Tucker B M, Hsu F C, Register T C, Xu J, Smith S C, Murea M, Bowden D W, Freedman B I, Lenchik L
Barry I. Freedman, MD, Internal Medicine - Nephrology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1053, Phone: 336-716-6461, Fax: 336-716-4318,
J Frailty Aging. 2019;8(2):72-78. doi: 10.14283/jfa.2019.5.
Appendicular skeletal muscle mass index and muscle attenuation (density) are negatively associated with mortality in European-derived populations.
The present analyses assessed association between axial skeletal muscle density and muscle index with mortality in European Americans with type 2 diabetes mellitus (T2D).
Single-center observational study.
Diabetes Heart Study.
839 European Americans with T2D.
Computed tomography-measured psoas and paraspinous muscle mass index (cross sectional area/height2) and radiographic density (Hounsfield Units) were assessed in all participants. A Cox proportional hazards model was computed. The fully-adjusted model included covariates age, sex, body mass index, smoking, alcohol use, diabetes duration, insulin use, hormone replacement therapy (women), prevalent cardiovascular disease (CVD), hypertension, and coronary artery calcified atherosclerotic plaque mass score. Deaths were recorded in the National Death Index data through December 31, 2015.
Participants included 428 women and 411 men with median (25th, 75th quartile) age 62.8 (56.1, 69.1) years and diabetes duration 8.0 (5.0, 14.0) years. After 11.9 (9.4, 13.3) years of follow-up, 314 (37.4%) of participants were deceased. In the fully-adjusted model, psoas muscle density (hazard ratio [HR] 0.81, p<0.001), psoas muscle index (HR 0.82, p=0.008), and paraspinous muscle density (HR 0.85, p=0.003) were inversely associated with mortality. Paraspinous muscle index was not significantly associated with mortality (HR 0.90, p=0.08). Results did not differ significantly between men and women.
In addition to established risk factors for mortality and CVD, higher psoas muscle index, psoas muscle density, and paraspinous muscle density were significantly associated with lower all-cause mortality in European Americans with T2D.
在欧洲裔人群中，四肢骨骼肌质量指数和肌肉衰减（密度）与死亡率呈负相关。
本分析评估了2型糖尿病（T2D）的欧裔美国人中，轴向骨骼肌密度和肌肉指数与死亡率之间的关联。
单中心观察性研究。
糖尿病心脏研究。
839名患有T2D的欧裔美国人。
对所有参与者进行计算机断层扫描测量腰大肌和椎旁肌质量指数（横截面积/身高²）以及放射密度（亨氏单位）。计算Cox比例风险模型。完全调整模型包括协变量年龄、性别、体重指数、吸烟、饮酒、糖尿病病程、胰岛素使用、激素替代疗法（女性）、心血管疾病（CVD）、高血压和冠状动脉钙化动脉粥样硬化斑块质量评分。通过2015年12月31日的国家死亡指数数据记录死亡情况。
参与者包括428名女性和411名男性，年龄中位数（第25、75四分位数）为62.8（56.1，69.1）岁，糖尿病病程为8.0（5.0，14.0）年。经过11.9（9.4，13.3）年的随访，314名（37.4%）参与者死亡。在完全调整模型中，腰大肌密度（风险比[HR]0.81，p<0.001）、腰大肌指数（HR 0.82，p = 0.008）和椎旁肌密度（HR 0.85，p = 0.003）与死亡率呈负相关。椎旁肌指数与死亡率无显著关联（HR 0.90，p = 0.08）。男性和女性的结果无显著差异。
除了已确定的死亡率和CVD风险因素外，较高的腰大肌指数、腰大肌密度和椎旁肌密度与T2D欧裔美国人较低的全因死亡率显著相关。
