老年糖尿病患者相位角与肌肉量减少的相关研究

Correlation between phase angle and loss of muscle mass in elderly diabetic patients

目的探讨老年糖尿病患者相位角与肌肉量减少的相关性.方法回顾性分析北京医院营养科就诊的259例老年患者人体成分分析和实验室检测数据,比较糖尿病(106例)和非糖尿病(153例)患者人体成分和实验室指标差异,探讨老年糖尿病患者相位角与肌肉量减少的相关性.结果老年糖尿病患者相位角(5.17±0.65)度,低于非糖尿病患者(5.37±0.76)度(t=-2.075,P<0.05),年龄和空腹血糖高于老年非糖尿病患者(均P<0.05);两组患者体质指数、脂肪、体脂百分数、内脏脂肪面积、骨骼肌指数、身体细胞量、总蛋白、白蛋白、血红蛋白比较差异无统计学意义(均P>0.05).老年糖尿病患者相位角与年龄呈负相关(均P<0.01),与体质指数(r=-0.288)、骨骼肌(r=0.477)、骨骼肌指数(r=0.505)和血红蛋白(r=0.382,)呈正相关(r=-0.680,P<0.01).老年非糖尿病患者相位角与年龄呈负相关(r=-0.666,P<0.01),与体质指数(r=0.296,P<0.01),骨骼肌(r=0.504,P<0.01)、去脂体重(r=0.161,P<0.05)、骨骼肌指数(r=0.441,P<0.01)、身体细胞量(r=0.496,P<0.01)、血红蛋白(r=0.420,P<0.01)呈正相关.以男性骨骼肌指数<7.0 kg/m^(2),女性<5.7 kg/m^(2)为肌肉量减少的标准,老年糖尿病患者肌肉量减少检出率[16.0%(17例)]高于老年非糖尿病患者[7.8%(12例)],差异有统计学意义(χ^(2)=4.229,P<0.05).多元Logistic回归分析结果显示,老年糖尿病肌肉量减少与低相位角(OR=0.413,95%CI:0.280~0.973,P<0.05)和增龄(OR=2.174,95%CI:1.574~3.003,P<0.01)有关.结论老年糖尿病患者相位角低于非糖尿病老年人,肌肉量减少者高于非糖尿病老年人.相位角降低、增龄与老年糖尿病肌肉量减少有关.

Objective To investigate the correlation between phase angle and musele mass reduction in elderly diabetic patients.Methods This paper retrospectively collected and analyzed the data of human composition and laboratory index in elderly patients with diabetes(n=106)and non-diabetic(n=153)patients in the Nutrition Department of Beijing Hospital,compared the differences between two groups,and explored the correlation between phase angle and muscle mass reduction in elderly diabetic patients.Phase angle was detected by bioelectrical impedance which was calculated as reactance/resistanceX 180/.Results Phase angle was lower in elderly diabetic patients(5.17±0.65)°than in non-diabetic elderly patients(5.37±0.76)(t=-2.075.P<0.05);age and fasting blood glucose were higher in elderly diabetic patients than in non-diabetic elderly patients(all P<0.05).There was no significant difference between the two groups in body mass index,fat,body fat percentage,visceral fat area,skeletal muscle index,body cell mass,total protein,albumin,and hemoglobin(all P>0.05).Correlation analysis results showed that in elderly diabetic patients,the phase angle was negatively correlated with body mass index(r=0.288,P<0.01),age(r=-0.680,P<0.01),was positively correlated with skeletal muscle(r=0.477,P<0.01),skeletal muscle index(r=0.505,P<0.01)and hemoglobin(r=0.382,P<0.01);and in the elderly non-diabetic group,phase angle was negatively correlated with age(r=-0.666,P<0.01)and positively correlated with body mass index(r=0.296,P<0.01),skeletal muscle(r=0.504,P<0.01),fat free mass(0.161,P<0.05),skeletal muscle index(r=0.441,P<0.01),body cell volume(r=0.496,P<0.01),and hemoglobin(r=0.420,P<0.01).The bioelectrical impedance apectroscopy detected skeletal muscle mass index<7.0 kg/m^(2) for male and<5.7 kg/m^(2) for female were used as the diagnosis standard for reduced muscle mass.The detection rate of musele mass reduction was higher in elderly diabetic patients(17 cases,16.04%)than in elderly non-diabetic patients(12 cases,7.84%4.229,P<0.05).The results of multiple regression analysis showed that the decrease of muscle mass in elderly diabetic patients was related to low phase angle(OR=0.413,95%CI:D.280-0.973,P<0.05)and aging(OR=2.174,95%CI:1.574-3.003,P<0.01).Conclusions The phase angle is lower in diabetic elderly patients than in non-diabetic elderly patients,and the incidence of muscle mass reduction is higher in diabetic elderly patients than in non-diabetic elderly people.Decreased phase angle and increased age are related to the decrease of muscle mass in elderly diabetic patients.