Lin Jui-An, Hou Jin-De, Wu Szu-Yuan
Center for Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11031, Taiwan.
Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei 11031, Taiwan.
J Clin Med. 2022 Jul 29;11(15):4424. doi: 10.3390/jcm11154424.
Purpose: The effect of sarcopenia on the survival of patients with type 2 diabetes remains unclear. Therefore, we designed a propensity score-matched population-based cohort study to compare the patients with diabetes with or without sarcopenia. Patients and Methods: We included patients with type 2 diabetes and categorized them into two groups according to whether they had sarcopenia and compared their survival; patients in the groups were matched at a ratio of 1:2. Results: The matching process yielded a final cohort of 201,698 patients (132,805 and 68,893 in the sarcopenia and nonsarcopenia diabetes groups, respectively) who were eligible for further analysis. According to both univariate and multivariate Cox regression analyses, the adjusted hazard ratios (aHRs; 95% confidence interval [CI]) of all-cause death for the sarcopenia diabetes group compared with the control group: 1.35 (1.33−1.38; p < 0.001). The aHRs (95% CIs) of all-cause death for those aged 41−50, 51−60, and >60 years (compared with those aged ≤40 years) were 1.53 (1.48−1.60), 2.61 (2.52−2.72), and 6.21 (5.99−6.45), respectively. The aHR (95% CI) of all-cause death for the male patients compared with the female patients was 1.56 (1.54−1.60). The aHRs (95% CIs) of all-cause death for those with adapted Diabetes Complications Severity Index (aDCSI) scores of 1, 2, 3, 4, and ≥5 (compared with an aDCSI score of 0) were 1.01 (1.00−1.14), 1.38 (1.35−1.42), 1.58 (1.54−1.63), and 2.23 (2.14−2.33), respectively. Conclusion: Patients with type 2 diabetes and sarcopenia had higher mortality than did those without sarcopenia.
肌肉减少症对2型糖尿病患者生存的影响尚不清楚。因此，我们设计了一项倾向评分匹配的基于人群的队列研究，以比较有或无肌肉减少症的糖尿病患者。患者与方法：我们纳入了2型糖尿病患者，并根据是否患有肌肉减少症将他们分为两组，比较其生存率；两组患者按1:2的比例进行匹配。结果：匹配过程产生了一个最终队列，共201,698例患者（肌肉减少症糖尿病组和非肌肉减少症糖尿病组分别为132,805例和68,893例），他们有资格进行进一步分析。根据单因素和多因素Cox回归分析，肌肉减少症糖尿病组与对照组相比，全因死亡的调整后风险比（aHRs；95%置信区间[CI]）为1.35（1.33−1.38；p<0.001）。41−50岁、51−60岁和>60岁（与≤40岁者相比）的全因死亡aHRs（95%CI）分别为1.53（1.48−1.60）、2.61（2.52−2.72）和6.21（5.99−6.45）。男性患者与女性患者相比，全因死亡的aHR（95%CI）为1.56（1.54−1.60）。适应糖尿病并发症严重指数（aDCSI）评分为1、2、3、4和≥5（与aDCSI评分为0相比）的全因死亡aHRs（95%CI）分别为1.01（1.00−1.14）、1.38（1.35−1.42）、1.58（1.54−1.63）和2.23（2.14−2.33）。结论：2型糖尿病合并肌肉减少症的患者死亡率高于无肌肉减少症的患者。
