Correlation analysis between thyroid hormone and sarcopenia in elderly patients with type 2 diabetic nephropathy
Objective To investigate the correlation between thyroid hormone and sarcopenia in elderly patients with type 2 diabetic nephropathy.Methods A total of 200 patients(97 males and 103 females)aged ≥60 years old with type 2 di-abetic nephropathy who were admitted to Huadong Hospital Affiliated to Fudan University from June 2018 to June 2023 were collected.Their general condition(including height,weight,waist-to-hip ratio,etc.)and laboratory indicators such as liver and kidney function,glycated hemoglobin,urinary microalbumin,thyroid function,and 6-meter walking speed were meas-ured.Their dominant hand grip strength was measured by electronic grip dynamometer and body composition was measured by biological impedance method.Chi-square test was used to compare the rates and logistic regression was used to analyze the cor-relation.Results(1)In this study population,the proportion of muscle mass decline,grip strength decline and pace decline were 22.3％,44.0％and 67.5％,respectively,and the prevalence rate of sarcopenia was 15.6％.(2)Taking free triiodo-thyronine(FT3)4.0 pmol/L as the cut-off point,patients were divided into FT3 low value group and FT3 high value group.The proportion of sarcopenia in the FT3 low value group was higher than that in the FT3 high value group(23.5％vs 8.2％),and the difference was statistically significant(x2=7.733,P=0.005).(3)Taking total triiodothyronine(TT3)1.2 nmol/L as the cut-off point,the patients were divided into TT3 low value group and TT3 high value group.The proportion of pace de-cline in the TT3 low value group was higher than that in the TT3 high value group(76.9％vs 57.6％),and the difference was statistically significant(x2=7.065,P=0.008);the proportion of grip strength decline in the low TT3 group was higher than that in the high TT3 group(51.3％vs 35.9％),and the difference was statistically significant(x2=4.092,P=0.043).(4)Taking thyroid stimulating hormone(TSH)1.5 mIU/L as the cut-off point,the patients were divided into low TSH group and high TSH group.The proportion of grip strength decrease in the low TSH group was lower than that in the high TSH group(34.1％vs 50.5％),and the difference was statistically significant(x2=5.128,P=0.024).(5)Logistic regression analysis showed that diabetic nephropathy patients with low FT3 levels had an increased risk of developing sarcopenia(OR=0.369,95％CI:0.153-0.889);patients with low TT3 level had slower walking speed(OR=0.448,95％CI:0.221-0.911).Conclusion The detection rate of decreased muscle content and muscle strength in hospitalized elderly patients with diabetic nephropathy is high.Some thyroid hormone indexes are closely related to sarcopenia,and low FT3 level is an independent cor-relation factor for sarcopenia in elderly patients with diabetic nephropathy.
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