Type 2 diabetes mellitus (T2DM), as a chronic metabolic disorder, represents a significant health threat to middle-aged and elderly populations in China and is a major risk factor for osteosarcopenia. The presence of osteosarcopenia can markedly impact the health status and quality of life of individuals with T2DM. A comprehensive examination of the epidemiological characteristics of osteosarcopenia holds substantial significance in guiding the prevention and management of osteosarcopenia among T2DM patients in China.

To conduct a systematic evaluation of the prevalence of osteosarcopeniain patients with T2DM in China.

A comprehensive search was conducted for studies on the prevalence of osteosarcopenia in Chinese patients with T2DM across multiple databases, including CNKI, Wanfang Data, VIP, SinoMed, Cochrane Library, PubMed, Web of Science, EBSCO and Embase. The search period extended from the establishment of these databases to June 2024. Two researchers independently screened the literature, extracting relevant information such as the first author, publication year, survey period, geographical region, osteosarcopenia prevalence, diagnostic criteria, assessment tools and quality evaluation information. The methodological quality of the included studies was assessed using the AHRQ tool. Data were analyzed using Stata 15.0.

A total of 18 cross-sectional studies were included, involving 3 724 T2DM patients, of whom 623 were diagnosed with osteosarcopenia. The meta-analysis revealed that the overall prevalence of osteosarcopenia in Chinese T2DM patients was 21% (95%CI=15%-26%). Subgroup analysis showed that the prevalence after 2020 (25%) was higher than that before 2020 (19%) ; the prevalence in the elderly group (27%) was higher than in the middle-aged group (13%) ; the prevalence using the AWGS diagnostic criteria (23%) was higher than with the AWGS2 criteria (14%) ; the detection rate by BIA (22%) was higher than by DXA (17%) ; males (38%) had a higher prevalence than females (36%) ; the prevalence in patients with a T2DM duration of ≤10years (25%) was higher than in those with a duration > 10 years (20%) ; the prevalence in the western region (27%) was higher than in the central (18%) and eastern regions (16%) (P<0.05). Meta-regression analysis revealed no statistically significant results (P>0.05), and no significant sources of heterogeneity were identified.

Existing evidence suggests a relatively high prevalence of osteosarcopenia among patients with T2DM in China, with significant disparities observed across factors such as survey period, age groups, diagnostic criteria, assessment tools, gender, duration of T2DM, and regional differences. Consequently, it is imperative to enhance early screening and intervention strategies for high-risk populations, in order to effectively prevent and mitigate the progression of the disease.