Dynapenic obesity is relatively common in individuals with T2DM and is closely related to aging, nutritional and inflammatory status, and sex-specific hormonal differences, with 25(OH)D inversely associated with DO in males and DHEA inversely while PTH positively associated with DO in females.
The incidence rates of dynapenic obesity (DO) in males and females with T2DM were 20.6% and 37.9%, respectively.
In males, 25(OH)D levels were significantly lower in those with DO compared to ND/NO, and 25(OH)D remained significantly inversely associated with DO progression after full adjustment.
In females, serum dehydroepiandrosterone (DHEA) level was inversely associated with DO progression.
In females, parathyroid hormone (PTH) level was positively associated with DO progression.
DO patients compared to ND/NO patients typically exhibited advanced age, poorer nutritional status, reduced gait speed, and low-grade inflammation.
Multiple hormone axes from pituitary-target gland axes and the vitamin D system were assessed in sex-stratified analyses of T2DM patients.
This research suggests that a condition called dynapenic obesity — where a person simultaneously has low muscle strength and excess body fat — is quite common among people with type 2 diabetes, affecting roughly 1 in 5 men and more than 1 in 3 women in this study. Researchers examined whether hormone levels from several body systems (including vitamin D, stress hormones, and parathyroid hormone) were linked to the likelihood of having this condition, and found that these links differ meaningfully between men and women. In men, lower levels of vitamin D (measured as 25(OH)D) were associated with a higher likelihood of dynapenic obesity. In women, two different hormones mattered: lower levels of DHEA (a hormone related to sex hormone production) and higher levels of parathyroid hormone (which regulates calcium and bone metabolism) were each linked to greater odds of having the condition. Beyond hormones, the study also found that people with dynapenic obesity tended to be older, have poorer nutritional status, walk more slowly, and show signs of low-grade inflammation compared to those without the condition. These findings highlight that dynapenic obesity in type 2 diabetes is tied to a cluster of biological changes — not just one factor — and that the hormonal contributors appear to differ by sex. This research suggests that monitoring specific hormone levels, particularly vitamin D in men and DHEA and parathyroid hormone in women, may be relevant when evaluating muscle and fat health in people with type 2 diabetes. Because this was a cross-sectional study (a snapshot in time), it cannot prove that these hormone differences cause dynapenic obesity, only that they are associated. Future research would need to follow patients over time to better understand the direction of these relationships.
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Upload Your LabsYu D, Ou Q, Xie B, Li Y, Liao K, Li R, et al.. (2026). Sex‑specific associations between multiple hormone axes and dynapenic obesity in middle‑aged and older patients with type 2 diabetes: A cross-sectional study.. Medicine. https://doi.org/10.1097/MD.0000000000050242