脂肪与肌肉比率与 1 型糖尿病成人患者的胰岛素抵抗和心血管代谢紊乱相关。

Fat-to-muscle ratio is associated with insulin resistance and cardiometabolic disorders in adults with type 1 diabetes mellitus.

机构信息

Department of Nutrition, The Second Xiangya Hospital of Central South University, Changsha, China.

National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China.

出版信息

Diabetes Obes Metab. 2023 Nov;25(11):3181-3191. doi: 10.1111/dom.15212. Epub 2023 Jul 17.

DOI:10.1111/dom.15212

PMID:37455673

Abstract

AIMS

This study aimed to investigate the correlation of the fat-to-muscle ratio (FMR) with insulin resistance (IR) and cardiometabolic disorders (CMD) in patients with type 1 diabetes mellitus (T1DM).

MATERIALS AND METHODS

We retrospectively recruited 420 adults with T1DM [52.6% men, median age 32.4 (24.5, 43.0) years]. Body composition was assessed by bioelectrical impedance analysis and FMR was calculated. The characteristics of the overall participants were compared between tertiles of FMR. Logistic regression analyses were performed to assess the association of FMR tertiles with IR and cardiometabolic risk factors.

RESULTS

Median age and median haemoglobin A1c of all participants were 32.4 (24.5, 43.0) years and 7.4 (6.5, 8.7)%, respectively. The prevalence of IR and CMD was 18% and 38.6%. The FMR significantly differed between men and women [0.39 (0.31, 0.53) vs. 0.74 (0.63, 0.92), respectively, p < .001]. The proportion of IR and CMD gradually increased as the FMR increased. The multivariable-adjusted odd ratios for IR and CMD in FMR tertile 3 compared with tertile 1 were 4.8 [95% confidence interval (CI): (1.9, 12.1)] and 9.7 (95% CI: 4.2, 22.3), respectively, in men. For women, the corresponding odd ratios were 4.0 (95% CI: 1.2, 12.9) for IR and 5.8 (95% CI: 2.4, 13.6) for CMD.

CONCLUSIONS

FMR is associated with IR and CMD in adults with T1DM and could be used as a promising parameter for targeting treatment in T1DM.

摘要

目的

本研究旨在探讨 1 型糖尿病（T1DM）患者脂肪与肌肉比值（FMR）与胰岛素抵抗（IR）和心脏代谢紊乱（CMD）的相关性。

材料与方法

我们回顾性招募了 420 名 T1DM 成年患者[52.6%为男性，中位年龄 32.4（24.5，43.0）岁]。采用生物电阻抗分析法评估身体成分，并计算 FMR。比较 FMR 三分位组间的总体参与者特征。采用 logistic 回归分析评估 FMR 三分位与 IR 和心脏代谢危险因素的关联。

结果

所有参与者的中位年龄和中位糖化血红蛋白（HbA1c）分别为 32.4（24.5，43.0）岁和 7.4（6.5，8.7）%。IR 和 CMD 的患病率分别为 18%和 38.6%。男性和女性的 FMR 差异有统计学意义[分别为 0.39（0.31，0.53）和 0.74（0.63，0.92），p<0.001]。随着 FMR 的增加，IR 和 CMD 的比例逐渐增加。与 FMR 三分位 1 相比，三分位 3 的男性发生 IR 和 CMD 的多变量调整比值比（OR）分别为 4.8（95%置信区间（CI）：1.9，12.1）和 9.7（95% CI：4.2，22.3），女性的相应 OR 分别为 4.0（95% CI：1.2，12.9）和 5.8（95% CI：2.4，13.6）。