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解析肌肉量和力量在预测2型糖尿病风险中的作用:一项系统综述

Unraveling the role of muscle mass and strength in predicting type 2 diabetes risk: a systematic review.

作者信息

Putranata Hans, Hengky Antoninus, Hartoko Budhi

机构信息

Department of Internal Medicine, Fatima General Hospital, Ketapang Regency, West Kalimantan, Indonesia.

Center of Health Research, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.

出版信息

Acta Diabetol. 2025 Feb;62(2):157-176. doi: 10.1007/s00592-024-02440-9. Epub 2025 Jan 6.

Abstract

INTRODUCTION

Skeletal muscle is the largest insulin-sensitive tissue in the human body, alteration in muscle mass and strength substantially impact glucose metabolism. This systematic review aims to investigate further the relationship between muscle mass and strength towards type 2 diabetes mellitus (T2DM) incidence.

METHODS

This systematic review included cohort studies that examinedthe relationship between muscle mass and/or muscle strength on T2DM incidence. A comprehensive search was conducted across PubMed, EBSCO, ProQuest, and Google scholar employing specific Medical Subject Headings (MeSH) and relevant keywords related to or synonymous with "muscle mass", "muscle strength", and "Type 2 Diabetes Mellitus incidence".

RESULTS

Twenty-five cohort studies were included, 11 studies on muscle mass and 16 studies on muscle strength. Participants included were 278,475 for muscle mass and 400,181 for muscle strength. Skeletal muscle mass normalized to body weight (SMM/BW), appendicular skeletal musce mass normalized to body weight (ASM/BW), and handgrip strength normalized to body mass index (HGS/BMI) consistently demonstrate significant inverse association with T2DM even after sex and/or BMI stratification. Handgrip strength normalized to body weight (HGS/BW) demonstrates a strong inverse association with T2DM incidence, however, adiposity should be considered.

CONCLUSION

Muscle mass and strength demonstrate strong association with T2DM incidence. Adiposity, a key T2DM risk factor, should also be assessed through a simple BMI or a sophisticated technique with BIA or CT-scan. The combination of muscle variables and adiposity could further enhance T2DM risk assessment. However, T2DM risks are multifactorial, with various contributing factors, further large-scale studies are needed to validate these findings.

摘要

引言

骨骼肌是人体中最大的胰岛素敏感组织,肌肉质量和力量的改变会对葡萄糖代谢产生重大影响。本系统评价旨在进一步研究肌肉质量和力量与2型糖尿病(T2DM)发病率之间的关系。

方法

本系统评价纳入了检验肌肉质量和/或肌肉力量与T2DM发病率之间关系的队列研究。通过PubMed、EBSCO、ProQuest和谷歌学术进行了全面检索,使用了特定的医学主题词(MeSH)以及与“肌肉质量”、“肌肉力量”和“2型糖尿病发病率”相关或同义的相关关键词。

结果

纳入了25项队列研究,其中11项关于肌肉质量,16项关于肌肉力量。纳入的参与者中,肌肉质量研究的有278475人,肌肉力量研究的有400181人。即使在按性别和/或体重指数分层后,以体重标准化的骨骼肌质量(SMM/BW)、以体重标准化的四肢骨骼肌质量(ASM/BW)以及以体重指数标准化的握力(HGS/BMI)始终显示与T2DM存在显著负相关。以体重标准化的握力(HGS/BW)与T2DM发病率呈现出强烈的负相关,不过,应考虑肥胖因素。

结论

肌肉质量和力量与T2DM发病率密切相关。肥胖是T2DM的一个关键危险因素,也应通过简单的体重指数或使用生物电阻抗分析(BIA)或计算机断层扫描(CT)扫描等复杂技术进行评估。肌肉变量和肥胖的结合可以进一步增强T2DM风险评估。然而,T2DM风险是多因素的,有多种促成因素,需要进一步的大规模研究来验证这些发现。

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