Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Republic of Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Atherosclerosis. 2020 Jul;305:19-25. doi: 10.1016/j.atherosclerosis.2020.05.021. Epub 2020 Jun 16.
Sarcopenia leads to metabolic and vascular abnormalities. However, little is known regarding the independent relationship between skeletal muscle mass and atherosclerosis in patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the association between skeletal muscle mass and carotid atherosclerosis in men and women with T2DM.
In this cross-sectional study, a total of 8202 patients with T2DM were recruited from the Seoul Metabolic Syndrome cohort. Skeletal muscle mass was estimated using bioimpedance analysis, while skeletal muscle mass index (SMI, %) was defined as total skeletal muscle mass (kg)/body weight (kg) × 100. Both carotid arteries were examined by B-mode ultrasound. Carotid atherosclerosis was defined by having a carotid plaque or mean carotid intima-media thickness (IMT) ≥1.1 mm.
Among the entire population, 4299 (52.4%) subjects had carotid atherosclerosis. The prevalence of carotid atherosclerosis increased with decreasing SMI quartiles for both sexes. The odds ratios for carotid atherosclerosis were 2.33 (95% confidence interval [CI], 1.17-4.63) and 2.24 (95% CI, 1.06-4.741) in the lowest versus highest SMI quartile in men and women, respectively, after the adjustment for clinical risk factors. In men, the risk of atherosclerosis increased linearly with decreasing SMI quartiles (p for trend = 0.036).
Low skeletal muscle mass was independently associated with the presence of carotid atherosclerosis in men and women with T2DM.
肌少症可导致代谢和血管异常。然而，关于 2 型糖尿病（T2DM）患者骨骼肌质量与动脉粥样硬化之间的独立关系知之甚少。本研究旨在评估 T2DM 男性和女性骨骼肌质量与颈动脉粥样硬化之间的关系。
在这项横断面研究中，共招募了 8202 名来自首尔代谢综合征队列的 T2DM 患者。使用生物电阻抗分析来估计骨骼肌质量，而骨骼肌质量指数（SMI，%）定义为总骨骼肌质量（kg）/体重（kg）×100。通过 B 型超声检查双侧颈动脉。颈动脉粥样硬化定义为颈动脉斑块或平均颈动脉内膜中层厚度（IMT）≥1.1mm。
在整个人群中，4299 名（52.4%）患者存在颈动脉粥样硬化。颈动脉粥样硬化的患病率随着 SMI 四分位数的降低而增加，无论男女。在校正临床危险因素后，SMI 最低四分位数与最高四分位数相比，男性和女性的颈动脉粥样硬化的比值比分别为 2.33（95%可信区间[CI]，1.17-4.63）和 2.24（95%CI，1.06-4.741）。在男性中，随着 SMI 四分位数的降低，动脉粥样硬化的风险呈线性增加（趋势检验 p=0.036）。
骨骼肌质量低与 T2DM 男性和女性颈动脉粥样硬化的存在独立相关。
