相位角与中老年2型糖尿病患者肌少症的相关性研究  

The correlation between phase angle and sarcopenia in middle-aged and elderly patients with type 2 diabetes mellitus

作　　者：李茜 朱红 叶梦 吴研哲 吴利 麻微微[1] Li Qian;Zhu Hong;Ye Meng;Wu Yanzhe;Wu Li;Ma Weiwei(School of Public Health,Capital Medical University,Beijing 100069,China;Department of Clinical Nutrition,Nanjing Drum Tower Hospital Group Suqian Hospital,Suqian 223800,Jiangsu Province,China;Department of Endocrinology,Nanjing Drum Tower Hospital Group Suqian Hospital,Suqian 223800,Jiangsu Province,China;Chengde Medical University,Chengde 067050,Hebei Province,China)

机构地区：[1]首都医科大学公共卫生学院,北京100069 [2]南京鼓楼医院集团宿迁医院临床营养科,江苏宿迁223800 [3]南京鼓楼医院集团宿迁医院内分泌科,江苏宿迁223800 [4]承德医学院临床医学系,河北承德067050

出　　处：《首都医科大学学报》2025年第2期340-347,共8页Journal of Capital Medical University

基　　金：江苏省老年健康科研项目(LD2022015);宿迁市指导性科技计划项目(Z2023107)。

摘　　要：目的探讨相位角与合并肌少症的中老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者之间的关联及其对中老年T2DM患者合并肌少症风险的预测价值。方法收集于2022年3月至2024年6月期间在南京鼓楼医院集团宿迁医院内分泌科住院的中老年T2DM患者356例,其中单纯糖尿病患者274例,T2DM伴有肌少症患者82例。通过Logistic回归分析来确定相位角与肌少症的关联性。利用受试者工作特征(receiver operating characteristic,ROC)曲线评估相位角对T2DM患者合并肌少症的预测能力,同时采用Jonckheere-Terpstra方法检验相位角在T2DM患者肌少症严重程度变化中的趋势。结果单因素分析显示,T2DM患者合并肌少症组的相位角(phase angle,PhA)值明显低于单纯糖尿病组,组间差异有统计学意义(P<0.05);同时发现T2DM患者合并肌少症组的身高、体质量、体质量指数(body mass index,BMI)、腰围、上臂围、小腿围、空腹胰岛素、餐后2 h胰岛素、空腹C肽、餐后2 h C肽、三酰甘油、白蛋白、尿素氮、体成分各项指标、6 m步速、肌肉质量和肌肉力量相关指标均明显低于单纯糖尿病组;T2DM患者合并肌少症组年龄、糖尿病病程、糖化血红蛋白、血清25-羟基维生素D[25-hydroxyvitamin D,25-(OH)D]明显高于单纯糖尿病组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果表明,在排除其他因素的干扰作用后,PhA仍然与T2DM患者合并肌少症的有关联(P<0.05),PhA降低了T2DM患者合并肌少症的风险增大。ROC曲线分析结果表明,PhA预测T2DM患者合并肌少症的曲线下面积(area under the curve,AUC)为0.769(95%CI:0.710~0.829),表明PhA具有预测T2DM患者合并肌少症效能。趋势检验结果表明,PhA与T2DM患者的肌少症病情程度呈显著负相关(P<0.05)。结论相位角与T2DM患者合并肌少症显著相关,可用于早期预测识别和诊断合并肌少症的T2DM患者。Objective To explore the association between phase angle(PhA)and sarcopenia in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM),and to evaluate its predictive value for the risk of sarcopenia in these patients.Methods We collected data from 356 middle-aged and elderly T2DM patients hospitalized in the Department of Endocrinology,Nanjing Drum Tower Hospital Group Suqian Hospital from March 2022 to June 2024,including 274 patients with diabetes only and 82 patients with T2DM combined with sarcopenia.A Logistic regression analysis was conducted to assess the relationship between phase angle and sarcopenia.The predictive value of PhA for sarcopenia in T2DM patients was analyzed using the receiver operating characteristic(ROC)curve,and the trend of PhA with the severity of sarcopenia in T2DM patients was tested by the Jonckheere-Terpstra method.Results Univariate analysis showed that the PhA value in the T2DM with sarcopenia group was significantly lower than that in the diabetes alone group,with a statistically significant difference(P<0.05).Additionally,height,body mass,body mass index(BMI),waist circumference,arm circumference,calf circumference,fasting insulin,postprandial 2 h insulin,fasting C-peptide,postprandial 2 h C-peptide,triglycerides,albumin,blood urea nitrogen,body composition indicators,6 m walking speed,muscle mass,and muscle strength-related indicators were significantly lower in the T2DM with sarcopenia group compared to the diabetes alone group.Age,duration of diabetes,glycated hemoglobin,25-hydroxyvitamin D[25-(OH)D]were significantly higher in the T2DM with sarcopenia group,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis indicated that,after adjusting for other factors,PhA remained associated with sarcopenia in T2DM patients(P<0.05),with a decreased PhA increasing the risk of sarcopenia.ROC curve analysis showed that the area under the curve(AUC)for PhA predicting sarcopenia in T2DM patients was 0.769(95%CI:0.710-0.829),indicating th

关 键 词：2型糖尿病 肌少症 相位角 中老年 预测 诊断 

分 类 号：R589[医药卫生—内分泌]