肌肉减少症与胰岛素抵抗相关性研究

Relationships between sarcopenia and insulin resistance in hospitalized old patients

目的:通过胰岛素抵抗稳态模型评估法(Homeostasis model assessment of insulin resistance,HOMA2-IR)探讨肌肉减少症与胰岛素抵抗的关系。方法:将2014年6月至2016年1月我院收治的60岁以上并完成了双能X线吸收仪(Dual-energy X-ray absorptiometry,DXA)检查、双上肢握力及6米步行速度测试的患者分为肌少症组及对照组两组,两组分别测定糖化血红蛋白,空腹血糖、空腹胰岛素或C肽并计算出HOMA2-IR指数,比较肌少症组与对照组的相关指标。结果:与对照组比较,肌少症组的HOMA2-IR值更高(P<0.05)。HOMA2-IR指数与握力、6米步行速度显著负相关(P<0.01),与四肢肌肉量/身高的平方负相关(P<0.05)。Logistic回归分析提示肌少症与HOMA2-IR存在独立相关性(P<0.05)。结论:肌少症发病与胰岛素抵抗之间存在独立相关性,治疗肌少症可能改善患者胰岛素抵抗。

Objective:To explore the relationship between sarcopenia and insulin resistance by HOMA2-IR.Methods:The patients were divided into the sarcopenia group and the control group according to the dual energy X-ray examination,muscle mass/height2,grip strength,6-meter walking speed.Then fasting blood glucose,fasting insulin or C peptide,glycosylated hemoglobin,were completed.The HOMA2-IR index of the patients was calculated and compared.Results:HOMA2-IR value of the sarcopenia group was significantly higher than that of the control group(P<0.05).HOMA2-IR was negatively correlated with grip strength and 6-meter walking speed(P<0.01),and negatively correlated with the appendicular skeletal muscle mass/height2(P<0.05).Logistic regression analysis showed that there was an independent correlation between sarcopenia and HOMA2-IR(P<0.05).Conclusion:There is an independent correlation between sarcopenia and insulin resistance.Early detection and intervention of sarcopenia may help to reduce insulin resistance.