Yuan Jing, Jia Pu
Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
Diabetol Metab Syndr. 2024 Jun 2;16(1):122. doi: 10.1186/s13098-024-01355-3.
Sarcopenia and diabetes are both prevalent health problems worldwide. However, little is known about the relationship between prediabetes and the prevalence and severity of sarcopenia. Therefore, the current study aimed to explore the association between glucose status and the components of sarcopenia, including low muscle mass (LMM), low muscle strength (LMS) and low gait speed (LGS) in US adults.
Data from the 1999 to 2002 National Health and Nutrition Examination Survey (NHANES) were analyzed. A total of 4002 participants aged ≥ 50 years with available information on glucose status (NGR: 1939 cases; prediabetes: 1172 cases; diabetes: 891 cases) and sarcopenia were included in this study. Sarcopenia was defined according to the Foundation for National Institute of Health criteria. Muscle mass, muscle strength and gait speed were used to evaluate sarcopenia and its severity. Weighed multivariable logistic regression were used to explore the association between glucose status and the components of sarcopenia. The hypothetical population attributable fraction (PAF) for the glucose status was also calculated.
The mean age of the cohort was 63.01 ± 9.89 years, with 49.4% being male. Multiple logistic regression analysis suggested that diabetes was an independent risk factor for sarcopenia (OR = 5.470, 95% CI 1.551-19.296) and showed a marginal association with severe sarcopenia (OR = 10.693, 95% CI 0.955-119.73) compared to NGR in men, but not in women. Additionally, prediabetes was independently associated with severe sarcopenia (OR = 3.647, 95% CI 1.532-8.697), LMS (OR = 1.472, 95% CI 1.018-2.127) and LGS (OR = 1.673, 95% CI 1.054-2.655) in the entire cohort. When stratifying by gender, we further observed that prediabetes was significantly associated with LMS in men (OR = 1.897, 95% CI 1.019-3.543) and related to LMM (OR = 3.174, 95% CI 1.287-7.829) and LGS (OR = 2.075, 95% CI 1.155-3.727) in women. HbA1c was positively associated with the prevalence of sarcopenia in men (OR = 1.993, 95% CI 1.511-2.629). PAF showed that diabetes accounted for 16.3% of observed sarcopenia cases. Maintaining NGR in the entire population could have prevented 38.5% of sarcopenia cases and 50.9% of severe sarcopenia cases.
Prediabetes and diabetes were independently associated with the prevalence and severity of sarcopenia in US population. Slowing down the progression of hyperglycemia could have prevented a significant proportion of sarcopenia cases.
肌肉减少症和糖尿病都是全球普遍存在的健康问题。然而，关于糖尿病前期与肌肉减少症的患病率和严重程度之间的关系，人们知之甚少。因此，本研究旨在探讨美国成年人血糖状态与肌肉减少症各组成部分之间的关联，包括低肌肉量（LMM）、低肌肉力量（LMS）和低步速（LGS）。
分析了1999年至2002年美国国家健康和营养检查调查（NHANES）的数据。本研究共纳入4002名年龄≥50岁且有血糖状态信息（正常血糖：1939例；糖尿病前期：1172例；糖尿病：891例）和肌肉减少症信息的参与者。肌肉减少症根据美国国立卫生研究院标准定义。肌肉量、肌肉力量和步速用于评估肌肉减少症及其严重程度。采用加权多变量逻辑回归分析来探讨血糖状态与肌肉减少症各组成部分之间的关联。还计算了血糖状态的假设人群归因分数（PAF）。
该队列的平均年龄为63.01±9.89岁，男性占49.4%。多变量逻辑回归分析表明，糖尿病是肌肉减少症的独立危险因素（OR = 5.470，95% CI 1.551 - 19.296），与男性正常血糖相比，与严重肌肉减少症有边缘关联（OR = 10.693，95% CI 0.955 - 119.73），但女性无此关联。此外，在整个队列中，糖尿病前期与严重肌肉减少症（OR = 3.647，95% CI 1.532 - 8.697）、LMS（OR = 1.472，95% CI 1.018 - 2.127）和LGS（OR = 1.673，95% CI 1.054 - 2.655）独立相关。按性别分层时，我们进一步观察到糖尿病前期与男性的LMS显著相关（OR = 1.897，95% CI 1.019 - 3.543），与女性的LMM（OR = 3.174，95% CI 1.287 - 7.829）和LGS（OR = 2.075，95% CI 1.155 - 3.727）相关。糖化血红蛋白（HbA1c）与男性肌肉减少症的患病率呈正相关（OR = 1.993，95% CI 1.511 - 2.629）。PAF显示糖尿病占观察到的肌肉减少症病例的16.3%。在整个人口中维持正常血糖水平可预防38.5%的肌肉减少症病例和50.9%的严重肌肉减少症病例。
糖尿病前期和糖尿病与美国人群中肌肉减少症的患病率和严重程度独立相关。减缓高血糖的进展可预防相当比例的肌肉减少症病例。
