2型糖尿病患者骨骼肌质量指数与非创伤性肩袖损伤的相关性

Association of skeletal muscle mass index with non-traumatic rotator cuff tear in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者骨骼肌质量指数(SMI)与发生非创伤性肩袖损伤(RCT)的关系。方法回顾性分析2020年6月至2022年12月于晋中市第三人民医院内分泌及骨科住院的180例T2DM患者的临床资料,按照磁共振检查结果及病史分为T2DM合并非创伤性RCT组(T2DM+RCT组,n=80)与T2DM未合并肩袖损伤组(T2DM+non-RCT组,n=100)。比较两组患者一般资料、体脂率、骨骼肌质量、糖尿病病程、糖化血红蛋白(HbA1c)等的差异。使用二元logistic回归分析T2DM患者发生非创伤性RCT的危险因素。绘制受试者工作特征(ROC)曲线分析各因素对T2DM患者发生非创伤性RCT的预测价值。结果T2DM+RCT组女性患者比例、体重、身体质量指数(BMI)、糖尿病病程、体脂率及HbA1c水平均高于T2DM+non-RCT组(P<0.05);SMI低于T2DM+non-RCT组[6.10(5.50,7.18)kg/m^(2) vs 5.40(4.50,6.10)kg/m^(2),Z=4.443,P<0.01]。二元logistic回归分析显示,SMI、BMI、糖尿病病程及HbA1c水平是RCT的影响因素(P<0.05)。ROC曲线显示,SMI诊断T2DM患者合并RCT的最佳截断值为5.15 kg/m^(2),灵敏度为48.80%,特异度为82.00%,AUC=0.693(95%CI:0.614~0.771)。SMI、BMI、糖尿病病程及HbA1c四者联合诊断价值最高,灵敏度为81.30%,特异度为91.00%,AUC=0.926(95%CI:0.885~0.966)。结论T2DM患者非创伤性RCT的发生与SMI存在相关性,对非创伤性RCT形成有一定预测价值。

Objective To investigate the relationship between skeletal muscle mass index(SMI)and non-traumatic rotator cuff tear(RCT)in patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 180 T2DM patients who were hospitalized in the Department of Endocrinology and Orthopedics,the Third People s Hospital of Jinzhong from June 2020 to December 2022 were retrospectively analyzed.According to the results of MRI and medical history,the patients were divided into T2DM+RCT group(n=80)and T2DM+non-RCT group(n=100).The general data,body fat ratio,skeletal muscle mass,duration of diabetes,glycosylated hemoglobin(HbA1c)and other factors were compared between the two groups.Binary logistic regression was used to analyze the risk factors for non-traumatic RCT in T2DM patients.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of various factors for non-traumatic RCT in T2DM patients.Results The proportion of female,body weight,body mass index(BMI),duration of diabetes,body fat ratio and HbA1c level in T2DM+RCT group were higher than those in T2DM+non-RCT group(P<0.05).The SMI was lower than that of the T2DM+non-RCT group[6.10(5.50,7.18)kg/m^(2) vs 5.40(4.50,6.10)kg/m^(2),Z=4.443,P<0.01].Binary logistic regression analysis showed that SMI,BMI,duration of diabetes and HbA1c were influencing factors for RCT.The ROC curve showed that the optimal cut-off value of SMI in diagnosing RCT in T2DM patients was 5.15 kg/m^(2),with a sensitivity of 48.80%and a specificity of 82.00%,and AUC=0.693(95%CI:0.614-0.771).The combination of SMI,BMI,duration of diabetes and HbA1c had the highest diagnostic value,with a sensitivity of 81.30%and a specificity of 91.00%,and AUC=0.926(95%CI:0.885-0.966).Conclusion There is a correlation between SMI and non-traumatic RCT in diabetic patients,which has a particular predictive value for non-traumatic RCT.