Association of skeletal muscle mass index with albuminuria in elderly patients with type 2 diabetes mellitus
Objective To investigate the correlation between skeletal muscle mass index(SMI)and al-buminuria in elderly patients with type 2 diabetes.Methods From February 2020 to May 2022,298 elderly pa-tients with type 2 diabetes who were more than or equal to 60 years old and admitted to the Department of Nephrology and Department of Geriatric Endocrinology of the hospital were selected as the study objects.Gen-eral data such as patient history and laboratory examination indicators were collected,and limbs SMI was cal-culated after measurement by bioelectrical impedance method.Patients were divided into the normal urinary protein group(ACR＜30 mg/g,135 cases),the microalbuminuria group(ACR 30-300 mg/g,91 cases)and the macroalbuminuria group(ACR＞300 mg/g,72 cases)according to urinary microalbumin/creatinine ratio(ACR)levels.Chi-square test was used to compare the groups.Spearman rank correlation coefficient was used to analyze the relationship between ACR and SMI,multiple logistic regression model was used for independ-ence test,and the Cut-off value of SMI affecting albuminuria was found according to the receiver operating characteristic curve generated according to gender.Results Compared with the normal albuminuria group,the course of disease in the microalbuminuria group and the large albuminuria group was significantly prolonged,the levels of glycosylated hemoglobin and fasting blood glucose were significantly increased,and the estimated glomerular filtration rate and SMI were significantly decreased,with statistical significance(P＜0.05).Com-pared with the microalbuminuria group,the course of disease was significantly prolonged,the level of glycosy-lated hemoglobin was significantly increased,and the estimated glomerular filtration rate and SMI were signif-icantly decreased in the massive albuminuria group,with statistical significance(P＜0.05).Decreased SMI was an independent risk factor for increased ACR in elderly patients with type 2 diabetes[odds ratio=1.685,95％confidence interval(95％CI)1.078-2.638,P=0.022].When proteinuria was greater than 30 mg/g,the sub-ject's area under the curve(AUC)was 0.717(95％CI 0.554-0.880,P=0.001),and the Cut-off value of SMI was 6.05 kg/m2.For males,the AUC was 0.714(95％CI 0.586-0.842,P=0.001),and the Cut-off value of SMI was 7.55 kg/m2.For females,the AUC was 0.611(95％CI 0.511-0.711,P=0.033),and the Cut-off value of SMI was 5.85 kg/m2.Conclusion SMI may be an independent risk factor for the progression of diabetic nephropathy,with an increased risk for men with an SMI＜7.55 kg/m2 and women with an SMI＜5.85 kg/m2.
万方数据
维普
