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一项横断面研究:对糖化血红蛋白水平高的2型糖尿病患者的低肌肉量和骨质疏松症的评估。

A cross-sectional study: an assessment of low muscle mass and osteoporosis in type 2 diabetes mellitus patients with a high glycated hemoglobin level.

作者信息

Fang Lingna, Zhong Shao, Ma Dan, Li Chong, Hao Yanmin, Gao Yan, Zhang Li, Shen Liwen

机构信息

Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Qianjin Road 91#, Kunshan, 215300, China.

Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China.

出版信息

Ther Adv Chronic Dis. 2021 Jun 23;12:20406223211026762. doi: 10.1177/20406223211026762. eCollection 2021.

Abstract

BACKGROUND

Low muscle mass and osteoporosis are commonly observed in individuals with type 2 diabetes mellitus (T2DM). We investigated the prevalence of low muscle mass and osteoporosis in patients with T2DM who had high glycated hemoglobin (HbA1c) levels.

METHODS

We included 187 Chinese patients with T2DM who were aged ⩾50 years and evaluated their body composition using dual-energy X-ray absorptiometry. We measured levels of fasting blood glucose, HbA1c, B collagen-specific sequences (B-CTX), osteocalcin (OC), propeptide of type 1 procollagen (P1NP), and 25-hydroxy vitamin D.

RESULTS

Of the total patients, 82 were men and 105 were women. The prevalence rates of low muscle mass, osteopenia, and osteoporosis were 35.8%, 38.0%, and 31.0%, respectively. The prevalence rate of low muscle mass was significantly higher in women with HbA1c levels >9.0% than in those with HbA1c levels <9.0%. The prevalence rates of osteopenia and osteoporosis in men with HbA1c levels >9.0% differed significantly from those with HbA1c levels <9.0%. The appendicular skeletal muscle mass index (ASMI), trunk muscle mass, lumbar spinal bone mineral content (BMC), lumbar spine BMD, femoral BMC, and femoral BMD were significantly decreased, and the serum levels of B-CTX, OC, and P1NP were significantly increased in patients with T2DM who had osteoporosis. The ASMI was associated with osteopenia/osteoporosis in men and women with T2DM.

CONCLUSIONS

In patients with T2DM, high HbA1c levels were associated with higher prevalence rates of low muscle mass in women and osteoporosis in men, and ASMI was a risk factor of osteoporosis.

摘要

背景

低肌肉量和骨质疏松症在2型糖尿病(T2DM)患者中较为常见。我们调查了糖化血红蛋白(HbA1c)水平较高的T2DM患者中低肌肉量和骨质疏松症的患病率。

方法

我们纳入了187例年龄≥50岁的中国T2DM患者,并使用双能X线吸收法评估他们的身体成分。我们测量了空腹血糖、HbA1c、I型胶原交联C端肽(B-CTX)、骨钙素(OC)、I型前胶原氨基端前肽(P1NP)和25-羟基维生素D的水平。

结果

在全部患者中,男性82例,女性105例。低肌肉量、骨量减少和骨质疏松症的患病率分别为35.8%、38.0%和31.0%。HbA1c水平>9.0%的女性中低肌肉量的患病率显著高于HbA1c水平<9.0%的女性。HbA1c水平>9.0%的男性中骨量减少和骨质疏松症的患病率与HbA1c水平<9.0%的男性有显著差异。患有骨质疏松症的T2DM患者的四肢骨骼肌质量指数(ASMI)、躯干肌肉量、腰椎骨矿物质含量(BMC)、腰椎骨密度、股骨BMC和股骨骨密度显著降低,血清B-CTX、OC和P1NP水平显著升高。ASMI与T2DM男性和女性的骨量减少/骨质疏松症相关。

结论

在T2DM患者中,高HbA1c水平与女性低肌肉量和男性骨质疏松症的较高患病率相关,且ASMI是骨质疏松症的一个危险因素。

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