糖尿病周围神经病变与肌少症的关联性

doi:10.6040/j.issn.1671-7554.0.2021.0380

摘要/Abstract

摘要： 目的探讨2型糖尿病患者糖尿病周围神经病变(DPN)与肌少症的关联性。方法选取2型糖尿病患者166例,根据骨骼肌质量指数、握力及步速分为肌少症组(n=62)与非肌少症组(n=104);有DPN的症状或体征、同时存在神经传导速度减慢的患者诊断为DPN。应用单因素分析及多因素Logistic回归分析进行统计学处理,比较两组患者的临床特征、生化指标及DPN患病率的差异。结果肌少症组患者的年龄大于非肌少症组,体质量指数、谷氨酸氨基转移酶水平、骨骼肌质量指数、握力、步速均低于非肌少症组(P<0.05)。肌少症组DPN的比例为83.87%,骨质疏松症比例为70.97%,均高于非肌少症组(P<0.05)。性别为男性(OR=0.025; 95%CI:0.004~0.143)及DPN(OR=32.927, 95%CI:6.169~175.742)为2型糖尿病患者发生肌少症的独立危险因素,而较高的体质指数是2型糖尿病患者发生肌少症的保护性因素(OR=0.546,95%CI:0.420~0.710)。结论 DPN是2型糖尿病患者发生肌少症的独立危险因素,对于患有DPN的患者,应进行肌少症的临床筛查。

关键词: 肌少症, 糖尿病周围神经病变, 2型糖尿病, 骨骼肌质量指数, 体质量指数

Abstract: Objective To investigate the relationship between diabetic peripheral neuropathy(DPN)and sarcopenia in patients with type 2 diabetes mellitus(T2DM). Methods A total of 166 patients with T2DM were selected and divided into sarcopenia group(n=62)and non-sarcopenia group(n=104)according to the skeletal muscle mass index, grip strength and gait speed. Patients with symptoms or signs of DPN and a decrease in nerve conduction were diagnosed as diabetic peripheral neuropathy. Single factor analysis and multivariate Logistic regression analysis were used for statistical processing to compare the differences of clinical characteristics, biochemical indicators and prevalence of diabetic peripheral neuropathy between the two groups. Results The patients in sarcopenia group were older, but the body mass index, alanine aminotransferase level, skeletal muscle mass index, grip strength, and gait speed were lower than those in the non-sarcopenia group(P<0.05). The proportion of DPN and osteoporosis in the sarcopenia group were 83.87% and 70.97%, respectively, which were higher than those in the non-sarcopenia group(P<0.05). Male sex(OR=0.025, 95%CI: 0.004-0.143)and DPN(OR=32.927, 95%CI: 6.169-175.742)were independent risk factors for sarcopenia. Higher body mass index was a protective factor for sarcopenia(OR=0.546, 95%CI: 0.420-0.710). Conclusion DPN is an independent risk factor for sarcopenia in patients with T2DM. For patients with DPN, clinical screening for sarcopenia is recommended.

Key words: Sarcopenia, Diabetic peripheral neuropathy, Type 2 diabetes mellitus, Skeletal muscle mass index, Body mass index

中图分类号:

R589

郑凤杰,宋玉文,孙爱丽,潘喆,王殿辉,娄能俊,吕丽, 庄向华,陈诗鸿. 糖尿病周围神经病变与肌少症的关联性[J]. 山东大学学报 (医学版), 2021, 59(6): 38-44.

ZHENG Fengjie, SONG Yuwen, SUN Aili, PAN Zhe, WANG Dianhui, LOU Nengjun, LYU Li, ZHUANG Xianghua, CHEN Shihong. Correlation between diabetic peripheral neuropathy and sarcopenia[J]. Journal of Shandong University (Health Sciences), 2021, 59(6): 38-44.

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