2型糖尿病患者肌少症的相关因素

摘要

目的：探讨2型糖尿病（type 2 diabetes mellitus， T2DM）患者肌少症与性别、年龄、25羟基维生素D （25-hydroxyvitamin D，25OHD）及病程的关系。方法选取2014年8月至2015年6月于安徽省立医院内分泌科住院的T2 DM患者132例，以同期体检的60例正常人为对照，采用双能X线吸收检测法（ dual energy X-ray absorptiometry， DXA）对人体组织成分进行测定，并应用电化学发光法测定体内25OHD水平。根据Baumgartner诊断标准诊断肌少症，比较T2DM组与对照组肌少症发生率，再分别比较两组男女性别发病情况。根据年龄分别将两组研究对象分为5组，比较各年龄段肌少症发生率；根据25 OHD水平分为维生素D严重缺乏组（＜10 ng／mL ）、缺乏组（≥10且＜20 ng／mL ）、不足组（≥20且＜30 ng／mL ）、充足组（≥30 ng／mL），比较各组肌少症发生率。根据糖尿病病程将T2DM组研究对象分为5组，比较各组肌少症发病情况。结果（1） T2DM组肌少症发生率（24.2％）高于对照组（11.7％）；（2）两组男性肌少症发生率均大于女性（ T2 DM组：32.8％vs.15.4％；对照组：23.1％vs.2.9％， P均＜0.05）；（3）80岁以上年龄段组肌少症发生率最高（ T2 DM组：50.0％，对照组：42.9％），且肌少症患者的平均年龄均大于肌量正常者（ P＜0.05）；（4）25OHD严重缺乏组肌少症患病人数多（T2DM组：41.7％，对照组：30.0％），且肌少症患者的25 OHD水平较肌量正常者低（ P＜0.05）；（5）糖尿病患者中，病程20年以上患肌少症（61.1％）最多，肌少症患者的糖尿病病程较肌量正常者长（P＜0.05）。结论2型糖尿病、老龄化是肌少症发病的危险因素，糖尿病病程越长，发病率越高；男性发病率高于女性；低25OHD水平可能与肌少症发生有关。%Objective To investigate the relationship between sarcopenia , gender, age, 25-hydroxyvitamin D (25OHD) level and diabetic duration in type 2 diabetes mellitus (T2DM) patients.Methods Sixty controls, one hun-dred thirty-two patients with T2DM were enrolled in the study .All the subjects underwent body composition measurement by dual-energy X-ray absorptiometry (DXA), and the serum 25OHD level were measured by electrochemiluminescence method.Sarcopenia was diagnosed by the Baumgartner diagnostic criteria .The prevalence of sarcopenia in T2DM group and the control group was compared , and in different gender respectively .The subjects in the two groups were divided in-to five subgroups according to age .Afterwards, these subgroups were divided into vitamin D severe deficiency ( <10 ng/mL), deficiency (≥10 and <20 ng/mL), insufficiency (≥20 and <30 ng/mL) and sufficiency group (≥30 ng/mL).T2DM group was divided into a-e groups according to the diabetic duration .The prevalence of sarcopenia in each group was compared .Results Compared with the control group (11.7%), the prevalence of sarcopenia in T2DM group (24.2%) was higher.The prevalence of sarcopenia in men was higher than in women ( T2DM group: 32.8%/15.4%; the control group: 23.1%/2.9%, P<0.05 ) .The prevalence of sarcopenia in subjects older than 80 years old (T2DM group: 50.0%, the control group: 42.9%) was the highest, and the subjects with sarcopenia was older than those without sarcopenia (P<0.05).The prevalence of sarcopenia in vitamin D severe deficiency group (T2DM group: 41.7%; the control group: 30.0%) was higher, and the 25OHD level of subjects with sarcopenia was lower than those without sarcopenia ( P<0.05 ) .The prevalence of sarcopenia in diabetic duration more than 20 years group (61.1%) was higher, and the diabetic duration of subjects with sarcopenia was longer than those without sarcopenia (P<0.05).Conclusion Aging, gender, T2DM and diabetic duration are risk factors for sarcopenia .Low serum 25OHD level may be related to sarcopenia .