老年2型糖尿病患者肌肉量减少与动脉粥样硬化的相关性分析  

Association of muscle mass loss with atherosclerosis in elderly patients with type 2 diabetes

作　　者：孔悠然 张欣欣 段明 王叙馥[2] 董冰子 孙晓方[1] 王颜刚[1] 袁鹰[1] Kong Youran;Zhang Xinxin;Duan Ming;Wang Xufu;Dong Bingzi;Sun Xiaofang;Wang Yangang;Yuan Ying(Department of Endocrinology and Metabolism,the Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Nuclear Medicine,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院内分泌与代谢病科,266003 [2]青岛大学附属医院核医学科,266003

出　　处：《中华内分泌代谢杂志》2021年第1期28-33,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81800769)。

摘　　要：目的探究老年2型糖尿病患者肌量减少与动脉粥样硬化的相关性。方法选择年龄≥60岁的2型糖尿病患者322例,根据四肢骨骼肌指数(ASMI)分为肌量减少组(152例)与非肌量减少组(170例)。入组对象均进行体格检查、双能X线骨密度仪检查、颈部及下肢动脉超声检查、实验室检查。结果在纳入的322例患者中,合并肌少症49例,患病率为15.22%;合并肌量减少152例,患病率为47.2%。肌量减少组的体重指数(BMI)、T值(T-score)、ASMI、尿酸、稳态模型评估的胰岛素抵抗指数(HOMA-IR)显著低于非肌量减少组(均P<0.05)。肌量减少组的颈动脉粥样硬化分级、下肢动脉粥样硬化分级均显著高于非肌量减少组(P<0.05)。多因素logistic回归分析显示,颈动脉粥样硬化、下肢动脉粥样硬化是肌肉量减少的危险因素,BMI、25-羟维生素D3是肌肉量减少的保护因素。老年2型糖尿病患者颈动脉与下肢动脉粥样硬化分级具有一致性(P<0.01)。结论动脉粥样硬化对老年2型糖尿病患者早期肌少症具有预测价值。Objective To investigate the association of muscle mass loss with atherosclerosis in elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 322 patients with T2DM aged≥60 years old were divided into muscle mass loss group(n=152)and non-muscle mass loss group(n=170)according to their appendicular skeletal muscle mass index(ASMI).All participants underwent physical examination,dual-energy X-ray absorptiometry check,carotid and lower extremity ultrasound,as well as laboratory tests.Results Among 322 patients,49(15.22%)patients were suffered from sarcopenia and 152(47.2%)patients with reduced muscle mass.The carotid and lower extremity atherosclerosis grades in the muscle mass loss group were significantly higher than those in the non-muscle mass loss group(P<0.05),with lower body mass index(BMI),T-score,ASMI,uric acid,and homeostasis model assessment of insulin resistance index(P<0.05).Multivariate logistic regression analysis showed that carotid atherosclerosis and lower extremity atherosclerosis were risk factors for muscle mass loss while BMI and 25-(OH)D3 were protective factors for muscle mass loss.There existed a consistency in carotid atherosclerosis grade and lower extremity atherosclerosis grade of elderly patients with T2DM(P<0.01).Conclusion Atherosclerosis has a predictive value for early sarcopenia in elderly patients with T2DM.

关 键 词：老年人 糖尿病 2型 肌量减少 动脉粥样硬化 

分 类 号：R587.2[医药卫生—内分泌]