老年住院2型糖尿病患者肌少症与炎症因子关系的研究  

Association between inflammatory cytokines and sarcopenia in geriatric hospitalized patients with type 2 diabetes mellitus

作　　者：付俊玲 穆志静[1] 孙丽娜[1] 赵蕾[1] 修双玲[1] Junling Fu;Zhijing Mu;Lina Sun;Lei Zhao;Shuangling Xiu(Department of Endocrinology,Xuanwu Hospital,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

出　　处：《中华糖尿病杂志》2023年第1期20-25,共6页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：北京市属医院科研培育计划项目(PX2020034);2021年度宣武医院国自然青年培育项目(QNPY2020014);首都医科大学校培育基金(PYZ21033);糖尿病防治研究北京市重点实验室开放基金资助项目(10025220102);北京市属医学科研院所公益发展改革试点项目:老年患者慢病智能化管理及创新模式研究(京医研2021-8)。

摘　　要：目的探讨老年住院2型糖尿病(T2DM)患者肌少症与炎症因子的关系。方法为回顾性研究。选择2017年4月至2019年4月在首都医科大学宣武医院内分泌科住院的年龄>60岁的T2DM患者508例作为研究对象。收集患者的一般资料,包括身高、体重,计算体重指数(BMI)。检测糖化血红蛋白(HbA1c)及血清炎症因子(C反应蛋白和白细胞介素-6)。测量患者四肢骨骼肌质量、握力、步速,并计算四肢骨骼肌质量指数(ASMI)。按照亚洲肌少症诊断标准,将患者分为非肌少症组和肌少症组。采用t检验、Mann-Whitney U检验或χ2检验比较两组间一般临床资料。采用线性回归分析法和logistic回归分析法探讨肌少症的影响因素。结果508例患者中,肌少症组41例,非肌少症组467例。与非肌少症组相比,肌少症组T2DM患者的年龄更大[分别为(74.04±7.79)和(67.03±6.60)岁]、BMI更低[分别为(22.90±3.37)和(25.98±3.51)kg/m^(2)]、HbA1c水平[分别为(9.16±2.17)%和(8.43±1.83)%]及C反应蛋白水平[分别为2.89(1.55,5.26)和2.18(1.31,3.77)mg/L]更高(P<0.05)。线性回归分析结果显示,在校正性别、年龄和BMI后,C反应蛋白(β=-0.101,95%CI-0.150~-0.045)和白细胞介素-6(β=-0.057,95%CI-0.149~-0.003)与ASMI呈显著负相关(P<0.05);logistic回归分析结果显示,在校正性别、年龄、BMI和HbA1c后,C反应蛋白仍是肌少症的独立风险因素(OR=1.357,95%CI 1.024~1.798,P<0.05)。结论老年住院T2DM患者中C反应蛋白与肌少症风险独立相关。Objective To explore the association between inflammatory cytokines and sarcopenia in geriatric hospitalized patients with type 2 diabetes mellitus(T2DM).Methods A total of 508 patients with T2DM aged>60 years old who were hospitalized in the Department of Endocrinology from April 2017 to April 2019 in Xuanwu Hospital of Capital Medical University were retrospectively enrolled.General information of the patients,including height and weight was collected and body mass index(BMI)was calculated.Glycated hemoglobin A1c(HbA1c)and inflammatory cytokines(C-reactive protein and interleukin-6)were tested.The appendicular skeletal muscle mass,grip strength and walking speed were measured,moreover,appendicular skeletal muscle mass index(ASMI)was calculated.The patients were divided into non-sarcopenia group and sarcopenia group according to the Asian diagnostic criteria of sarcopenia.The t-test,Mann-Whitney U test andχ2 test were used to compare the general clinical data between the two groups.Linear and logistic regression was used to explore the influencing factors of sarcopenia.Results Of the 508 patients,41 were sarcopenia and 467 were non-sarcopenia.Compared to the non-sarcopenia group,patients with sarcopenia were older[(74.04±7.79)vs.(67.03±6.60)years,respectively],had lower BMI[(22.90±3.37)vs.(25.98±3.51)kg/m^(2),respectively],and had higher levels of HbA1c[(9.16±2.17)%vs.(8.43±1.83)%,respectively]and C-reactive protein[2.89(1.55,5.26)vs.2.18(1.31,3.77)mg/L,respectively](all P<0.05).Linear regression analysis showed that after adjusting for age,gender and BMI,C-reactive protein(β=-0.101,95%CI-0.150--0.045)and interleukin-6(β=-0.057,95%CI-0.149--0.003)were negatively correlated with ASMI(P<0.05).Logistic regression analysis showed that after adjusting for age,gender,BMI and HbA1c,C-reactive protein remained an independent risk factor for sarcopenia(OR=1.357,95%CI 1.024-1.798,P<0.05).Conclusion C-reactive protein is independently associated with the risk of sarcopenia in geriatric hospitalized patients with T

关 键 词：糖尿病 2型 肌少症 炎症因子 

分 类 号：R587.2[医药卫生—内分泌] R685[医药卫生—内科学]