Division of Diabetes, Metabolism and Endocrinology, Kawasaki Medical School, Okayama, Japan.
Iwamoto Medical Clinic, Kagawa, Japan.
J Diabetes Investig. 2021 Mar;12(3):417-424. doi: 10.1111/jdi.13366. Epub 2020 Aug 11.
AIMS/INTRODUCTION: This study examined the association between body mass index (BMI) and the risk of sarcopenia in Japanese type 2 diabetes patients.
Patients with type 2 diabetes who visited an outpatient clinic comprised the study's participants. Sarcopenia was defined using the definition of the Asian Working Group for Sarcopenia 2014. The area under the curve was examined for the presence of sarcopenia based on the receiver operating characteristic curve of BMI.
Among 1,137 patients, 210 were diagnosed with low grip strength, 78 with slow gait speed, 444 with low muscle mass and 142 with sarcopenia. The optimal cut-off point of BMI level for risk of sarcopenia was 24.4 kg/m (area under the curve 0.729, 95% confidence interval 0.688-0.770, sensitivity 0.587, specificity 0.789). Furthermore, the receiver operating characteristic curve of BMI for sarcopenia did not significantly differ (P = 0.09) from that of gait speed, an established marker of sarcopenia. In both the male and female groups, there was no difference between the receiver operating characteristic curves of BMI and gait speed for sarcopenia. (P = 0.23 and P = 0.40, respectively).
These results suggest that a BMI <24 kg/m among Japanese patients with type 2 diabetes could increase their risk of sarcopenia, the extent of which is equivalent to the risk for sarcopenia from slow gait speed in this study. Further prospective investigation, however, is required.
目的/引言:本研究旨在探讨日本 2 型糖尿病患者的体重指数(BMI)与肌少症风险之间的关系。
本研究的参与者为就诊于门诊的 2 型糖尿病患者。肌少症采用亚洲肌少症工作组 2014 年的定义进行定义。根据 BMI 的受试者工作特征曲线,检查存在肌少症的曲线下面积。
在 1137 名患者中,210 名患者被诊断为握力低,78 名患者为步态速度慢,444 名患者为肌肉量低,142 名患者为肌少症。BMI 水平发生肌少症风险的最佳截断点为 24.4kg/m(曲线下面积为 0.729,95%置信区间为 0.688-0.770,灵敏度为 0.587,特异性为 0.789)。此外,BMI 对肌少症的受试者工作特征曲线与步态速度(肌少症的既定标志物)无显著差异(P=0.09)。在男性和女性组中,BMI 和步态速度对肌少症的受试者工作特征曲线之间均无差异(分别为 P=0.23 和 P=0.40)。
这些结果表明,日本 2 型糖尿病患者的 BMI<24kg/m可能会增加其肌少症的风险,其程度相当于本研究中步态速度导致肌少症的风险。然而,还需要进一步的前瞻性研究。