2型糖尿病患者肌肉减少症与蛋白尿的相关性
[Correlation between sarcopenia and albuminuria in patients with type 2 diabetes].
作者信息
Yan Junfeng, Zheng Kaiyuan, Lin Chuan, Liu Chun
机构信息
Department of Nephrology, Chongqing General Hospital, Chongqing 400013, China.
Department of Endocrinology/Integrated Chinese and Western Medicine, Chongqing General Hospital, Chongqing 400013, China.
出版信息
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Mar 30;40(3):407-412. doi: 10.12122/j.issn.1673-4254.2020.03.20.
OBJECTIVE
To investigate the correlation between sarcopenia and albuminuria in patients with type 2 diabetes mellitus (T2DM).
METHODS
A total of 360 T2DM patients (including 206 male and 154 female patients) hospitalized in our hospital between January, 2015 and December, 2018 were enrolled. According to their medical history and laboratory test results, the patients were divided into albuminuria group (=122) and non-albuminuria group (=238). The clinical and anthropological data were collected and skeletal muscle index (SMI), appendage lean mass, muscle index, total body fat, bone mineral capacity and bone mineral density were measured using dual-energy X-ray absorptiometry. Logistic regression was used to analyze the correlation of these body composition parameters with albuminuria or chronic kidney disease (CKD) in the diabetic patients.
RESULTS
The disease course of T2DM, history of hypertension, age, systolic blood pressure, low density lipoprotein cholesterol, triglyceride, uric acid, waistline, Urinary albumin creatinine ratio, serum creatinine, and glomerular filtration rate differed significantly between the diabetic patients with albuminuria and those without albuminuria ( < 0.05). The prevalence rate of sarcopenia was significantly higher in patients with albuminuria (31.4% 13.1%, < 0.01). Compared with those without albuminuria, the patients with albuminuria had significantly decreased SMI (=-2.304, =0.021) and body mass index (=- 5.534, < 0.01) and significantly increased total body fat (=- 2.838, =0.005). Multivariate logistic regression analysis showed that after adjustment for age, gender, total body fat, smoking history, drinking history, duration of diabetes, HbA1c, history of hypertension, systolic blood pressure, low density lipoprotein cholesterol, body mass index, and triglyceride, the patients with a decreased SMI had a significantly increased risk of albuminuria (=0.011 and 0.010), but SMI was not correlated with the risk of CKD in patients with T2DM ( > 0.05).
CONCLUSIONS
Sarcopenia is probably an independent risk factor for albuminuria in patients with T2DM.
目的
探讨2型糖尿病（T2DM）患者肌肉减少症与蛋白尿之间的相关性。
方法
选取2015年1月至2018年12月在我院住院的360例T2DM患者（包括206例男性和154例女性患者）。根据患者病史和实验室检查结果，将患者分为蛋白尿组（n = 122）和无蛋白尿组（n = 238）。收集临床和人体测量学数据，并使用双能X线吸收法测量骨骼肌指数（SMI）、附属器瘦体重、肌肉指数、全身脂肪、骨矿物质含量和骨密度。采用逻辑回归分析这些身体成分参数与糖尿病患者蛋白尿或慢性肾脏病（CKD）的相关性。
结果
T2DM病程、高血压病史、年龄、收缩压、低密度脂蛋白胆固醇、甘油三酯、尿酸、腰围、尿白蛋白肌酐比值、血清肌酐和肾小球滤过率在有蛋白尿和无蛋白尿的糖尿病患者之间差异有统计学意义（P < 0.05）。蛋白尿患者肌肉减少症的患病率显著更高（31.4% 对13.1%，P < 0.01）。与无蛋白尿患者相比，有蛋白尿患者的SMI显著降低（β = -2.304，P = 0.021）和体重指数显著降低（β = -5.534，P < 0.01），全身脂肪显著增加（β = -2.838，P = 0.005）。多因素逻辑回归分析显示，在调整年龄、性别、全身脂肪、吸烟史、饮酒史、糖尿病病程、糖化血红蛋白、高血压病史、收缩压、低密度脂蛋白胆固醇、体重指数和甘油三酯后，SMI降低的患者蛋白尿风险显著增加（P = 0.011和P = 0.010），但SMI与T2DM患者的CKD风险无关（P > 0.05）。
结论
肌肉减少症可能是T2DM患者蛋白尿的独立危险因素。
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