血糖水平与超声检测局部肌肉量及肌肉质量的相关性研究  

Correlation study between blood glucose level and local muscle mass measured by ultrasound

作　　者：吕珊[1] 狄文娟[1] 朱思平[1] 林蔚[1] 刘娟[1] 赖兵[1] 姜敏[2] Lyu Shan;Di Wenjuan;Zhu Siping;Lin Wei;Liu Juan;Lai Bing;Jiang Min(Department of Gerontology,the First Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China;Department of Gerontology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical College,Nanjing 210008,China)

机构地区：[1]南京医科大学第一附属医院老年医学科,210029 [2]南京大学医学院附属鼓楼医院老年医学科,210008

出　　处：《中华糖尿病杂志》2020年第10期824-829,共6页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家自然科学基金(81871096);江苏省卫生科研项目(BJ18018)。

摘　　要：目的探讨血糖水平与尺骨前肌、股外侧肌的厚度和肌肉质量的相关性。方法回顾性分析2018年6月至2019年1月在南京医科大学第一附属医院老年医学科住院的130例患者,按照2017年中国糖尿病诊断标准分为血糖正常组38例、糖耐量异常组47例、糖尿病组45例。采用超声检测尺骨前肌和股外侧肌的厚度,并采用QLAB软件分析感兴趣区肌肉质量。3组间计量资料的比较采用单因素方差分析,糖化血红蛋白、空腹血糖与各变量间的相关性采用Pearson相关分析法,多因素分析采用多元回归分析法。结果 3组患者间的尺骨前肌厚度、股外侧肌厚度差异均无统计学意义(P>0.05),而尺骨前肌和股外侧肌的肌肉质量差异有统计学意义(P<0.05),其中,糖耐量异常组、糖尿病组分别与血糖正常组比较,尺骨前肌肌肉质量和股外侧肌肌肉质量的差异均有统计学意义(P<0.05)。空腹血糖与股外侧肌ROI的肌肉质量呈正相关(r=0.233,P=0.008)。糖化血红蛋白与尺骨前肌的肌肉质量(r=0.293,P=0.001)和股外侧肌的肌肉质量(r=0.278,P=0.001)呈正相关。在校正了年龄、体质指数、白蛋白、血脂这些影响肌肉量及肌肉质量的因素之后,糖化血红蛋白与股外侧肌和尺骨前肌的肌肉质量呈正相关性(β值分别为0.517和0.337,P值分别为0.014和0.041)。结论肌肉质量在糖耐量异常阶段就开始变差,接着出现肌肉量的减少;糖化血红蛋白相比空腹血糖与肌肉质量具有更好的相关性。Objective To explore the effect of blood glucose level on the thickness and quality of anterior ulnar muscle and vastus lateralis muscle.Methods A retrospective study was conducted by collecting the data of patients hospitalized in the Geriatric Department of the First Hospital Affiliated to Nanjing Medical University from June 2018 to January 2019.One hundred and thirty people were included in this study.According to the Chinese diabetes diagnosis standard in 2017,they were divided into normal group(38 cases),abnormal glucose tolerance group(47 cases)and diabetes group(45 cases).The thickness of anterior ulnar and vastus lateralis muscle were detected by ultrasound and the quality of region of interested(ROI)was analyzed by QLAB software.Single factor analysis of variance was used to compare the measurement data among the three groups.Pearson correlation analysis was used to analyze the correlation between glycated hemoglobin,fasting blood glucose and muscular variables.Multiple regression analysis was used for multiple factor analysis.Results There was no significant difference in the thickness of anterior ulnar muscle and lateral femoral muscle among the three groups(P>0.05).However,there was significant difference in the muscle quality of anterior ulnar muscle and lateral femoral muscle among the three groups(P<0.05);Compared with normal group,the muscle quality were significantly increased in impaired glucose tolerance group and diabetes group.There was a positive correlation between fasting blood glucose and ROI of vastus lateralis muscle(r=0.233,P<0.01),between glycated hemoglobin A1c(HbA1c)and ROI of anterior ulnar muscle(r=0.293,P<0.01),and between HbA1c and ROI of lateral femoral muscle(r=0.278,P<0.01).Multiple linear regression model analysis showed that there was still a positive correlation between glycosylated hemoglobin and the quality of lateral femoral muscle and anterior ulnar muscleafter adjusting for factors which will affect muscular quality and muscle mass including age,body mass index,album

关 键 词：糖化血红蛋白 血糖 超声 局部肌肉 肌肉质量 

分 类 号：R685[医药卫生—骨科学]