小腿围与髋关节骨密度测定对2型糖尿病合并肌少症的诊断价值研究

Diagnostic value of calf circumference and hip joint BMD in type 2 diabetes mellitus with sarcopenia

目的 探讨小腿围与髋关节骨密度测定对2型糖尿病合并肌少症的诊断价值。方法 选取2022年1月—2023年1月在华北理工大学附属医院内分泌科住院的105例2型糖尿病患者为研究对象,并根据肌少症诊断标准,将其中合并肌少症的40例2型糖尿病患者为病例组,未合并肌少症的65例2型糖尿病患者为对照组。比较二组患者的性别、年龄、病程、BMI、髋关节骨密度、小腿围、胰岛素水平等临床资料,采用Logistic回归分析探讨小腿围、髋关节骨密度与2型糖尿病患者合并肌少症的关系。受试者工作特征(ROC)曲线探讨小腿围与髋关节骨密度对T2DM患者患有肌少症的预测价值。结果 与对照组相比,病例组患者小腿围和髋关节骨密度偏低,差异有统计学意义(P<0.05)。多因素非条件Logistic回归分析显示,小腿围(OR=0.592)、髋关节骨密度(OR=0.002)和基础代谢率(OR=0.995)与2型糖尿病合并肌少症相关(P<0.05)。ROC曲线分析示小腿围AUC 0.811 (95%CI:0.626~0.818)、髋关节骨密度AUC 0.722 (95%CI:0.730~0.892)及两者联合指标的AUC 0.863(95%CI:0.794~0.933),且差异有统计学意义(P<0.05)。结论 小腿围和髋关节骨密度对2型糖尿病患者患有肌少症有诊断价值,联合指标对T2DM合并肌少症的诊断价值高于单独指标。

Objective To investigate the application value of bone mineral density measurement of calf circumference and hip joint in screening for sarcopenia in type 2 diabetes patients.Methods A total of 105 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology, Affiliated Hospital of North China University of Science and Technology from January 2022 to January 2023 were selected as the study objects. According to the diagnostic criteria for sarcopenia, 40 patients with type 2 diabetes with sarcopenia were selected as the case group, and 65 patients without sarcopenia were selected as the control group. Gender, age, course of disease, BMI, hip bone mineral density, calf circumference, insulin level and other clinical data of the two groups were compared. Logistic analysis was used to explore the relationship between calf circumference, hip bone mineral density and type 2 diabetes patients with sarcopenia. To investigate the predictive value of lower leg circumference and hip bone mineral density in patients with T2DM with sarcopenia. Results Compared with the control group, the bone mineral density(BMD) of the calf circumference and hip joint in the case group was lower, and the difference was statistically significant(P<0.05). Multivariate Logistic regression analysis showed that calf circumference(OR=0.592), hip bone mineral density(OR=0.002) and basal metabolic rate(OR=0.995) were correlated with type 2 diabetes mellitus with sarcosis(P<0.05). ROC curve analysis showed AUC 0.811(95%CI: 0.626-0.818) for calf circumference, AUC 0.722(95%CI: 0.730-0.892) for hip bone mineral density and AUC 0.863(95%CI:0.794-0.933) for their combined indexes, and the difference was statistically significant(P<0.05).Conclusion Calf circumference and hip bone mineral density(BMD) have diagnostic value for type 2 diabetes patients with sarcopenia, and the diagnostic value of combined indexes for T2DM patients with sarcopenia is higher than that of single indexes.