INS and sarcopenia: In patients with cachexia, a large amount of protein consumption is also an important cause of sarcopenia; (4) Changes in hormone levels: Changes in hormone levels such as estrogen, testosterone, insulin, and adrenocorticotropic hormone (ACTH) lead to changes in the skeletal muscle microenvironment, leading to the occurrence of sarcopenia [65, 66]; (5) Osteoporosis is an important type of diabetic metabolic bone disease.