血清铁蛋白、鸢尾素、性激素结合球蛋白对围绝经期女性2型糖尿病并发肌少症的预测价值  

Predictive value of serum ferritin,irisin and SHBG expression levels on sarcopenia in perimenopausal women with T2DM

作　　者：马立 李天华 肖爽 Ma Li;Li Tianhua;Xiao Shuang(Department of Gynaecology,Shijiazhuang Maternal and Child Health Hospital,Shijiazhuang Hebei 050000,P.R.China;Department of Menopausal Health Care,Shijiazhuang Maternal and Child Health Hospital,Shijiazhuang Hebei 050000,P.R.China)

机构地区：[1]石家庄市妇幼保健院妇科,河北石家庄050000 [2]石家庄市妇幼保健院更年期保健科,河北石家庄050000

出　　处：《中国计划生育和妇产科》2025年第2期98-102,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：河北省2022年度医学科研课题(项目编号:20221660)。

摘　　要：目的评估血清铁蛋白(ferritin,Fer)、鸢尾素、性激素结合球蛋白(sex hormone binding globulin,SHBG)水平对围绝经期女性2型糖尿病(type 2 diabetes mellitus,T2DM)患者并发肌少症的预测价值。方法随机选取石家庄市妇幼保健院2023年1月至2024年3月就诊的围绝经期女性T2DM患者128例为研究对象,根据是否患肌少症分为观察组(27例)和对照组(101例)。比较两组一般资料以及血清检测指标,Spearman分析观察组各指标与围绝经期T2DM并发肌少症的相关性,Logistic回归分析围绝经期女性T2DM患者发生肌少症的影响因素,ROC曲线检测血清Fer、鸢尾素、SHBG对围绝经期女性T2DM患者肌少症的预测效能。结果发生肌少症患者27例,发生率21.09%。相关性分析表明,围绝经期T2DM并发肌少症患者的血清Fer水平与骨骼肌质量(skeletal muscle mass,SMM)呈负相关,与年龄、体质量指数(body mass index,BMI)、体脂肪质量(body fat mass,BFM)、内脏脂肪面积(viscera lfat area,VFA)、腰臀比(waist-hip ratio,WHR)呈正相关(P<0.05);鸢尾素水平与年龄呈负相关,与BMI、SMM呈正相关(P<0.05);SHBG水平与WHR、SMM呈正相关,与年龄、BMI呈负相关(P<0.05)。经Logistic回归分析显示,Fer、鸢尾素、SHBG、BMI、SMM、年龄、BFM、VFA均可能是围绝经期T2DM患者合并肌少症的影响因素(P<0.05)。ROC曲线分析表明,围绝经期T2DM患者血清Fer、鸢尾素、SHBG水平以及三者联合对于发生肌少症的AUC分别为0.876、0.821、0.780、0.931,均大于0.7,其中三者联合预测并发肌少症的价值最高(P<0.05)。结论Fer、鸢尾素、SHBG水平对围绝经期女性T2DM患者并发肌少症具有较高的预测价值,三者联合检测预测价值最高。Objective To evaluate the predictive value of serum ferritin(Fer),irisin and sex hormone binding globulin(SHBG)levels for sarcopenia in perimenopausal women with type 2 diabetes mellitus(T2DM).Methods A total of 128 perimenopausal female T2DM patients treated in Shijiazhuang Maternal and Child Health Hospital from January 2023 to March 2024 were randomly selected as the study objects,and were divided into observation group(27 cases)and control group(101 cases)according to whether they had sarcopenia.The general data and serum detection indicators of the two groups were compared,Spearman correlation analysis was used to analyze the correlation between indicators of the observation group and perimenopausal T2DM complicated with sarcopenia,and Logistic regression was used to analyze the influencing factors of sarcopenia in perimenopausal female T2DM patients.ROC curve was used to detect the predictive efficacy of serum Fer,irisin and SHBG in perimenopausal female T2DM patients with sarcopenia.Results There were 27 patients with sarcopenia(21.09%).Correlation analysis showed that the serum Fer level in the perimenopausal female with T2DM complicated with sarcopenia was negatively correlated with SMM,and positively correlated with age,body mass index(BMI),body fat mass(BFM),visceral fat area(VFA)and waist-hip ratio(WHR)(P<0.05).Irisin level was negatively correlated with age,but positively correlated with BMI and SMM(P<0.05).SHBG level was positively correlated with WHR and SMM,and negatively correlated with age and BMI(P<0.05).Logistic regression analysis showed that Fer,irisin,SHBG,BMI,SMM,age,BFM and VFA may be the influencing factors for perimenopausal T2DM patients with sarcopenia(P<0.05).ROC curve analysis showed that the serum levels of Fer,irisin and SHBG and the AUC of their combination for the occurrence of sarcopenia in perimenopausal T2DM patients were 0.876,0.821,0.780 and 0.931,respectively,all of which were greater than 0.7,among which the combination of the three had the highest predictive value for th

关 键 词：血清铁蛋白 鸢尾素 SHBG T2DM 肌少症 

分 类 号：R587.1[医药卫生—内分泌] R681[医药卫生—内科学]