Herder Christian, Maalmi Haifa, Saatmann Nina, Zaharia Oana-Patricia, Strassburger Klaus, Burkart Volker, Norman Kristina, Roden Michael
Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany.
German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany.
J Clin Endocrinol Metab. 2024 Feb 20;109(3):e1238-e1248. doi: 10.1210/clinem/dgad605.
Low skeletal muscle mass (SMM) is associated with long-standing diabetes but little is known about SMM in newly diagnosed diabetes.
We aimed to identify correlates of SMM in recent-onset diabetes and to compare SMM between novel diabetes subtypes.
SMM was normalized to body mass index (SMM/BMI) in 842 participants with known diabetes duration of less than 1 year from the German Diabetes Study (GDS). Cross-sectional associations between clinical variables, 79 biomarkers of inflammation, and SMM/BMI were assessed, and differences in SMM/BMI between novel diabetes subtypes were analyzed with different degrees of adjustment for confounders.
Male sex and physical activity were positively associated with SMM/BMI, whereas associations of age, BMI, glycated hemoglobin A1c, homeostatic model assessment for β-cell function, and estimated glomerular filtration rate with SMM/BMI were inverse (all P < .05; model r2 = 0.82). Twenty-three biomarkers of inflammation showed correlations with SMM/BMI after adjustment for sex and multiple testing (all P < .0006), but BMI largely explained these correlations. In a sex-adjusted analysis, individuals with severe autoimmune diabetes had a higher SMM/BMI whereas individuals with severe insulin-resistant diabetes and mild obesity-related diabetes had a lower SMM/BMI than all other subtypes combined. However, differences were attenuated after adjustment for the clustering variables.
SMM/BMI differs between diabetes subtypes and may contribute to subtype differences in disease progression. Of note, clinical variables rather than biomarkers of inflammation explain most of the variation in SMM/BMI.
低骨骼肌质量（SMM）与长期糖尿病相关，但对于新诊断糖尿病患者的SMM情况知之甚少。
我们旨在确定新发病糖尿病患者SMM的相关因素，并比较新型糖尿病亚型之间的SMM情况。
在德国糖尿病研究（GDS）中，对842名已知糖尿病病程小于1年的参与者，将SMM标准化为体重指数（SMM/BMI）。评估临床变量、79种炎症生物标志物与SMM/BMI之间的横断面关联，并分析新型糖尿病亚型之间SMM/BMI的差异，同时对混杂因素进行不同程度的调整。
男性和身体活动与SMM/BMI呈正相关，而年龄、BMI、糖化血红蛋白A1c、β细胞功能的稳态模型评估以及估计肾小球滤过率与SMM/BMI呈负相关（均P < 0.05；模型r2 = 0.82）。在对性别和多重检验进行调整后，23种炎症生物标志物与SMM/BMI存在相关性（均P < 0.0006），但BMI在很大程度上解释了这些相关性。在性别调整分析中，重度自身免疫性糖尿病患者的SMM/BMI较高，而重度胰岛素抵抗性糖尿病和轻度肥胖相关性糖尿病患者的SMM/BMI低于所有其他亚型的总和。然而，在对聚类变量进行调整后，差异有所减弱。
糖尿病亚型之间的SMM/BMI存在差异，可能导致疾病进展的亚型差异。值得注意的是，临床变量而非炎症生物标志物解释了SMM/BMI的大部分变异。
