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2型糖尿病患者身体成分和骨密度的年龄相关变化及其与糖尿病病程和血糖控制的关系

Age-Related Changes in Body Composition and Bone Mineral Density and Their Relationship with the Duration of Diabetes and Glycaemic Control in Type 2 Diabetes.

作者信息

Tang Ying, Gong Lilin, Chen Xiangjun, Du Zhipeng, Hu Jinbo, Xu Zhixin, Wu Jinshan, Li Qifu, Wang Zhihong

机构信息

Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.

Department of Endocrinology, West China-Guang'an Hospital, Sichuan University, Sichuan, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2020 Dec 1;13:4699-4710. doi: 10.2147/DMSO.S278425. eCollection 2020.

Abstract

PURPOSE

To investigate age-related changes in body composition (BC) and bone mineral density (BMD) in type 2 diabetes (T2D) and analyse whether diabetes duration or glycaemic control affects these factors.

PATIENTS AND METHODS

We enrolled 1474 hospitalized T2D patients (817 males and 657 females; 45-85 years). BC and BMD were assessed by dual-energy X-ray absorptiometry (DEXA). Patients were stratified into age groups: 45-54, 55-64, 65-74, and ≥75 years. Continuous variables were compared using -tests or one-way analysis of variance (ANOVA), and categorical variables were compared using chi-square tests. Effects of age, diabetes duration, and haemoglobin A (HbA) on BC and BMD were assessed with multiple linear regression models.

RESULTS

In T2D, in females, changes in fat mass index (FMI) were positively correlated with age, while changes in lean mass index (LMI) were unrelated to age. Changes in FMI or LMI in males were unrelated to age. For regional BC distribution, changes in visceral adipose tissue (VAT) were positively correlated with age for both males and females, while changes in appendage lean mass (ALM) were negatively correlated with age. For BMD, changes in total BMD (TBMD) in males were not correlated with age, while changes in lumbar spine BMD (LBMD) were positively correlated with age, and femoral neck BMD (FNBMD) was negatively correlated with age. Changes in BMD in all parts of females were negatively correlated with age. In addition, changes in BC and BMD were unrelated to diabetes duration, and HbA was mainly associated with decreases in lean mass but had little effect on other BC and BMD parameters.

CONCLUSION

In T2D, changes in BC and BMD were associated with age but not diabetes duration. A higher HbA is associated with lower lean mass.

摘要

目的

研究2型糖尿病(T2D)患者身体成分(BC)和骨密度(BMD)的年龄相关变化,并分析糖尿病病程或血糖控制是否会影响这些因素。

患者与方法

我们纳入了1474例住院的T2D患者(男性817例,女性657例;年龄45 - 85岁)。通过双能X线吸收法(DEXA)评估BC和BMD。患者被分为年龄组:45 - 54岁、55 - 64岁、65 - 74岁和≥75岁。连续变量采用t检验或单因素方差分析(ANOVA)进行比较,分类变量采用卡方检验进行比较。使用多元线性回归模型评估年龄、糖尿病病程和糖化血红蛋白(HbA)对BC和BMD的影响。

结果

在T2D患者中,女性的脂肪量指数(FMI)变化与年龄呈正相关,而瘦体重指数(LMI)变化与年龄无关。男性的FMI或LMI变化与年龄无关。对于局部BC分布,男性和女性的内脏脂肪组织(VAT)变化均与年龄呈正相关,而附属器瘦体重(ALM)变化与年龄呈负相关。对于BMD,男性的总骨密度(TBMD)变化与年龄无关,而腰椎骨密度(LBMD)变化与年龄呈正相关,股骨颈骨密度(FNBMD)变化与年龄呈负相关。女性所有部位的BMD变化均与年龄呈负相关。此外,BC和BMD的变化与糖尿病病程无关,HbA主要与瘦体重降低有关,但对其他BC和BMD参数影响较小。

结论

在T2D患者中,BC和BMD的变化与年龄相关,但与糖尿病病程无关。较高的HbA与较低的瘦体重相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdc1/7719045/c5e1878934fe/DMSO-13-4699-g0001.jpg

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