Mohapatra Subarna, Ramachandran Madumathy, Behera Kishore Kumar, Priyadarsini Nibedita, Nanda Pranati, Devi Sujata
Department of Physiology, All India Institute of Medical Sciences, Bhubaneswar, India.
Department of Endocrinology, All India Institute of Medical Sciences, Bhubaneswar, India.
Endocrinol Diabetes Nutr (Engl Ed). 2022 Oct;69(8):591-599. doi: 10.1016/j.endien.2022.03.009.
BACKGROUND & OBJECTIVE: Diabetic peripheral neuropathy (DPN) is considered to be a risk factor for development of sarcopenia. Therefore, our study aimed to detect the association between peripheral neuropathy with skeletal muscle mass and function in type two diabetes mellitus (T2DM) patients.
A total of 176 participants, ≥45 years were included in the study. Out of 176, 60 were healthy volunteers, 60 had T2DM without neuropathy, 56 had T2DM with neuropathy. In all the participants peripheral nerve function was assessed by nerve conduction studies (Common peroneal and Sural nerve) and sarcopenia parameters were evaluated according to the Asian Working Group for Sarcopenia (AWGS) criteria.
The present study suggested that diabetic peripheral neuropathy (DPN) was associated with decline in muscle mass, which was found only in men. Our study showed a positive correlation between appendicular skeletal muscle index (ASMI) and common peroneal nerve amplitude and sural nerve amplitude with r=0.527, p<0.05; r=0.847, p<0.001 respectively. Furthermore, in multiple linear regression analyses, we found a positive relationship between ASMI and sural nerve amplitude after adjustment for confounders like age, duration of diabetes, and HbA1C (B=0.739; p<0.001).
As DPN patients are more prone to developing sarcopenia, and periodic assessment of skeletal muscle mass and function is warranted to initiate early lifestyle interventions in these patients, which will improve their quality of life.
糖尿病周围神经病变（DPN）被认为是肌肉减少症发生的一个危险因素。因此，我们的研究旨在检测2型糖尿病（T2DM）患者中周围神经病变与骨骼肌质量和功能之间的关联。
共有176名年龄≥45岁的参与者纳入本研究。在这176名参与者中，60名是健康志愿者，60名患有无神经病变的T2DM，56名患有神经病变的T2DM。对所有参与者通过神经传导研究（腓总神经和腓肠神经）评估周围神经功能，并根据亚洲肌肉减少症工作组（AWGS）标准评估肌肉减少症参数。
本研究表明，糖尿病周围神经病变（DPN）与肌肉质量下降有关，这仅在男性中发现。我们的研究显示，四肢骨骼肌指数（ASMI）与腓总神经振幅和腓肠神经振幅呈正相关，r分别为0.527，p<0.05；r为0.847，p<0.001。此外，在多元线性回归分析中，我们发现调整年龄、糖尿病病程和糖化血红蛋白等混杂因素后，ASMI与腓肠神经振幅呈正相关（B=0.739；p<0.001）。
由于DPN患者更容易发生肌肉减少症，因此有必要定期评估骨骼肌质量和功能，以便在这些患者中尽早开展生活方式干预，这将改善他们的生活质量。
