不同方法校正的肌肉质量与老年2型糖尿病躯体功能的相关性比较  

Comparison of the correlation between muscle mass corrected by different methods and physical function in older adults with type 2 diabetes mellitus

作　　者：修双玲[1,2] 孙丽娜 穆志静[1] 付俊玲[1] 赵蕾 Xiu Shuangling;Sun Lina;Mu Zhijing;Fu Junling;Zhao Lei(Department of Endocrinology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;Department of Geriatrics, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院内分泌科,北京100053 [2]首都医科大学老年医学系,北京100053

出　　处：《首都医科大学学报》2022年第2期284-288,共5页Journal of Capital Medical University

基　　金：北京市属医院科研培育计划项目(PX2020034);北京市属医学科研院所公益发展改革试点项目(京医研2021-8)。

摘　　要：目的探索不同方法校正的肌肉质量与老年2型糖尿病(type 2 diabetes mellitus,T2DM)躯体功能的相关性。方法纳入首都医科大学宣武医院内分泌科≥60岁的T2DM患者248例,测定血红蛋白(hemoglobin,Hb),糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、空腹血糖(fasting plasma glucose,FPG),维生素D、握力、步速、起立行走计时(timed go and up,TUG)测试时间,计算体质量指数(body mass index,BMI)。并用双能X线吸收检测仪测定四肢骨骼肌肌肉质量(appendicular skeletal muscle mass,ASM),分别用身高(height,ht)的平方(ASM/ht2)和BMI(ASM/BMI)两种方法对肌肉质量校正,分析躯体功能的影响因素。结果偏相关分析结果显示,ASM/BMI均与握力、步速、TUG时间显著相关(分别为r=0.636,P<0.001;r=0.191,P=0.003;r=-0.143,P=0.026),而ASM/ht2仅与握力相关(r=0.513,P<0.001)。多元Logistic回归分析结果显示,低ASM/BMI显著影响患者的步速和TUG时间(分别为OR=4.73,95%CI:1.54~14.60,P=0.007;OR=2.92,95%CI:1.12~7.63,P=0.029),而ASM/ht2对患者躯体功能无显著影响。结论低ASM/BMI而不是低ASM/ht2与老年T2DM患者差的躯体功能相关,ASM/BMI可能是更适合于T2DM患者的肌肉质量校正方法。Objective To explore effects of muscle mass modified by different methods on physical function in old people with type 2 diabetes mellitus(T2DM).Methods A total of 248 old people with T2DM aged more than 60 years were included in the study.Levels of hemoglobin(Hb),glycosylated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),vitamin D were measured and grip strength,gait speed,timed go and up(TUG)time were assessed.Body mass index(BMI)was calculated.Furthermore,appendicular skeletal muscle mass(ASM)was assessed by dual energy X-ray absorptiometry(DXA)and were adjusted by height square(ASM/ht2)and BMI(ASM/BMI)accordingly.The influencing factors for physical function were evaluated.Results The partial correlation analysis showed that ASM/BMI was associated with grip strength,gait speed and TUG time(r=0.636,P<0.001;r=0.191,P=0.003;r=-0.143,P=0.026;respectively),while ASM/ht2 was only associated with grip strength(r=0.513,P<0.001).In a multiple logistic analysis,low ASM/BMI was associated with increased risk of low gait speed and long TUG time(OR=4.73,95%CI:1.54-14.60,P=0.007;OR=2.92,95%CI:1.12-7.63,P=0.029,respectively),while ASM/ht2 had no significant effect on physical function.Conclusion Low ASM/BMI but not low ASM/ht2 was significantly associated with poor physical function in older adults with T2DM.ASM/BMI may be a more suitable method of muscle mass correction for T2DM patients.

关 键 词：2型糖尿病 肌肉质量 肌少症 躯体功能 

分 类 号：R587.1[医药卫生—内分泌]