2型糖尿病患者血清胆红素水平与骨骼肌含量降低的相关性研究  

Correlation between serum bilirubin level and muscle mass reduction in patients withtype 2 diabetes mellitus

作　　者：王泽渊 田晨光[1] 李新 Wang Zeyuan;Tian Chenguang;Li Xin(Department of Endocrinology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院内分泌科,郑州450014

出　　处：《中华实验外科杂志》2023年第11期2335-2338,共4页Chinese Journal of Experimental Surgery

基　　金：河南省科技厅科技攻关项目(182102310596)。

摘　　要：目的:探讨2型糖尿病(T2DM)患者正常范围内血清胆红素水平[直接胆红素(DBIL)、间接胆红素(IBIL)、总胆红素(TBIL)]与肌量降低的相关性。方法:选取2022年6月至2023年3月郑州大学第二附属医院内分泌科收治的192例2型糖尿病住院患者作为研究对象,使用横断面调查法,根据亚洲肌少症工作组(AWGS)诊断标准,使用生物电阻抗法检测四肢骨骼肌含量并计算四肢骨骼肌质量指数(ASMI),将研究对象分为肌量降低组(62例)与肌量正常组(130例),并收集所有患者一般资料和实验室指标。通过t检验或非参数检验比较两组间各指标的差异性,spearman相关性分析各指标与ASMI的相关性,二元Losgistic回归分析T2DM患者四肢骨骼肌量降低的影响因素。结果:肌量降低组DBIL、IBIL、TBIL低于肌量正常组{DBIL[4.10(3.20,4.73)μmol/L]比(4.67±1.29)μmol/L,Z=-2.160,P<0.05、IBIL(4.43±1.54)μmol/L比(5.10±1.38)μmol/L,t=3.004,P<0.05、TBIL[7.90(7.07,10.18)μmol/L]比(9.77±2.55)μmol/L,Z=-2.948,P<0.05},Spearman秩相关分析示ASMI与BMI(r=0.259,P<0.05)、DBIL(r=0.632,P<0.05)、IBIL(r=0.669,P<0.05)、TBIL(r=0.693,P<0.05)呈显著正相关,与年龄(r=-0.229,P<0.05)、糖尿病病程(r=-0.225,P<0.05)、糖化血红蛋白(HbA1c)(r=-0.232,P<0.05)显著负相关。Logistic回归分析示IBIL、TBIL是T2DM并发肌少症的保护因素[IBIL:比值比(OR)=0.654,95%可信区间(CI)(0.428,0.998),P<0.05、TBIL:OR=0.868,95%CI(0.768,0.982),P<0.05]。结论:正常范围内较高水平的IBIL、TBIL与T2DM患者ASMI呈正相关,可能是2型糖尿病合并肌少症患者的保护性因素。Objective To analyze the correlation between normal serum bilirubin levels[direct bilirubin(DBIL),indirect bilirubin(IBIL),total bilirubin(TBIL)]and muscle mass reduction in patients with type 2 diabetes mellitus(T2DM).Methods A number of 192 hospitalized patients with type 2 diabetes were admitted to the Department of Endocrinology of the Second Affiliated Hospital of Zhengzhou University from June 2022 to March 2023 were selected as the research subjects.According to the diagnostic criteria of Asian sarcopenia Working Group(AWGS),a cross-sectional survey method was used.AMSI was tested out by bioelectrical impedance analysis.The subjects were divided into reduced muscle mass group(n=62)and normal muscle mass group(n=130).The differences of each index between the two groups were compared by t test or nonparametric test.Spearman correlation analysis was used to analyze the correlation between each index and ASMI.Binary Logistic regression analysis was used to analyze the influencing factors of linb skeletal muscle reduction in T2DM patients.Results DBIL,IBIL and TBIL in the low muscle mass group were significantly lower than those in the normal muscle mass group{DBIL[4.10(3.20,4.73)μmol/L]vs.(4.67±1.29)μmol/L,Z=-2.160,P<0.05,IBIL(4.43±1.54)μmol/L vs.(5.10±1.38)μmol/L,t=3.004,P<0.05,IBIL(4.43±1.54)μmol/L vs.(5.10±1.38)μmol/L,t=3.004,P<0.05,respectively P<0.05,TBIL[7.90(7.07,10.18)μmol/L]vs.(9.77±2.55)μmol/L,Z=-2.948,P<0.05}.Spearman rank correlation analysis showed that ASMI was associated with BMI(r=0.259,P<0.05)and DBIL(r=0.632,P<0.05),IBIL(r=0.669,P<0.05)and TBIL(r=0.693,P<0.05)were significantly positively correlated with age(r=-0.229,P<0.05),duration of diabetes(r=-0.225,P<0.05),glycosylated hemoglobin(r=-0.232,P<0.05),and TBIL(r=0.693,P<0.05).Logistic regression analysis showed that IBIL and TBIL were protective factors for T2DM complicated with sarcopenia[IBIL:odds ratio(OR)=0.654,95%confidence interval(CI)(0.428,0.998),P<0.05、TBIL:OR=0.868,95%CI(0.768,0.982),P<0.05].Conclusion Higher levels

关 键 词：肌少症 2型糖尿病 血清胆红素 四肢骨骼肌质量指数 

分 类 号：R587.1[医药卫生—内分泌]