解放军医学杂志2024，Vol.49Issue(5) ：489-494.DOI:10.11855/j.issn.0577-7402.2272.2023.1103

2型糖尿病患者四肢骨骼肌成分与糖化血红蛋白水平的相关性分析

Association between appendicular skeletal muscle composition and glycosylated hemoglobin a1c level in patients with type 2 diabetes mellitus

刘浪浪 袁曦 范枝俏 王新 靳玉欣 杨艾利 赵国宏
解放军医学杂志2024，Vol.49Issue(5) ：489-494.DOI:10.11855/j.issn.0577-7402.2272.2023.1103
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  • 维普
  • 万方数据

2型糖尿病患者四肢骨骼肌成分与糖化血红蛋白水平的相关性分析

Association between appendicular skeletal muscle composition and glycosylated hemoglobin a1c level in patients with type 2 diabetes mellitus

刘浪浪 1袁曦 1范枝俏 1王新 1靳玉欣 1杨艾利 1赵国宏1
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作者信息

  • 1. 空军军医大学唐都医院内分泌科,陕西西安 710038
  • 折叠

摘要

目的 探讨2型糖尿病(T2DM)患者四肢骨骼肌成分(四肢骨骼肌含量及四肢骨骼肌指数)与糖化血红蛋白(HbA1c)水平之间的关系.方法 收集2021年4月-2022年6月于空军军医大学唐都医院内分泌科住院治疗的459例成人T2DM患者进行回顾性分析.所有患者均应用生物电阻抗分析评估身体成分.根据患者HbA1c水平分为糖化达标组(HbA1c≤7.0%,n=145)与糖化不达标组(HbA1c>7.0%,n=314).比较两组患者的一般资料、生化指标及肌肉含量、脂肪含量等人体成分.采用Spearman相关分析及多元logistic回归分析T2DM患者身体成分与HbA1c达标之间的关系.结果 糖化达标组患者的四肢骨骼肌含量及指数均优于糖化不达标组(P<0.05),但两组患者的性别、降糖药物用药史、体脂(体脂肪含量、四肢脂肪含量及内脏脂肪含量)等方面差异均无统计学意义(P>0.05).Spearman相关分析显示,肌肉成分中,四肢骨骼肌含量及指数均与HbA1c呈负相关(r=-0.158,P=0.001;r=-0.187,P<0.001).Logistic回归分析显示,上肢骨骼肌含量(OR=3.570,95%CI 2.293～5.559)和下肢骨骼肌含量(OR=1.297,95%CI 1.146～1.468)为糖化达标的独立保护因素.结论 四肢骨骼肌含量是HbA1c达标的保护因素,随着四肢骨骼肌含量增加,HbA1c水平逐渐降低.其中,上肢肌肉含量的增加与HbA1c达标的相关性更强.

Abstract

Objective To investigate the relationship between appendicular skeletal muscle composition(muscle mass and muscle index)and glycosylated hemoglobin A1c(HbA1c)level in type 2 diabetes mellitus(T2DM)patients.Methods A total of 459 adult T2DM patients hospitalized in the Department of Endocrinology,Tangdu Hospital of Air Force Medical University from April 2021 to June 2022 were selected as the research objects.Bioelectrical impedance analysis was used to evaluate the body composition of the patients.The patients were divided into two groups according to HbA1c level:standard glycation group(HbA1c≤7.0%,n=145)and unqualified glycation group(HbA1c>7.0%,n=314).The two groups'general data,biochemical indexes,muscle content,fat content and other body composition were analyzed.Spearman correlation analysis and multiple logistic regression analysis were used to analyze the relationship between body composition and glycemic control in type 2 diabetic patients.Results The appendicular skeletal muscle mass and its index(ASMI)of the patients in the standard glycation group were better than those in the unqualified glycation group(P<0.05).However,there were no significant differences in gender,history of antidiabetic drugs and body fat(body fat content,limb fat content and visceral fat content)between the two groups(P>0.05).Spearman correlation analysis showed that appendicular skeletal muscle mass and its index were negatively correlated with HbA1c(r=-0.158,P=0.001;r=-0.187,P<0.001).Logistic regression analysis showed that upper limb skeletal muscle mass(OR=3.570,95%CI 2.293-5.559)and lower limb skeletal muscle mass(OR=1.297,95%CI 1.146-1.468)were independent protective factors for achieving glycation standard in HbA1c group.Conclusions The skeletal muscle mass of limbs is a protective factor for reaching the standard of HbA1c.With the increase of skeletal muscle mass of limbs,the level of HbA1c gradually decreases.Among them,the increase of upper limb muscle mass has a stronger correlation with reaching the standard of HbA1c.

关键词

糖尿病,2型/糖化血红蛋白/身体成分分析/骨骼肌含量/骨骼肌指数

Key words

diabetes mellitus,type 2/glycosylated hemoglobin/body composition analysis/skeletal muscle mass/skeletal muscle mass index

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基金项目

国家自然科学基金青年基金(81502402)

出版年

2024
解放军医学杂志
人民军医出版社

解放军医学杂志

CSTPCD北大核心
影响因子：1.644
ISSN：0577-7402
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