2型糖尿病中的肌肉减少症：一项横断面观察研究。

Sarcopenia in Type 2 Diabetes Mellitus: A Cross-Sectional Observational Study.

作者信息

Pechmann L M, Jonasson T H, Canossa V S, Trierweiler H, Kisielewicz G, Petterle R R, Moreira C A, Borba V Z C

机构信息

Internal Medicine and Endocrine Division (SEMPR), Universidade Federal do Paraná, Centro de Diabetes Curitiba, Curitiba, PR, Brazil.

Endocrine Division, Hospital de Clínicas da Universidade Federal Do Paraná (SEMPR), Avenida Agostinho Leão Júnior, 285, Alto da Glória, Curitiba, PR 80030-110, Brazil.

出版信息

Int J Endocrinol. 2020 Oct 29;2020:7841390. doi: 10.1155/2020/7841390. eCollection 2020.

DOI:10.1155/2020/7841390

PMID:33178269

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7644336/

Abstract

BACKGROUND

The aim of this study was to compare the prevalence of low muscle mass and sarcopenia in patients with type 2 diabetes mellitus (T2DM) versus paired controls (control group, CG) and the association between sarcopenia and chronic diabetes complications.

METHODS

Men and women ≥50 years with T2DM (T2DM group, T2DMG) were recruited during routine outpatient visits. Total body densitometry and handgrip strength (HGS) were evaluated in the T2DMG and CG, while the T2DMG was also evaluated for the physical performance using the gait speed (GS) test. Sarcopenia was diagnosed according to the criteria of the Foundation for the National Institutes of Health Sarcopenia Project (FNIH).

RESULTS

The study included 177 individuals in the T2DMG and 146 in the CG. The mean HGS value was lower in the T2DMG (24.4 ± 10.3 kg) compared with the CG (30.9 ± 9.15 kg), < 0.001, with low HGS in 46 (25.9%) and 10 (9%) in the T2DMG and CG, respectively ( < 0.001). The prevalence of sarcopenia defined according to the FNIH criteria was higher in the T2DMG 23 (12.9%) compared with the CG 8 (5.4%), < 0.03. The presence of albuminuria increased the odds of sarcopenia (odds ratio (OR) 2.84, 95% confidence interval (CI) 1.07-7.68, =0.04) and osteoporosis (OR 3.38, 95% CI 1.12-9.89, =0.03), even in patients with mild to moderate nephropathy. The body composition analysis showed increased odds of sarcopenia with increased percentage of total fat (%TF) in women (OR 1.18, 95% CI, 1.03-1.43, =0.03) and men (OR 1.31, 95% CI, 1.10-1.75, =0.01).

CONCLUSION

Patients with T2DM presenting with albuminuria, osteoporosis, and increased %TF were more likely to have sarcopenia. This finding emphasizes the need for patients with T2DM to be evaluated for sarcopenia to allow for early implementation of measures to prevent or treat this disorder.

摘要

背景

本研究旨在比较2型糖尿病（T2DM）患者与配对对照组（对照组，CG）中低肌肉量和肌肉减少症的患病率，以及肌肉减少症与慢性糖尿病并发症之间的关联。

方法

在常规门诊就诊期间招募年龄≥50岁的T2DM男性和女性（T2DM组，T2DMG）。对T2DMG和CG进行全身密度测定和握力（HGS）评估，同时使用步速（GS）测试对T2DMG的身体表现进行评估。根据美国国立卫生研究院肌肉减少症项目基金会（FNIH）的标准诊断肌肉减少症。

结果

该研究纳入了177名T2DMG患者和146名CG患者。与CG（30.9±9.15 kg）相比，T2DMG的平均HGS值较低（24.4±10.3 kg），P<0.001，T2DMG和CG中HGS较低的患者分别为46例（25.9%）和10例（9%）（P<0.001）。根据FNIH标准定义的肌肉减少症患病率在T2DMG中为23例（12.9%），高于CG中的8例（5.4%），P<0.03。即使在轻度至中度肾病患者中，蛋白尿的存在也增加了肌肉减少症（优势比（OR）2.84，95%置信区间（CI）1.07 - 7.68，P = 0.04）和骨质疏松症（OR 3.38，95%CI 1.12 - 9.89，P = 0.03）的发病几率。身体成分分析显示，女性（OR 1.18，95%CI，1.03 - 1.43，P = 0.03）和男性（OR 1.31，95%CI，1.10 - 1.75，P = 0.01）中，随着总脂肪百分比（%TF）增加，肌肉减少症的发病几率增加。