AGE预测2型糖尿病患者肌少症发生风险  

AGE predict the risk of sarcopenia in type 2 diabetes mellitus patients

作　　者：黄慧静 曹永红 洪琼 邹玲玲 戴武 HUANG Huijing;CAO Yonghong;HONG Qiong;ZOU Lingling;DAI Wu(Department of Endocrinology,Hospital Affiliated to Anhui Medical University(The Second People’s Hospital of Hefei),Hefei 230011,Anhui,China;The Fifth School of Clinical Medicine,Anhui Medical University,Hefei 230032,Anhui,China)

机构地区：[1]安徽医科大学附属合肥医院(合肥市第二人民医院)内分泌科,安徽合肥230011 [2]安徽医科大学第五临床医学院,安徽合肥230032

出　　处：《中国现代医生》2023年第25期45-49,共5页China Modern Doctor

基　　金：合肥市卫生健康应用医学研究项目(合卫科教[2019]172号);安徽医科大学校科研基金项目(2020xkj247);合肥市第二人民医院院级科研重点项目(2022yzd001)。

摘　　要：目的 分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者发生肌少症的危险因素,建立列线图预测模型探讨糖基化终末产物(advanced glycation end product,AGE)预测T2DM患者肌少症的患病风险。方法 选取2021年10月至2022年10月于合肥市第二人民医院住院的T2DM患者180例为研究对象,根据是否合并肌少症将其分为对照组(n=146)和肌少症组(n=34)。比较两组患者的一般资料,采用Logistic回归分析探讨T2DM患者发生肌少症的危险因素,并建立列线图模型。结果 两组患者的年龄、病程、AGE、肌力、起立试验、四肢骨骼肌质量指数(appendicular skeletal muscle mass index,ASMI)、体质量指数(body mass index,BMI)、糖化血红蛋白、尿白蛋白/肌酐比值比较差异均有统计学意义(P<0.05),多因素回归分析结果 显示BMI、肌力、AGE均是T2DM患者发生肌少症的独立危险因素(P<0.05);以BMI、肌力、AGE建立预测模型,经验证该模型校准度良好,具有良好的区分度。绘制受试者操作特征曲线发现其预测T2DM患者发生肌少症的曲线下面积为0.933,有良好的预测价值;校正曲线及决策曲线分析评估结果 显示该模型具有更高的净收益和更好的临床应用价值。结论 AGE是T2DM患者发生肌少症的独立危险因素,对T2DM患者的肌少症诊断具有一定的预测作用。Objective To analyze the risk factors of sarcopenia in patients with type 2 diabetes mellitus(T2DM),and establish a nomogram prediction model to investigate advanced glycation end product(AGE)predicts the risk of sarcopenia in T2DM patients.Methods A total of 180 T2DM patients hospitalized in the Second People’s Hospital of Hefei from October 2021 to October 2022 were selected as study objects,and divided into control group(n=146)and sarcopenia group(n=34)according to whether they were complicated with sarcopenia.The general data of the two groups were compared,and the risk factors of sarcopenia in T2DM patients were discussed by Logistic regression analysis,and a nomogram model was established.Results There were significant differences in age,course of disease,AGE,muscle strength,standing test,appendicular skeletal muscle mass index(ASMI),body mass index(BMI),glycated hemoglobin and urinary albumin/creatinine ratio between the two groups(P<0.05).Multivariate regression analysis showed that BMI,muscle strength and AGE were independent risk factors for sarcopenia in T2DM patients(P<0.05).The prediction model was established based on BMI,muscle strength and AGE,and it was proved that the model had good calibration and differentiation.Receiver operating characteristic curve was drawn,and area under the curve was 0.933 in predicting the occurrence of sarcopenia in T2DM patients,which had good predictive value.Calibration curve and decision curve-analysis(DCA)evaluation results showed that the model had higher net benefit and better clinical application value.Conclusion AGE is an independent risk factor for sarcopenia in T2DM patients,and it can predict the diagnosis of sarcopenia in T2DM patients.

关 键 词：2型糖尿病 糖基化终末产物 肌少症 列线图 

分 类 号：R587.1[医药卫生—内分泌]