Liu Jidong, Yu Dongqing, Xu Mingyue, Feng Ruiying, Sun Yujing, Yin Xiaofei, Lai Hong, Wang Chuan, Liu Jinbo
Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, China.
Open Med (Wars). 2021 Oct 20;16(1):1583-1590. doi: 10.1515/med-2021-0376. eCollection 2021.
Type 2 diabetes mellitus (T2DM) is a strong risk tfactor for osteosarcopenia. The relationship between musculoskeletal index and β-cell function remains controversial. We aimed to describe the clinical characteristics of osteosarcopenia and to explore the association between osteosarcopenia and β-cell function, as well as insulin resistance in patients with T2DM. A total of 150 middle-aged and older nonobese patients with T2DM were recruited. Bone mineral density (BMD) and body composition were measured by the dual-energy X-ray absorptiometry scanner. The homeostasis model assessment of insulin resistance and Matsuda index were used to evaluate insulin resistance status. β-Cell function was estimated by the area under the curve insulin/glucose (AUC-Ins/Glu) and the area under the curve C-peptide/glucose (AUC-CP/Glu). T2DM patients with osteosarcopenia had lower body mass index, waist circumference, body fat percentage, AUC-Ins/Glu, and AUC-CP/Glu. Both AUC-Ins/Glu (OR = 0.634 = 0.008) and AUC-CP/Glu (OR = 0.491, = 0.009) were negatively associated with the presence of osteosarcopenia. Multivariate linear regression analysis showed that β-cell function was positively associated with the skeletal muscle mass index, whereas it showed no correlation with lumbar or hip BMD. β-Cell function is associated with osteosarcopenia in middle-aged and older nonobese patients with T2DM. These findings suggest that β-cell function might be a protective factor against osteosarcopenia.
2型糖尿病(T2DM)是骨少肌症的一个重要危险因素。肌肉骨骼指数与β细胞功能之间的关系仍存在争议。我们旨在描述骨少肌症的临床特征,并探讨骨少肌症与T2DM患者β细胞功能以及胰岛素抵抗之间的关联。共招募了150例中老年非肥胖T2DM患者。采用双能X线吸收仪测量骨密度(BMD)和身体成分。采用胰岛素抵抗稳态模型评估和松田指数评估胰岛素抵抗状态。通过胰岛素/葡萄糖曲线下面积(AUC-Ins/Glu)和C肽/葡萄糖曲线下面积(AUC-CP/Glu)评估β细胞功能。患有骨少肌症的T2DM患者的体重指数、腰围、体脂百分比、AUC-Ins/Glu和AUC-CP/Glu较低。AUC-Ins/Glu(OR = 0.634,P = 0.008)和AUC-CP/Glu(OR = 0.491,P = 0.009)均与骨少肌症的存在呈负相关。多变量线性回归分析显示,β细胞功能与骨骼肌质量指数呈正相关,而与腰椎或髋部BMD无相关性。β细胞功能与中老年非肥胖T2DM患者的骨少肌症有关。这些发现表明,β细胞功能可能是预防骨少肌症的一个保护因素。