Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.
Department of Informatics, West China Hospital, Sichuan University, Chengdu, China.
Diabetes Obes Metab. 2024 Mar;26(3):820-828. doi: 10.1111/dom.15373. Epub 2023 Nov 23.
To investigate the sex-specific associations between predicted skeletal muscle mass index (pSMI) and incident type 2 diabetes in a retrospective longitudinal cohort of Chinese men and women.
We enrolled Chinese adults without diabetes at baseline from WATCH (West chinA adulT health CoHort), a large health check-up-based database. We calculated pSMI to estimate skeletal muscular mass, and measured blood glucose variables and assessed self-reported history to identify new-onset diabetes. The nonlinear association between pSMI and incident type 2 diabetes was modelled using the penalized spline method. The piecewise association was estimated using segmented linear splines in weighted Cox proportional hazards regression models.
Of 47 885 adults (53.2% women) with a median age of 40 years, 1836 developed type 2 diabetes after a 5-year median follow-up. In women, higher pSMI was associated with a lower risk of incident type 2 diabetes (P = 0.09, hazard ratio [HR] per standard deviation increment in pSMI: 0.79 [95% confidence interval {CI} 0.68, 0.91]). A nonlinear association of pSMI with incident type 2 diabetes was detected in men (P < 0.001). In men with pSMI lower than 8.1, higher pSMI was associated with a lower risk of incident type 2 diabetes (HR 0.58 [95% CI 0.40, 0.84]), whereas pSMI was not significantly associated with incident diabetes in men with pSMI equal to or greater than 8.1 (HR 1.08 [95% CI 0.93, 1.25]).
In females, a larger muscular mass is associated with a lower risk of type 2 diabetes. For males, this association is significant only among those with diminished muscle mass.
在一项回顾性纵向队列研究中，调查预测骨骼肌指数（pSMI）与中国男女 2 型糖尿病发病的性别特异性关联。
我们从基于健康检查的大型数据库 WATCH（中国西部成年人健康队列）中招募了基线时无糖尿病的中国成年人。我们计算 pSMI 来估计骨骼肌质量，并测量血糖变量并评估自我报告的病史以确定新诊断的糖尿病。使用惩罚样条方法对 pSMI 与 2 型糖尿病发病的非线性关联进行建模。使用加权 Cox 比例风险回归模型中的分段线性样条估计分段关联。
在 47885 名成年人（53.2%为女性）中，中位年龄为 40 岁，中位随访 5 年后有 1836 人发生 2 型糖尿病。在女性中，较高的 pSMI 与较低的 2 型糖尿病发病风险相关（P=0.09，pSMI 每标准差增加的风险比：0.79[95%置信区间 0.68，0.91]）。在男性中检测到 pSMI 与 2 型糖尿病发病之间的非线性关联（P<0.001）。在 pSMI 低于 8.1 的男性中，较高的 pSMI 与较低的 2 型糖尿病发病风险相关（HR 0.58[95%CI 0.40，0.84]），而在 pSMI 等于或大于 8.1 的男性中，pSMI 与新发糖尿病无显著相关性（HR 1.08[95%CI 0.93，1.25]）。
在女性中，更大的肌肉质量与较低的 2 型糖尿病风险相关。对于男性，这种关联仅在肌肉质量减少的人群中显著。
