肌少症与 2 型糖尿病患者的死亡风险相关。
Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus.
机构信息
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Diabetology, Kameoka Municipal Hospital, Kameoka, Japan.
出版信息
Front Endocrinol (Lausanne). 2021 Nov 11;12:783363. doi: 10.3389/fendo.2021.783363. eCollection 2021.
BACKGROUND
Sarcopenia has reportedly been associated with increased risk of mortality in general populations. However, few studies have investigated the association between sarcopenia and mortality in older people with type 2 diabetes mellitus (T2D). This study aimed to investigate the effect of sarcopenia on incident all-cause mortality in older people with T2D.
METHODS
Low muscle strength were set at handgrip strength <28 kg for men and <18 kg for women, and low skeletal muscle mass index (SMI), evaluated using the impedance body composition analyzer, were set at SMI <7.0 kg/m for men and <5.7 kg/m for women. People who had both low muscle strength and low SMI were diagnosed with sarcopenia. Due to a low incidence of all-cause mortality, the propensity score was used. The propensity score was evaluated using multivariable logistic regression models with the following parameters: age, sex, duration of diabetes, history of heart disease, history of cancer, smoking, exercise, alcohol, sodium-glucose cotransporter-2 inhibitor, glucagon-like peptide-1 receptor agonist, insulin, corticosteroid, hypertension, body mass index, glycosylated hemoglobin A1c, triglycerides, and creatinine, and the C-statistic was 0.89.
RESULTS
In this prospective cohort study, 396 people with an average age and duration of diabetes of 71.3 (6.3) years and 16.3 (11.3) years, respectively, were included. Of those included, 14.6% had sarcopenia. During the average 40.5 (16.5) months of follow-up, 13 people (6 out of the 338 without sarcopenia and 7 out of the 58 with sarcopenia) died. Incident rate were 5.1/1000 person years of follow-up in people without sarcopenia and 41.3/1000 person years of follow-up in people with sarcopenia. According to Cox regression analysis, sarcopenia was associated with all-cause mortality (adjusted hazard ratio: 6.12, 95% confidence interval: 1.52-24.7, = 0.011).
CONCLUSION
Sarcopenia is associated with incident all-cause mortality in older outpatients with T2D.
背景
据报道，肌少症与一般人群的死亡率增加有关。然而，很少有研究调查肌少症与 2 型糖尿病（T2D）老年人的死亡率之间的关系。本研究旨在探讨肌少症对 T2D 老年患者全因死亡率的影响。
方法
低肌肉力量设定为男性握力<28 千克，女性<18 千克；使用阻抗式身体成分分析仪评估的低骨骼肌质量指数（SMI）设定为男性<7.0 千克/平方米，女性<5.7 千克/平方米。同时存在低肌肉力量和低 SMI 的人被诊断为肌少症。由于全因死亡率发生率较低，因此使用了倾向评分。倾向评分使用多变量逻辑回归模型进行评估，模型参数包括年龄、性别、糖尿病病程、心脏病史、癌症史、吸烟、运动、饮酒、钠-葡萄糖共转运蛋白-2 抑制剂、胰高血糖素样肽-1 受体激动剂、胰岛素、皮质类固醇、高血压、体重指数、糖化血红蛋白 A1c、甘油三酯和肌酐，C 统计量为 0.89。
结果
在这项前瞻性队列研究中，纳入了 396 名平均年龄和糖尿病病程分别为 71.3（6.3）岁和 16.3（11.3）年的患者。其中 14.6%患有肌少症。在平均 40.5（16.5）个月的随访期间，有 13 人（338 名无肌少症患者中有 6 人，58 名有肌少症患者中有 7 人）死亡。无肌少症患者的全因死亡率为 5.1/1000 人年，有肌少症患者的全因死亡率为 41.3/1000 人年。根据 Cox 回归分析，肌少症与全因死亡率相关（调整后的危险比：6.12，95%置信区间：1.52-24.7，=0.011）。
结论
肌少症与 T2D 老年门诊患者的全因死亡率相关。
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