Lin Yuxi, Zhang Yongze, Shen Ximei, Weng Zhiyan, Huang Lingning, Zhao Fengying, Yan Sunjie
Department of Endocrinology the First Affiliated Hospital Fujian Medical University, Fuzhou 350005, China.
Department of Endocrinology National Regional Medical Center Binhai Campus of the First Affiliated Hospital Fujian Medical University, Fuzhou 350212, China.
J Lipids. 2024 Sep 30;2024:4986998. doi: 10.1155/2024/4986998. eCollection 2024.
Identifying -cells dysregulation in type 2 diabetes mellitus (T2DM) is crucial. Weight fluctuations are frequently observed during diabetes treatment. However, the relationship between body composition changes and islet -cell function in individuals with T2DM remains insufficiently investigated. This retrospective longitudinal study encompassed a cohort of 775 T2DM patients, who underwent body composition measuring using dual-energy X-ray absorptiometry (DEXA) and followed up for a median of 2.29 years. Key metrics included body mass index (BMI), fat mass index (FMI), trunk fat mass index (TFMI), muscle mass index (MMI), appendicular skeletal muscle mass index (ASMI), muscle/fat mass ratio (M/F), and the appendicular skeletal muscle mass/trunk fat mass ratio (A/T) were then categorized and grouped. Insulin, C-peptide, and glucose levels were assessed concurrently following a glucose load. -cell function included insulin resistance (HOMA-IR), insulin sensitivity (Matsuda index (MI)), and insulin secretion evaluated by HOMA- and C-peptidogenic index (CGI). Although no significant changes in BMI were observed, patients with T2DM at readmission exhibited higher FMI, TFMI, and ASMI, as well as elevated levels of HOMA-IR, MI, and CGI compared to baseline measurements. And lower MI, higher levels of CGI, and HOMA-IR were observed in BMI increased group. Univariate correlation analysis revealed a negative association between changes in BMI (BMI) and MI, while positive associations were observed in both HOMA-IR and CGI. Among body composition indexes, FMI exhibited the strongest correlation with HOMA-IR ( = 0.255, < 0.001), and ASMI was positively associated with MI and CGI ( = 0.131 and 0.194, respectively). Moreover, increased levels of BMI and FMI were associated with a greater risk of progressive insulin resistance compared to the decreased, whereas the trend was converse in ASMI and A/T. Increased FMI may partially contribute to the deterioration of insulin resistance, while increased ASMI is associated with improved insulin sensitivity and secretion. Maintaining an appropriate BMI and muscle/fat ratio is conductive to prevent the progression of insulin resistance in patients with T2DM.
识别2型糖尿病（T2DM）中β细胞功能失调至关重要。糖尿病治疗期间经常观察到体重波动。然而，T2DM患者身体成分变化与胰岛β细胞功能之间的关系仍未得到充分研究。这项回顾性纵向研究纳入了775例T2DM患者队列，他们接受了双能X线吸收法（DEXA）测量身体成分，并进行了中位时间为2.29年的随访。关键指标包括体重指数（BMI）、脂肪量指数（FMI）、躯干脂肪量指数（TFMI）、肌肉量指数（MMI）、四肢骨骼肌量指数（ASMI）、肌肉/脂肪量比（M/F）以及四肢骨骼肌量/躯干脂肪量比（A/T），然后进行分类和分组。在葡萄糖负荷后同时评估胰岛素、C肽和葡萄糖水平。β细胞功能包括胰岛素抵抗（HOMA-IR）、胰岛素敏感性（松田指数（MI））以及通过HOMA和C肽生成指数（CGI）评估的胰岛素分泌。尽管未观察到BMI有显著变化，但与基线测量相比，再次入院时的T2DM患者表现出更高的FMI、TFMI和ASMI，以及更高的HOMA-IR、MI和CGI水平。在BMI增加组中观察到较低的MI、较高的CGI水平和HOMA-IR。单变量相关分析显示BMI变化（ΔBMI）与MI之间呈负相关，而在HOMA-IR和CGI中均呈正相关。在身体成分指标中，FMI与HOMA-IR的相关性最强（r = 0.255，P < 0.001），ASMI与MI和CGI呈正相关（分别为r = 0.131和0.194）。此外，与降低相比，BMI和FMI升高与进行性胰岛素抵抗风险增加相关，而在ASMI和A/T中趋势相反。FMI升高可能部分导致胰岛素抵抗恶化，而ASMI升高与胰岛素敏感性和分泌改善相关。维持适当的BMI和肌肉/脂肪比有助于预防T2DM患者胰岛素抵抗的进展。
