Ma Minglei, Jiang Tao, Wen Zhen, Zhang Dongxue, Xiu Lei
Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Mar 10;16:723-732. doi: 10.2147/DMSO.S397528. eCollection 2023.
To assess the correlation between body components with insulin resistance (IR) and islet beta cell function in patients with newly diagnosed type 2 diabetes mellitus (T2DM) or pre-diabetes mellitus (pre-DM) and to explore whether this correlation differs in males and females.
111 newly diagnosed diabetic or pre-diabetic patients were recruited in this cross-sectional study. 75g oral glucose tolerance test was used to determine the diagnosis of DM or pre-DM. Homeostasis model assessment of insulin resistance (HOMA-IR) and glucose disposition index (DI) was calculated to assess IR and islet beta cell function, respectively. Whole-body and regional lean mass (LM) and fat mass (FM) were obtained by dual-energy X-ray absorptiometry (DEXA). Partial correlation and multiple linear regression analyses were used to determine the associations between body composition, IR, and islet beta cell function.
More body fat and appendicular fat was observed in female patients than in male, though with similar BMI. Legs fat % was negatively correlated with HOMA-IR, whereas legs lean % was positively associated with HOMA-IR in females (r = -0.673, = 0.017; r =0.664, = 0.018, respectively). The regression analysis showed that legs LM was positively correlated with HOMA-IR in females. However, in male patients, android FM was positively correlated with HOMA-IR (r = 0.462, = 0.007), and trunk LM was negatively associated with DI (r = -0.458, = 0.007). Nevertheless, no significant correlation was observed between body composition and islet beta cell function in female patients.
Android FM was positively correlated with IR only in male patients but not in females. Besides, relative legs fat and LM were independently associated with IR in female patients but not in males. Further studies are needed to explore the underlying mechanism.
评估新诊断的2型糖尿病（T2DM）或糖尿病前期（pre-DM）患者的身体成分与胰岛素抵抗（IR）及胰岛β细胞功能之间的相关性，并探讨这种相关性在男性和女性中是否存在差异。
本横断面研究招募了111例新诊断的糖尿病或糖尿病前期患者。采用75g口服葡萄糖耐量试验来确定糖尿病或糖尿病前期的诊断。分别计算胰岛素抵抗稳态模型评估（HOMA-IR）和葡萄糖处置指数（DI）以评估IR和胰岛β细胞功能。通过双能X线吸收法（DEXA）获得全身和局部瘦体重（LM）及脂肪量（FM）。采用偏相关和多元线性回归分析来确定身体成分、IR和胰岛β细胞功能之间的关联。
尽管女性患者与男性患者的体重指数（BMI）相似，但女性患者的体脂肪和四肢脂肪比男性更多。女性患者的腿部脂肪百分比与HOMA-IR呈负相关，而腿部瘦体重百分比与HOMA-IR呈正相关（r分别为-0.673，P = 0.017；r = 0.664，P = 0.018）。回归分析显示，女性患者的腿部LM与HOMA-IR呈正相关。然而，在男性患者中，腹部FM与HOMA-IR呈正相关（r = 0.462，P = 0.007），而躯干LM与DI呈负相关（r = -0.458，P = 0.007）。然而，女性患者的身体成分与胰岛β细胞功能之间未观察到显著相关性。
腹部FM仅在男性患者中与IR呈正相关，而在女性患者中并非如此。此外，相对腿部脂肪和LM在女性患者中与IR独立相关，而在男性患者中并非如此。需要进一步研究以探索其潜在机制。
