2 型糖尿病患者低骨骼肌量和肌少性肥胖对慢性肾脏病的影响。
Effect of low skeletal muscle mass and sarcopenic obesity on chronic kidney disease in patients with type 2 diabetes.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea.
Department of Biomedical Sciences, Inha University College of Medicine, Incheon, Republic of Korea.
出版信息
Obesity (Silver Spring). 2022 Oct;30(10):2034-2043. doi: 10.1002/oby.23512. Epub 2022 Sep 5.
OBJECTIVE
This study aimed to investigate the association between low muscle mass or sarcopenic obesity and the risk of incident chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM).
METHODS
A total of 3123 patients with T2DM with preserved renal function were followed up for incident CKD. Skeletal muscle mass was estimated from bioelectrical impedance analysis. CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m . Sarcopenic obesity was defined as the coexistence of sarcopenia and abdominal obesity.
RESULTS
During 8.9 years of follow-up, 530 (17.0%) patients developed incident CKD. When patients were divided into three groups based on sex-specific tertiles, lower muscle mass was not associated with an increased risk of incident CKD after adjustment for risk factors. However, when patients were divided into four groups according to the presence of sarcopenia and obesity, sarcopenic obesity was associated with an increased risk of incident CKD (adjusted hazard ratio 1.77; 95% CI: 1.24-2.51; p = 0.001) compared with the other groups.
CONCLUSIONS
Sarcopenic obesity, but not low muscle mass alone, may increase the risk of CKD in patients with T2DM.
目的
本研究旨在探讨 2 型糖尿病（T2DM）患者低肌肉量或肌少症合并腹型肥胖与慢性肾脏病（CKD）发病风险的关系。
方法
共对 3123 例肾功能正常的 T2DM 患者进行了 CKD 发病的随访。通过生物电阻抗分析法评估骨骼肌质量。CKD 定义为估算肾小球滤过率<60ml/min/1.73m。肌少症合并腹型肥胖定义为肌少症和腹型肥胖并存。
结果
在 8.9 年的随访期间，530（17.0%）例患者发生了 CKD。当根据性别特异的三分位将患者分为三组时，校正危险因素后，低肌肉量与 CKD 发病风险增加无关。然而，当根据是否存在肌少症和肥胖将患者分为四组时，与其他组相比，肌少症合并腹型肥胖与 CKD 发病风险增加相关（调整后的危险比 1.77；95%可信区间：1.24-2.51；p=0.001）。
结论
与单纯低肌肉量相比，肌少症合并腹型肥胖可能会增加 T2DM 患者发生 CKD 的风险。
Zotero 插件