Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China; Diabetes Research Institute of Fujian Province, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China.
Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China; Diabetes Research Institute of Fujian Province, 20 Cha Zhong Road, Fuzhou, Fujian 350005, China; Graduate Student of Department of Endocrinology, The First Affiliated Hospital of Fujian Medical University, Diabetes Research Institute of Fujian Province, Fuzhou 350005, Fujian, China.
Diabetes Res Clin Pract. 2020 Apr;162:108096. doi: 10.1016/j.diabres.2020.108096. Epub 2020 Feb 25.
This study aimed to investigate the association of sarcopenia and muscle mass with both peripheral neuropathy and nerve function in type 2 diabetes mellitus.
A total of 1794 patients (937 men and 857 women) with type 2 diabetes, with a mean age of 60.22 years, were enrolled for a cross-sectional study; of these, 183 patients were enrolled for a follow-up study with a median follow-up of 2.7 years. All participants underwent nerve conduction studies and muscle mass index (ASM/HT) measurements. The composite Z scores for the sensory nerve conduction velocity (SCV) and the motor nerve conduction velocity (MCV) were calculated. The changes in ASM/HT, SCV, and MCV were calculated from the measurements nearly 2 years apart and classified into three groups: a decrease in ASM/HT of >3%, a minor change within ±3%, and an increase in ASM/HT of >3%.
The ASM/HT of men was positively associated with the composite Z scores of MCV and SCV, and sarcopenia highly correlated with DPN after adjusting for confounding factors. The optimal cutoff point for ASM/HT that indicated DPN was 7.09 kg/m. Furthermore, increases in ASM/HT independently predicted a greater benefit of MCV and SCV increment outcomes, whereas a minor change in ASM/HT only significantly associated with lower benefit in terms of SCV increment. However, this phenomenon was not observed in women.
Sarcopenia and DPN exhibited a close association. The increased muscle mass improved the partial MCVs and SCVs. However, a sex-related discrepancy was observed in this phenomenon.
本研究旨在探讨肌少症和肌肉量与 2 型糖尿病周围神经病变和神经功能的关系。
共纳入 1794 例（男 937 例，女 857 例）2 型糖尿病患者，平均年龄为 60.22 岁，进行横断面研究；其中 183 例患者纳入随访研究，中位随访时间为 2.7 年。所有参与者均进行神经传导研究和肌肉质量指数（ASM/HT）测量。计算感觉神经传导速度（SCV）和运动神经传导速度（MCV）的综合 Z 评分。从两次测量间隔近 2 年的 ASM/HT、SCV 和 MCV 的变化中计算出变化，分为三组：ASM/HT 减少>3%、变化在±3%以内和 ASM/HT 增加>3%。
男性的 ASM/HT 与 MCV 和 SCV 的综合 Z 评分呈正相关，在调整混杂因素后，肌少症与 DPN 高度相关。ASM/HT 预示 DPN 的最佳截断点为 7.09kg/m。此外，ASM/HT 的增加独立预测 MCV 和 SCV 增加的获益更大，而 ASM/HT 的轻微变化仅与 SCV 增加的获益显著相关。然而，这一现象在女性中并未观察到。
肌少症和 DPN 密切相关。增加肌肉质量可改善部分 MCV 和 SCV。然而，这种现象存在性别差异。
