Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China.
Sci Rep. 2017 Aug 21;7(1):8372. doi: 10.1038/s41598-017-08972-1.
The aim of this study was to investigate the association of sarcopenia and diabetic foot disease (DFD) in a cross-sectional study. Body composition was assessed using dual-energy X-ray-absorptiometry (DXA) among 1105 patients with type 2 diabetes (120 patients with newly diagnosed DFD [DFD duration less than 3 months]). Severity of DFD was assessed, referring to foot ulcers, Wagner grade and the percentage of amputation. Skeletal muscle index (SMI) was calculated, and sarcopenia was defined as SMI less than 7.0 kg/m (in men) or 5.4 kg/m (in women). SMI was significantly decreased in patients with DFD compared to patients without (6.79 ± 1.20 vs. 7.21 ± 1.05 kg/m, P < 0.001). The percentage of sarcopenia in DFD patients was more than double than those without DFD (35.3% vs. 16.4%, P < 0.001). Multivariable logistic regression analysis showed that sarcopenia was independently associated with DFD (OR 2.05[95% CI 1.15,3.89], P = 0.027) after controlling confounders including age, diabetic duration and diabetic chronic complications. In DFD group, patients with sarcopenia exhibited more foot ulcers, higher Wagner grade and greater percentage of amputation compared to patients without sarcopenia. We conclude that sarcopenia is independently associated with DFD. Worse prognosis is seen in patients with DFD accompanied by sarcopenia.
本研究旨在通过横断面研究探讨肌少症与糖尿病足病（DFD）的相关性。在 1105 例 2 型糖尿病患者（120 例新诊断为 DFD [DFD 病程小于 3 个月]）中，使用双能 X 线吸收法（DXA）评估身体成分。根据足部溃疡、Wagner 分级和截肢百分比评估 DFD 的严重程度。计算骨骼肌指数（SMI），将 SMI 小于 7.0kg/m（男性）或 5.4kg/m（女性）定义为肌少症。与无 DFD 的患者相比，DFD 患者的 SMI 显著降低（6.79±1.20 与 7.21±1.05kg/m，P<0.001）。DFD 患者的肌少症发生率是无 DFD 患者的两倍多（35.3%与 16.4%，P<0.001）。多变量逻辑回归分析显示，在控制年龄、糖尿病病程和糖尿病慢性并发症等混杂因素后，肌少症与 DFD 独立相关（OR 2.05[95%CI 1.15，3.89]，P=0.027）。在 DFD 组中，与无肌少症的患者相比，肌少症患者的足部溃疡更多、Wagner 分级更高、截肢率更高。我们的结论是肌少症与 DFD 独立相关。伴有肌少症的 DFD 患者预后更差。
