老年2型糖尿病住院患者合并肌少症影响因素研究

Influencing factors of hospitalized elderly T2DM patients with sarcopenia

目的探讨老年2型糖尿病(T2DM)住院患者合并肌少症的临床特征及其影响因素。方法选取老年T2DM患者190例,根据肌少症诊断标准分为肌少症组43例和非肌少症组147例,进行握力、步速和人体成分分析等测定,采用Spearman相关分析骨骼肌质量指数(ASMI)相关影响因素,采用多因素logistic回归分析老年T2DM住院患者合并肌少症影响因素。结果肌少症组年龄和HDL水平明显高于非肌少症组,体质量指数(BMI)、基础代谢率、体蛋白、体脂肪、骨矿物质含量、内脏脂肪面积、上臂无脂肪周长及ASMI明显低于非肌少症组(P<0.05,P<0.01)。老年T2DM患者ASMI与性别、BMI、上臂无脂肪周长、骨矿物质含量、空腹胰岛素、血红蛋白呈正相关(P<0.05,P<0.01),与体脂百分比呈负相关(P<0.01)。logistic回归分析显示,性别、BMI、内脏脂肪面积、骨矿物质含量是老年T2DM患者合并肌少症的危险因素(95%CI:1.254~64.334,P=0.029;95%CI:0.213~0.702,P=0.002;95%CI:1.002~1.081,P=0.040;95%CI:0.001~0.371,P=0.009)。结论肌少症是老年T2DM患者常见共患疾病,肌少症的发生与性别、BMI、内脏脂肪面积及骨矿物质含量密切相关。

Objective To study the clinical characteristics and influencing factors of hospitalized elderly T2 DM patients with sarcopenia.Methods One hundred and ninety T2 DM patients were divided into sarcopenia group(n=43) and sarcopenia-free group(n=147) according to 2019 Asian Working Group for Sarcopenia Diagnostic Criteria.Their grip strength, 6-meter gait speed and body composition were measured.The relationship between T2 DM and ASMI was analyzed by Spearman correlation analysis.The influential factors of hospitalized elderly T2 DM patients with sarcopenia were analyzed by multivariate logistic regression analysis.Results The age was significantly older and the serum HDL level was significantly higher while the BMI,basal metabolic rate, body protein, body fat, bone mineral content, ASMI were significantly lower, the visceral fat area was significantly smaller and the upper arm fat-free circumference was significantly shorter in sarcopenia group than in sarcopenia-free group(P<0.05,P<0.01).The ASMI was positively related with gender, BMI,upper arm fat-free circumference, bone mineral content, fasting insulin and hemoglobin(P<0.05,P<0.01) and negatively related with body fat percentage in elderly T2 DM patients(P<0.01).The gender, BMI,visceral fat area and bone mineral content were the risk factors for sarcopenia in elderly T2 DM patients(95%CI:1.254-64.334,P=0.029;95%CI:0.213-0.702,P=0.002;95%CI:1.002-1.081,P=0.040;95%CI:0.001-0.371,P=0.009).Conclusion Sarcopenia, a common complication of elderly T2 DM patients, is closely related with their gender, bone mineral content, BMI and visceral fat area.