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非老年美国成年人中肌少症与糖尿病前期的关系。

Association between sarcopenia and prediabetes among non-elderly US adults.

机构信息

Department of Endocrinology, Shuguang Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

出版信息

J Endocrinol Invest. 2023 Sep;46(9):1815-1824. doi: 10.1007/s40618-023-02038-y. Epub 2023 Mar 1.

Abstract

AIM

To explore the specific association between sarcopenia and prediabetes based on large population samples.

METHODS

A total of 16,116 U.S. adults aged 20-59 with dual energy X-ray absorptiometry (DXA) was identified from the National Health and Nutrition Examination Surveys (NHANES). Sarcopenia was defined according to appendicular skeletal muscle mass (ASM) adjusted for body mass index (BMI). Multivariable binary logistic regression models were used to ascertain odds ratios (ORs) for developing prediabetes. Stratified analyses were also performed.

RESULTS

Prevalence of prediabetes was higher in the sarcopenia group (n = 1055) compared with the non-sarcopenia group (n = 15,061) (45.50% vs 28.74%, P < 0.001). Sarcopenia was strongly associated with an increased risk of prediabetes after full adjustment (OR = 1.21, 95CI%: 1.05, 1.39, P = 0.009). In the stratified analysis, this association remained significant independent of obesity, triglycerides, and low-density lipoprotein cholesterol levels. When sarcopenia subjects combined with obesity especially central obesity, the risk of prediabetes was the highest (OR = 2.63, 95CI%: 2.22, 3.11, P < 0.001). Furthermore, a greater proportion of any of impaired glucose tolerance (IGT) individuals was observed in the sarcopenia group compared to the non-sarcopenia group among prediabetes population (41.72% vs 24.06%, P < 0.001).

CONCLUSIONS

Sarcopenia was positively associated with prevalent prediabetes especially IGT in the non-elderly. Moreover, synergistic interactions between the sarcopenia and obesity could greatly increase the risk of prediabetes.

摘要

目的

基于大样本人群,探讨肌肉减少症与糖尿病前期之间的具体关联。

方法

从国家健康和营养调查(NHANES)中确定了 16116 名年龄在 20-59 岁、接受双能 X 线吸收法(DXA)检测的美国成年人。根据四肢骨骼肌质量(ASM)与体重指数(BMI)的比值来定义肌肉减少症。采用多变量二项逻辑回归模型确定发展为糖尿病前期的优势比(OR)。还进行了分层分析。

结果

与非肌肉减少症组(n=15061)相比,肌肉减少症组(n=1055)的糖尿病前期患病率更高(45.50% vs 28.74%,P<0.001)。在充分调整后,肌肉减少症与糖尿病前期的发生风险呈显著正相关(OR=1.21,95%CI%:1.05,1.39,P=0.009)。在分层分析中,这种关联在排除肥胖、甘油三酯和低密度脂蛋白胆固醇水平的影响后仍然显著。当肌肉减少症患者与肥胖症特别是中心型肥胖症合并时,糖尿病前期的风险最高(OR=2.63,95%CI%:2.22,3.11,P<0.001)。此外,在糖尿病前期人群中,与非肌肉减少症组相比,肌肉减少症组中任何糖耐量受损(IGT)个体的比例更高(41.72% vs 24.06%,P<0.001)。

结论

肌肉减少症与非老年人群中常见的糖尿病前期特别是 IGT 呈正相关。此外,肌肉减少症与肥胖症之间的协同相互作用可大大增加糖尿病前期的风险。

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