羧甲基赖氨酸与2型糖尿病合并肌少症的关系  

Relationship between carboxymethyl lysine and type 2 diabetes mellitus combined with sarcopenia

作　　者：魏剑芬 张肖 任杰 程明慧 靳玉倩 吴乃君 阚芳芳 焦丽静 Wei Jianfen;Zhang Xiao;Ren Jie;Cheng Minghui;Jin Yuqian;Wu Naijun;Kan Fangfang;Jiao Lijing(Department of Endocrinology,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China;Medical Imaging Center,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院内分泌科,唐山063000 [2]华北理工大学附属医院医学影像中心,唐山063000

出　　处：《中国综合临床》2025年第1期14-19,共6页Clinical Medicine of China

基　　金：河北省医学科学研究课题计划(20231274)。

摘　　要：目的探讨羧甲基赖氨酸(carboxymethyl lysine,CML)与2型糖尿病(type 2 diabetes,T2DM)合并肌少症的关系,为临床预防和早期干预肌少症的发生提供一定的临床参考。方法采用病例对照研究,选取2022年11月至2023年11月在华北理工大学附属医院内分泌科住院的142例T2DM患者,依据2019肌少症诊断及治疗专家共识中的诊断标准将患者分为病例组(T2DM合并肌少症,58例)和对照组(T2DM未合并肌少症,84例)。收集并比较两组患者的一般资料、血清学资料及人体成分等资料。符合正态分布的计量资料组间比较采用两独立样本t检验;非正态分布的计量资料组间比较采用非参数检验;计数资料组间比较采用χ^(2)检验。多因素Logistic回归分析羧甲基赖氨酸与2型糖尿病合并肌少症的关系。绘制受试者工作特征(receiver operating characteristic,ROC)曲线,分析羧甲基赖氨酸诊断T2DM合并肌少症的效能。结果单因素分析显示,病例组患者的体质量指数[(21.59±3.04)kg/m2]、空腹胰岛素[4.49(1.85,9.03)U/L]、空腹C肽水平[(1.45±0.96)mg/L]均低于对照组[(27.32±3.74)kg/m2、6.91(3.74,11.99)U/L、(2.64±1.23)mg/L],年龄[(64.67±6.75)岁]、病程[(12.16±6.69)年]、CML[(5.70±2.14)μg/L]均高于对照组[(62.23±7.33)岁、(8.70±8.01)年、(2.38±0.73)μg/L],差异均有统计学意义(统计量值分别为t=9.66、Z=2.86、t=6.46、t=2.02、t=2.70、t=13.17,P值分别为<0.001、0.004、<0.001、0.046、0.008、P<0.001)。多因素二元Logistic回归分析显示,CML[OR(95%CI)∶3.242(1.933~5.437)]、体质量指数[OR(95%CI)∶0.636(0.505~0.801)]与T2DM合并肌少症有关联(均P<0.001)。ROC曲线结果显示,CML的曲线下面积为0.934,相应最佳截断值为3.038μg/L,CML诊断T2DM合并肌少症诊断效能较高,诊断结果与实际结果的一致性较强。结论CML与T2DM合并肌少症相关,CML诊断T2DM合并肌少症的诊断效能较高,其在诊断T2DM合并肌少症具有一定的实用价值。ObjectivesTo explore the relationship between carboxymethyl lysine(CML)and type 2 diabetes(T2DM)with myopenia,so as to provide some clinical reference for clinical prevention and early intervention of myopenia.MethodsA case-control study was conducted,selecting 142 T2DM patients admitted to the Endocrinology Department of the Affiliated Hospital of North China University of Science and Technology from November 2022 to November 2023.According to the diagnostic criteria of the 2019 consensus of experts on the diagnosis and treatment of sarcopenia,the patients were divided into a case group(T2DM with sarcopenia,58 cases)and a control group(T2DM without sarcopenia,84 cases).Collect and compare general information,serological data,and body composition data of two groups of patients.Two independent sample t-test is used for inter group comparison of metric data that conforms to normal distribution;Non parametric tests are used for inter group comparisons of non normally distributed quantitative data;The comparison of count data between groups is conducted usingχ^(2) test.Multivariate logistic regression analysis was used to analyze the relationship between carboxymethyl lysine and type 2 diabetes with myopenia.Draw receiver operating characteristic(ROC)curves and analyze the efficacy of carboxymethyllysine in diagnosing T2DM with muscle atrophy.ResultsUnivariate analysis showed the BMI((21.59±3.04)kg/m 2),FINS(4.49(1.85,9.03)U/L),and FCP((1.45±0.96)mg/L)levels of the patients in the case group were lower than those in the control group(27.32±3.74)kg/m 2,6.91(3.74,11.99)U/L,(2.64±1.23)mg/L),while age,((64.67±6.75)years old)of disease duration(12.16±6.69)years,and CML(5.70±2.14μg/L)were higher than those in the control group((62.23±7.33)years old,(8.70±8.01)years,(2.38±0.73)μg/L),and the differences were statistically significant(Statistical values were t=9.66,Z=2.86,t=6.46,t=2.02,t=2.70,t=13.17;P values were<0.001,0.004,<0.001,0.046,0.008,<0.001).Multifactorial binary logistic regression analysis showed tha

关 键 词：2型糖尿病 肌少症 羧甲基赖氨酸 晚期糖基化终末产物 

分 类 号：R58[医药卫生—内分泌]