住院2型糖尿病患者肌少症相关因素影响分析

Analysis of relative factors to sarcopenia in hospitalized patients with type 2 diabetes mellitus

目的探讨住院T2DM患者肌少症发生率及其相关影响因素。方法选取2018年7月至2019年3月于南京中医药大学附属昆山市中医医院内分泌科住院的T2DM患者279例,收集患者性别、年龄、BMI、病程、HbA1c、TG、LDL-C、骨代谢指标及糖尿病周围神经病变(DPN)资料。双能X线吸收法测定患者身体成分,按照亚洲肌少症工作组诊断标准将研究对象分为合并肌少症组(Sar,n=132)和非合并肌少症组(T2DM,n=147),比较两组各项指标。结果T2DM患者肌少症总发生率为47.31%,男性高于女性(53.61%vs 38.05%,P<0.05)。T2DM患者DPN发生率为21.15%,Sar组高于T2DM组(31.82%vs 11.56%,P<0.05)。Sar组年龄、DM病程高于T2DM组[(61.77±11.42)vs(54.05±12.90)岁,(8.85±7.22)vs(6.40±6.03)年,P<0.05],TG、BMI低于T2DM组[(1.4±0.90)vs(2.03±2.27)mmol/L,(22.99±2.87)vs(26.93±3.31)kg/m^(2),P<0.05]。多因素Logistic回归分析显示,年龄[OR 1.076,95%CI(1.045,1.109),P<0.01]、性别[OR 4.576,95%CI(2.288,9.153),P<0.01]、DPN[OR 2.844,95%CI(1.243,6.511),P<0.05]是T2DM患者发生肌少症的危险因素,BMI[OR 0.605,95%CI(0.529,0.692),P<0.01]是T2DM患者发生肌少症的保护因素。结论DPN是T2DM患者发生肌少症的危险因素,尽早筛查及治疗DPN可能减少或延缓肌少症发生。

Objective To investigate the occurrence of sarcopenia in hospitalized patients with type 2 diabetes mellitus(T2 DM)and its related factors.in our department from July 2018 to March 2019 were enrolled in the study.Body composition was determined by dual energy X-ray absorptiometry.According to the diagnostic criteria of the Asian working group on sarcopenia,all the subjects were divided into sarcopenia group(Sar,n=132)and T2 DM copenia group(T2 DM,n=147).which was significantly higher in male than that in female(53.61%vs 38.05%,P<0.05).The proportion of diabetic peripheral neuropathy(DPN)in patients with T2 DM was 21.15%.The prevalence of DPN in Sar group was significantly higher than T2 DM group(31.82%vs 11.56%,P<0.05).The patients in Sar group was older[(61.77±11.42)vs(54.05±12.90)years,P<0.05]and had longer DM duration[(8.85±7.22)vs(6.40±6.03)years,P<0.05]than those in the T2 DM group.The levels of triglyceride[(1.4±0.90)vs(2.03±2.27)mmol/L,P<0.05]and BMI[(22.99±2.87 vs(26.93±3.31)kg/m^(2),P<0.05]were lower in the Sar group compared with the T2 DM group.Multivariate logistic regression analysis showed that age[OR 1.076,95%CI(1.045,1.109),P<0.01],gender[OR 4.576,95%CI(2.288,9.153),P<0.01]and DPN[OR 2.844,95%CI(1.243,6.511),P<0.05]were risk factors for sarcopenia,while BMI[OR 0.605,95%CI(0.529,0.692),P<0.01]was a protective factor for sarcopenia.Conclusion DPN is a risk factor for sarcopenia in T2 DM patients.Early screening and treatment of DPN may reduce or delay the occurrence of sarcopenia.