老年2型糖尿病患者胰岛素抵抗程度与骨骼肌量的相关性

Relationship between insulin resistance and skeletal muscle mass in elderly type 2 diabetic patients

摘要:

目的 探究老年2型糖尿病(T2DM)患者胰岛素抵抗(IR)程度与骨骼肌量的相关性。方法 选择2018年4月至2019年8月南京医科大学附属南京医院老年T2MD患者83例,根据是否合并肌肉减少症将患者分为2组,对照组为不合并肌肉减少症患者51例,研究组为合并肌肉减少症患者32例。比较2组患者的基本资料、血脂指标、血糖以及胰岛素抵抗指标。采用SPSS 19.0软件进行数据分析。根据数据类型,组间比较分别采用χ²检验或t检验。通过logistic回归分析T2DM患者骨骼肌量减少的危险因素。结果 研究组患者的年龄显著高于对照组,体质量指数显著低于对照组(P<0.05)。研究组患者的稳态模型胰岛β细胞功能指数(HOMA-β)显著低于对照组,而稳态模型胰岛素抵抗指数(HOMA-IR)显著高于对照组(P<0.05)。T2DM患者四肢骨骼肌质量指数(ASMI)数值与HOMA-β呈正相关(r=0.441, P<0.05),与HOMA-IR呈负相关(r=-0.463, P<0.05)。logistic回归分析结果显示年龄及IR是引起T2DM患者骨骼肌量降低的独立危险因素(P<0.05)。结论 年龄HOMA-β和HOMA-IR与T2DM患者的ASMI具有相关性,并且年龄、以及IR是引起T2DM患者肌肉减少症的独立危险因素。

Abstract:

Objective To investigate the relationship between the degree of insulin resistance (IR) and skeletal muscle mass in the elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 83 elderly T2MD patients in Nanjing Hospital Affiliated to Nanjing Medical University from April 2018 to August 2019 were enrolled. They were divided into two groups:the control group without muscle reduction and the study group with muscle reduction. The two groups were compared in the basic data, blood lipid index, blood glucose and insulin resistance index. SPSS statistics 19.0 was used for statistical analysis. Data comparison between two groups was perfomed using χ² test or t test depending on data type. Logistic regression was used to analyze the risk factors of skeletal muscle loss. Results The age of the study group were significantly higher than that of the control group (P<0.05). The body mass index of the study group was significantly lower than that of the control group (P<0.05). The study group had significantly lower homeostasis model assessment-β (HOMA-β) but significantly higher homeostasis model assessment of insulin resistance (HOMA-IR) than the control group (P<0.05). The appendicular skeletal muscle mass index (ASMI) values were positively correlated with HOMA-β (r=0.441, P<0.05) and negatively correlated with HOMA-IR (r=-0.463, P<0.05). Logistic regression analysis showed that age and IR were independent risk factors of skeletal muscle loss in the T2DM patients (P<0.05). Conclusion Age, HOMA-β, and HOMA-IR are associated with ASMI in the T2DM patients, and age and IR are independent risk factors of muscle loss in the T2DM patients.