老年2型糖尿病患者肌肉量减少与白蛋白尿的相关性研究

Relationship between low muscle mass and albuminuria in elderly patients with type 2 diabetes mellitus

目的 探讨老年2型糖尿病(T2DM)患者肌肉量减少与白蛋白尿的相关性。方法 选取2017年5月至10月在山西医科大学第一医院内分泌科住院的96例老年T2DM患者,根据尿微量白蛋白/肌酐比值(ACR)将研究对象分为两组:白蛋白尿组(ACR≥30 μg/mg,41例)与非白蛋白尿组(ACR<30 μg/mg,55例),比较两组四肢骨骼肌质量指数(SMI)、年龄、体重指数、空腹血糖、HbA1c等,以及肌肉量减少的检出率。并按SMI分为4组,比较白蛋白尿检出率,最后分析肌肉量减少与白蛋白尿的相关性。结果 与非白蛋白尿组相比,白蛋白尿组SMI降低(Z=4.700,P<0.05),而肌肉量减少检出率升高(χ2=5.525,P=0.019),随着SMI降低,白蛋白尿检出率升高(χ2=20.230,P<0.05)。SMI下降是白蛋白尿的独立危险因素(OR=0.438,95%CI: 0.292~0.658,P<0.001)。结论 老年T2DM患者出现白蛋白尿时肌肉量减少检出率升高,肌肉量减少是白蛋白尿的独立危险因素。

Objective To investigate the relationship between low muscle mass and albuminuria in elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of ninety-six elderly patients with T2DM who were admitted to the Department of Endocrinology,The First Hospital of Shanxi Medical University from May to October 2017 were enrolled in this study.According to ratio of urine albumin to creatinine(ACR),the subjects were divided into two groups:albuminuria group(ACR≥30μg/mg,n=41)and non-albuminuria group(ACR<30μg/mg,n=55).Skeletal muscle mass index(SMI),age,body mass index,fasting plasma glucose,HbA1c and detection rate of low muscle mass were compared between the two groups.Furthermore,all patients were divided into four groups according to SMI,and the detection rate of albuminuria were compared.Finally,the relationship between albuminuria and low muscle mass was explored.Results Compared with non-albuminuria group,SMI was lower(Z=4.700,P<0.05),while the detection rate of low muscle mass was higher in albuminuria group(χ2=5.525,P=0.019);the detection rate of albuminuria was increased with the decrease of SMI(χ2=20.230,P<0.05).The reduction of SMI was an independent risk factor of albuminuria(OR=0.438,95%CI:0.292-0.658,P<0.001).Conclusion In elderly T2DM patients with albuminuria,the detection rate of low muscle mass is higher,and low muscle mass is an independent risk factor for albuminuria.