Department of Clinical Nutrition, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Tokyo, Japan.
Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
J Diabetes Investig. 2023 Jun;14(6):801-810. doi: 10.1111/jdi.14007. Epub 2023 Mar 19.
AIMS/INTRODUCTION: Patients with type 2 diabetes mellitus are reported to be at a high risk for sarcopenia, and are known to have a poorer sleep quality. However, the association between sleep quality and skeletal muscle in patients with type 2 diabetes mellitus is not yet precisely understood.
A total of 110 inpatients with type 2 diabetes mellitus aged 40-90 years were enrolled. The sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Skeletal muscle mass was measured using bioelectrical impedance analysis. Muscle strength was evaluated by measuring the grip strength. We also performed dietary surveys and measurements of the plasma amino acid levels.
A high total score on the PSQI was significantly associated with reduced muscle strength, and the association persisted even after adjustments for confounders. On the other hand, adjusted analysis did not reveal any significant associations between the PSQI total score and the skeletal muscle mass. In regard to the associations with subscores of the PSQI, the scores for sleep latency, sleep efficiency, and daytime dysfunction were significantly negatively associated with the muscle strength. Although poor sleep quality was associated with a high confectionery intake and low plasma arginine, citrulline, and ornithine levels, neither confectionery intake levels nor the plasma levels of these amino acids was associated with the muscle strength.
Our study revealed a significant association between the sleep quality and muscle strength in patients with type 2 diabetes mellitus. These results suggest that poor sleep quality is an important risk factor for sarcopenia in patients with type 2 diabetes mellitus.
目的/引言：据报道，2 型糖尿病患者易患肌少症，且睡眠质量较差。然而，2 型糖尿病患者的睡眠质量与骨骼肌之间的关系尚不清楚。
共纳入 110 名年龄在 40-90 岁的 2 型糖尿病住院患者。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。使用生物电阻抗分析测量骨骼肌质量。通过测量握力评估肌肉力量。我们还进行了膳食调查和血浆氨基酸水平的测量。
PSQI 总分较高与肌肉力量减弱显著相关，即使在调整混杂因素后，这种关联仍然存在。另一方面，调整分析并未显示 PSQI 总分与骨骼肌质量之间存在任何显著关联。关于 PSQI 各分量表与肌肉力量的关联，睡眠潜伏期、睡眠效率和日间功能障碍得分与肌肉力量显著负相关。尽管睡眠质量差与甜食摄入量高和血浆精氨酸、瓜氨酸和鸟氨酸水平低有关，但甜食摄入量水平和这些氨基酸的血浆水平均与肌肉力量无关。
我们的研究揭示了 2 型糖尿病患者睡眠质量与肌肉力量之间的显著关联。这些结果表明，睡眠质量差是 2 型糖尿病患者肌少症的一个重要危险因素。
