skeletal muscle mass, and handgrip strength were significantly lower in diabetic women (p<0.001). Sarcopenic obesity was identified more frequently in the T2DM group compared with controls (42.5% vs. 16.7%, p<0.001). Serum vitamin D concentrations correlated negatively with BMI (r = -0.41), waist circumference (r = -0.45), HOMA-IR (r = -0.48), and hsCRP levels (r = -0.37), while positive correlations were observed with skeletal muscle mass (r = 0.39) and handgrip strength (r = 0.43) (all p<0.001). Multiple regression analysis identified sarcopenic obesity, serum vitamin D concentration, waist circumference, and hsCRP as independent predictors of insulin resistance.

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Published

2026-05-25

How to Cite

Kirovakov, Z., & Kostadinov, N. (2026). INTERRELATIONSHIPS BETWEEN SARCOPENIC OBESITY, VITAMIN D STATUS, AND INSULIN RESISTANCE IN BULGARIAN POSTMENOPAUSAL WOMEN WITH TYPE 2 DIABETES MELLITUS. Veredas Do Direito, 23(8), e236719. https://doi.org/10.18623/rvd.v23.6719

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Vol. 23 No. 8 (2026): Veredas do Direito, v. 23, n. 8 2026

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