基于问卷的身体活动分析与2型糖尿病患者身体成分动态变化的关联：一项横断面研究。

Association of Questionnaire-Based Physical Activity Analysis and Body Composition Dynamics in Type 2 Diabetes: A Cross-Sectional Study.

作者信息

Li Dan-Dan, Yang Xue, Yang Yang, Zhao Li-Hua, Zhang Tian-Tian, Wang Yi-Nan, Su Jian-Bin, Wang Li-Hua, Shi Hai-Yan

机构信息

Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, 226006, People's Republic of China.

Department of General Practice, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, 226006, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2024 Aug 8;17:2955-2966. doi: 10.2147/DMSO.S459356. eCollection 2024.

DOI:10.2147/DMSO.S459356

PMID:39135891

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11318602/

Abstract

BACKGROUND

Physical activity (PA) exerts an important influence on glycemic control in type 2 diabetes (T2D) patients. Alterations in body composition in patients with T2D may be involved in the overall pathophysiologic process, but PAs and alterations in body composition have been poorly studied.

METHODS

A total of 615 patients with T2D were selected by convenient sampling. The patients were investigated with the International Physical Activity Questionnaire (IPAQ-S). Moreover, biochemical indices were collected, and the progression of the body composition of the subjects was determined via dual-energy X-ray absorptiometry (DXA). The variables included lumbar bone mineral density (LSBMD), femoral neck bone mineral density (FNBMD), hip bone mineral density (HBMD), whole-body bone mineral density (TBMD), limb skeletal muscle mass index (ASMI), whole-body fat percentage (B-FAT) and trunk fat percentage (T-FAT). Moreover, the levels of physical activity (high level of physical activity [H-PA], medium level of physical activity [M-PA] and low level of physical activity [L-PA]) were divided into three groups to analyze the changes in patient body composition with changes in physical activity level.

RESULTS

One-way analysis of variance showed that β-CTX, TP1NP, HbA1c, B-FAT and T-FAT increased significantly (<0.05), while 25(OH)D, LSBMD, FNBMD, HBMD, TBMD and ASMI decreased significantly (<0.001) with the decrease of physical activity. However, there was no significant difference in serum lipids between lnHOMA-ir and lnHOMA-β (>0.05). Multiple linear regression model was established to gradually adjust for clinical confounding factors. It was found that physical activity level was independently positively correlated with LSBMD, FNBMD, HBMD, TBMD, and ASMI, and was independently negatively correlated with B-FAT and T-FAT in patients with type 2 diabetes.

CONCLUSION

A lack of physical activity is an independent risk factor for decreased bone mineral density, decreased skeletal muscle content and increased fat content in patients with T2D.

摘要

背景

体力活动（PA）对2型糖尿病（T2D）患者的血糖控制有重要影响。T2D患者身体成分的改变可能参与了整体病理生理过程，但体力活动与身体成分的改变尚未得到充分研究。

方法

采用方便抽样法选取615例T2D患者。采用国际体力活动问卷（IPAQ-S）对患者进行调查。此外，收集生化指标，并通过双能X线吸收法（DXA）测定受试者身体成分的变化。变量包括腰椎骨密度（LSBMD）、股骨颈骨密度（FNBMD）、髋部骨密度（HBMD）、全身骨密度（TBMD）、四肢骨骼肌质量指数（ASMI）、全身脂肪百分比（B-FAT）和躯干脂肪百分比（T-FAT）。此外，将体力活动水平（高水平体力活动[H-PA]、中等水平体力活动[M-PA]和低水平体力活动[L-PA]）分为三组，分析患者身体成分随体力活动水平变化的情况。

结果

单因素方差分析显示，随着体力活动的减少，β-CTX、TP1NP、HbA1c、B-FAT和T-FAT显著升高（<0.05），而25（OH）D、LSBMD、FNBMD、HBMD、TBMD和ASMI显著降低（<0.001）。然而，lnHOMA-ir和lnHOMA-β之间的血脂差异无统计学意义（>0.05）。建立多元线性回归模型逐步调整临床混杂因素。结果发现，体力活动水平与2型糖尿病患者的LSBMD、FNBMD、HBMD、TBMD和ASMI呈独立正相关，与B-FAT和T-FAT呈独立负相关。