Ito Hiroyuki, Miura Sayuri, Mori Toshiko, Miura Shun, I Chiaki, Matsumoto Suzuko, Inoue Hideyuki, Antoku Shinichi, Yamasaki Tomoko, Togane Michiko, Sugahara Moka, Yukawa Chizuko
Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
Laboratory Department, Edogawa Hospital, Tokyo, Japan.
JMA J. 2025 Jul 15;8(3):925-935. doi: 10.31662/jmaj.2025-0071. Epub 2025 Jun 27.
The phase angle (PhA), calculated through bioimpedance analysis (BIA), is a measure of skeletal muscle quality and cellular integrity. This study aimed to explore the relationship between PhA and diabetic microangiopathy in patients with type 2 diabetes.
We conducted a cross-sectional analysis of 556 adult Japanese outpatients with type 2 diabetes who underwent body composition evaluation using BIA. Clinical characteristics, including diabetic microangiopathy (retinopathy, nephropathy, and neuropathy), were assessed for their association with PhA. Furthermore, in 23 patients who underwent a second BIA assessment, we examined the relationship between changes in PhA and glycated hemoglobin (HbA1c) levels longitudinally. Statistical methods employed included Wilcoxon's signed-rank test, regression analyses, and trend tests.
PhA was significantly lower in patients with diabetic microangiopathy compared to those without it. It was positively correlated with the skeletal muscle mass index (SMI) and negatively correlated with the extracellular water-to-total body water ratio. Multiple regression analysis revealed that sex, age, nephropathy, peripheral neuropathy, hemoglobin, serum albumin, and low-density lipoprotein cholesterol levels were significant explanatory variables for PhA. In the longitudinal analysis, changes in HbA1c levels showed a significant negative correlation with changes in PhA, however, no association was observed between changes in HbA1c and changes in SMI.
PhA is significantly associated with age, malnutrition, and diabetic microvascular complications, and may provide insights into muscle and tissue health in patients with type 2 diabetes. Further research is required to examine causal relationships and explore potential interventions to preserve muscle quality in diabetic patients.
通过生物电阻抗分析（BIA）计算得出的相角（PhA）是骨骼肌质量和细胞完整性的一项指标。本研究旨在探讨2型糖尿病患者中PhA与糖尿病微血管病变之间的关系。
我们对556名成年日本2型糖尿病门诊患者进行了横断面分析，这些患者使用BIA进行了身体成分评估。评估了包括糖尿病微血管病变（视网膜病变、肾病和神经病变）在内的临床特征与PhA的相关性。此外，在23名接受第二次BIA评估的患者中，我们纵向研究了PhA变化与糖化血红蛋白（HbA1c）水平之间的关系。采用的统计方法包括Wilcoxon符号秩检验、回归分析和趋势检验。
与无糖尿病微血管病变的患者相比，有糖尿病微血管病变的患者PhA显著更低。它与骨骼肌质量指数（SMI）呈正相关，与细胞外水与总体水的比例呈负相关。多元回归分析显示，性别、年龄、肾病、周围神经病变血红蛋白、血清白蛋白和低密度脂蛋白胆固醇水平是PhA的显著解释变量。在纵向分析中，HbA1c水平的变化与PhA的变化呈显著负相关，然而，未观察到HbA1c变化与SMI变化之间存在关联。
PhA与年龄、营养不良和糖尿病微血管并发症显著相关，可能为2型糖尿病患者的肌肉和组织健康提供见解。需要进一步研究以检验因果关系，并探索在糖尿病患者中维持肌肉质量 的潜在干预措施。
