新诊断2型糖尿病中老年男性患者尿白蛋白与肌量减少的相关性

Correlation between urinary albumin and loss of muscle mass in middle-aged and elderly males with newly diagnosed type 2 diabetes mellitus

目的观察尿白蛋白对新诊断2型糖尿病(T2DM)中老年男性患者骨骼肌质量的影响。方法选取2019年3月至2020年8月于包钢医院住院且糖尿病病程<1年的新诊断T2DM的96例中老年(年龄≥45岁)男性患者为研究对象,根据有无白蛋白尿,分为无白蛋白尿组(n=50)和白蛋白尿组(n=46)。测定2组患者空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、血清肌酐(SCr)、四肢肌量及四肢骨骼肌量指数(ASMI)等临床指标。采用SPSS 19.0统计软件进行数据分析。以多元线性回归分析尿白蛋白与ASMI的独立相关性。结果白蛋白尿组空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、SCr、尿白蛋白肌酐比值(UACR)均高于无白蛋白尿组(t=2.762~13.343,均P<0.05);四肢肌量、ASMI及肾小球滤过滤(GFR)低于无白蛋白尿组(t=5.539~6.953,均P<0.05)。UACR与HOMA-IR、UA、SCr呈正相关(r=0.223~0.426,均P<0.05);与四肢肌量、ASMI及GFR呈负相关(r=-0.287~-0.490,均P<0.05)。多元线性回归分析提示,ASMI的独立影响因素为UACR(β=0.389,P=0.014)。结论UACR与中老年男性T2DM患者ASMI呈负相关,尿白蛋白是新诊断T2DM中老年男性患者ASMI的独立影响因素。

Objective To observe the effect of urinary albumin on skeletal muscle mass in middle-aged and elderly male patients with newly diagnosed type 2 diabetes mellitus(T2DM).Methods A total of 96 middle-aged and elderly male patients(≥45 years old)with newly diagnosed T2DM for less than 1 year in our hospital from March 2019 to August 2020 were enrolled in this study.According to the presence or absence of albuminuria,they were divided into non-albuminuria group(n=50)and albuminuria group(n=46).Their fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),serum creatinine(SCr),limb muscle mass,and limb appendicular skeletal muscle mass index(ASMI)and other clinical indicators were measured.SPSS statistics 19.0 was used to perform the statistical analysis.Multiple linear regression was used to analyze the independent correlation between urinary albumin and ASMI.Results Fasting insulin(FINS),homeostatic model assessment of insulin resistance(HOMA-IR),low-density lipoprotein cholesterol(LDL-C),uric acid(UA),SCr,and urinary albumin creatinine ratio(UACR)were significantly higher(t=2.762-13.343,all P<0.05),but limb muscle mass,ASMI and glomerular filtration(GFR)were obviously lower(t=5.539-6.953,all P<0.05)in the albuminuria group than the non-albuminuria group.UACR was positively correlated with HOMA-IR,UA and SCr(r=0.223-0.426,all P<0.05),and negatively with limb muscle mass,ASMI and GFR(r=-0.287--0.490,all P<0.05).Multiple linear regression analysis showed that UACR was an independent influencing factor of ASMI(β=0.389,P=0.014).Conclusion UACR is negatively correlated with ASMI in middle-aged and elderly male patients with T2DM.Urinary albumin is an independent factor for ASMI in those with newly diagnosed T2DM.