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鸢尾素是 2 型糖尿病患者合并肌少症性肥胖的预测因子:一项横断面研究。

Irisin is a predictor of sarcopenic obesity in type 2 diabetes mellitus: A cross-sectional study.

机构信息

Faculty of Medicine, Istinye University, Istanbul.

Department of Endocrinology and Metabolism.

出版信息

Medicine (Baltimore). 2021 Jul 2;100(26):e26529. doi: 10.1097/MD.0000000000026529.

Abstract

We aimed to evaluate sarcopenia and sarcopenic obesity (SO) in patients with type 2 diabetes mellitus (T2DM), possible relationships with serum irisin and myostatin levels, and the effect of glycemic control on SO.Ninety T2DM patients were included in this a cross-sectional study. Sarcopenia was determined by evaluating muscle mass (bioelectrical impedance analysis), muscle strength (HGS), and gait speed (GS). Patients with muscle mass loss with functionally reduced muscle strength and/or performance were considered sarcopenic. In addition, participants were divided into 3 groups according to the FM (fat mass)/FFM (fat-free mass) ratio [group 1:5th-50th percentiles; group 2:50th-95th percentiles and group 3: ≥95 percentiles (sarcopenic obese)]. Irisin, myostatin levels and metabolic parameters were measured in all patients.The prevalence of sarcopenia and SO was 25.6% and 35.6%, respectively. Irisin levels were lower in sarcopenic patients, while glycosylated hemoglobin (A1c), body mass index (BMI), FM, and FM index were higher (P < .05). From group 1 to group 3, BMI, FM, FM index, GS, myostatin, and A1c increased, and muscle mass percentage, HGS, and irisin decreased (P < .05). A positive correlation was found between FM/FFM and myostatin and a negative correlation between FM/FFM and irisin (r = 0.303, P = .004 vs. r = -0.491, P < .001). Irisin remained an important predictor of SO, even after adjusting for confounding variables (OR:1.105; 95% CI:0.965-1.338, P = .002). The optimal cut-off value for irisin to predict SO was 9.49 ng/mL (specificity = 78.1%, sensitivity = 75.8%). In addition, A1c was an independent risk factor for SO development (OR:1.358, P = .055).This study showed that low irisin levels (<9.49ng/mL) and poor glycemic control in T2DM patients were an independent risk factor, especially for SO.

摘要

我们旨在评估 2 型糖尿病(T2DM)患者的肌肉减少症和肌肉减少性肥胖症(SO),以及血清鸢尾素和肌肉生长抑制素水平的可能关系,和血糖控制对 SO 的影响。这项横断面研究纳入了 90 名 T2DM 患者。通过评估肌肉质量(生物电阻抗分析)、肌肉力量(HGS)和步态速度(GS)来确定肌肉减少症。肌肉质量下降伴有功能性肌肉力量和/或运动能力下降的患者被认为患有肌肉减少症。此外,根据 FM(脂肪量)/FFM(无脂肪量)比,参与者被分为 3 组[第 1 组:5%至 50%;第 2 组:50%至 95%;第 3 组:≥95%(肌肉减少性肥胖)]。所有患者均测量了鸢尾素、肌肉生长抑制素水平和代谢参数。肌肉减少症和 SO 的患病率分别为 25.6%和 35.6%。肌肉减少症患者的鸢尾素水平较低,而糖化血红蛋白(A1c)、体重指数(BMI)、FM 和 FM 指数较高(P<0.05)。从第 1 组到第 3 组,BMI、FM、FM 指数、GS、肌肉生长抑制素和 A1c 增加,肌肉质量百分比、HGS 和鸢尾素减少(P<0.05)。FM/FFM 与肌肉生长抑制素呈正相关,与鸢尾素呈负相关(r=0.303,P=0.004 与 r=-0.491,P<0.001)。即使在调整混杂变量后,鸢尾素仍然是 SO 的重要预测因子(OR:1.105;95%CI:0.965-1.338,P=0.002)。预测 SO 的鸢尾素最佳截断值为 9.49ng/mL(特异性=78.1%,敏感性=75.8%)。此外,A1c 是 SO 发生的独立危险因素(OR:1.358,P=0.055)。这项研究表明,T2DM 患者低水平的鸢尾素(<9.49ng/mL)和血糖控制不佳是独立的危险因素,尤其是 SO。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bfb/8257893/9b30562e9974/medi-100-e26529-g001.jpg

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