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Abstract：
BACKGROUND: Sarcopenia, an age-related disorder characterized by loss of skeletal muscle mass and function, is recently recognized as a complication in elderly patients with type 2 diabetes mellitus (T2DM). Skeletal muscles play a crucial role in glycemic metabolism, utilizing around 80% of blood glucose. Accordingly, we aimed to explore the relationship between glucose metabolism and muscle mass in T2DM.
METHODS: We employed the AWGS 2019 criteria for diagnosing low muscle mass and 1999 World Health Organization (WHO) diabetes diagnostic standards. This study included data of 191 individuals aged 60 and above with T2DM of Shanghai Pudong Hospital from November 2021 to November 2022. Fasting C-peptide (FPCP), fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (PPG) and postprandial 2-hour C-peptide (PPCP), glycated hemoglobin A1c (HbA1c), glycated albumin (GA), serum lipids spectrum, renal and hepatic function, hemoglobin, and hormone were measured. Based on the findings of univariate analysis, logistic regression and receiver operating characteristic (ROC) curves were established.
RESULTS: Participants with low muscle mass had significantly lower alanine and aspartate aminotransferase, and both FPCP and PPCP levels (P < 0.05). Compared with those without low muscle mass, low muscle mass group had significantly higher FPG, HbA1c, GA levels (P < 0.05). Body fat (BF, OR = 1.181) was an independent risk factor for low muscle mass. PPCP (OR = 0.497), BMI (OR = 0.548), and female (OR = 0.050) were identified as protective factors for low skeletal muscle. The AUC of BMI was the highest, followed by the PPCP, gender and BF (0.810, 0.675, 0.647, and 0.639, respectively), and the AUC of the combination of the above four parameters reached 0.895.
CONCLUSIONS: In this cross-sectional study, BMI, Female, and PPCP associated with T2DM were protective factors for low muscle mass. BF was associated with T2DM and risk factor for low muscle mass.
METHODS: We employed the AWGS 2019 criteria for diagnosing low muscle mass and 1999 World Health Organization (WHO) diabetes diagnostic standards. This study included data of 191 individuals aged 60 and above with T2DM of Shanghai Pudong Hospital from November 2021 to November 2022. Fasting C-peptide (FPCP), fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (PPG) and postprandial 2-hour C-peptide (PPCP), glycated hemoglobin A1c (HbA1c), glycated albumin (GA), serum lipids spectrum, renal and hepatic function, hemoglobin, and hormone were measured. Based on the findings of univariate analysis, logistic regression and receiver operating characteristic (ROC) curves were established.
RESULTS: Participants with low muscle mass had significantly lower alanine and aspartate aminotransferase, and both FPCP and PPCP levels (P < 0.05). Compared with those without low muscle mass, low muscle mass group had significantly higher FPG, HbA1c, GA levels (P < 0.05). Body fat (BF, OR = 1.181) was an independent risk factor for low muscle mass. PPCP (OR = 0.497), BMI (OR = 0.548), and female (OR = 0.050) were identified as protective factors for low skeletal muscle. The AUC of BMI was the highest, followed by the PPCP, gender and BF (0.810, 0.675, 0.647, and 0.639, respectively), and the AUC of the combination of the above four parameters reached 0.895.
CONCLUSIONS: In this cross-sectional study, BMI, Female, and PPCP associated with T2DM were protective factors for low muscle mass. BF was associated with T2DM and risk factor for low muscle mass.
摘要：
背景：肌肉减少症，一种以骨骼肌质量和功能丧失为特征的年龄相关疾病，最近被认为是老年2型糖尿病（T2DM）患者的并发症。骨骼肌在血糖代谢中起关键作用，利用约80%的血糖。因此，目的探讨2型糖尿病患者糖代谢与肌肉质量的关系。
方法：我们采用了AWGS2019诊断低肌肉质量的标准和1999年世界卫生组织（WHO）的糖尿病诊断标准。本研究纳入了2021年11月至2022年11月上海浦东医院191名60岁及以上T2DM患者的数据。空腹C肽（FPCP），空腹血糖（FPG），餐后2小时血浆葡萄糖（PPG）和餐后2小时C肽（PPCP），糖化血红蛋白A1c（HbA1c），糖化白蛋白（GA），血脂谱,肾功能和肝功能，血红蛋白,和激素被测量。根据单变量分析的结果，建立Logistic回归和受试者工作特征（ROC）曲线。
结果：肌肉质量低的参与者的丙氨酸和天冬氨酸转氨酶明显降低，FPCP和PPCP水平(P<0.05)。与那些没有低肌肉质量的人相比，低肌肉质量组的FPG明显增高,HbA1c,GA水平(P<0.05)。身体脂肪（BF，OR=1.181）是低肌肉质量的独立危险因素。PPCP（OR=0.497），BMI（OR=0.548），和女性（OR=0.050）被确定为低骨骼肌的保护因素。BMI的AUC最高，其次是PPCP，性别和BF（分别为0.810、0.675、0.647和0.639），以上四个参数组合的AUC达到0.895。
结论：在这项横断面研究中，BMI,女性,与T2DM相关的PPCP是低肌肉质量的保护因素。BF与T2DM和低肌肉质量的危险因素相关。
方法：我们采用了AWGS2019诊断低肌肉质量的标准和1999年世界卫生组织（WHO）的糖尿病诊断标准。本研究纳入了2021年11月至2022年11月上海浦东医院191名60岁及以上T2DM患者的数据。空腹C肽（FPCP），空腹血糖（FPG），餐后2小时血浆葡萄糖（PPG）和餐后2小时C肽（PPCP），糖化血红蛋白A1c（HbA1c），糖化白蛋白（GA），血脂谱,肾功能和肝功能，血红蛋白,和激素被测量。根据单变量分析的结果，建立Logistic回归和受试者工作特征（ROC）曲线。
结果：肌肉质量低的参与者的丙氨酸和天冬氨酸转氨酶明显降低，FPCP和PPCP水平(P<0.05)。与那些没有低肌肉质量的人相比，低肌肉质量组的FPG明显增高,HbA1c,GA水平(P<0.05)。身体脂肪（BF，OR=1.181）是低肌肉质量的独立危险因素。PPCP（OR=0.497），BMI（OR=0.548），和女性（OR=0.050）被确定为低骨骼肌的保护因素。BMI的AUC最高，其次是PPCP，性别和BF（分别为0.810、0.675、0.647和0.639），以上四个参数组合的AUC达到0.895。
结论：在这项横断面研究中，BMI,女性,与T2DM相关的PPCP是低肌肉质量的保护因素。BF与T2DM和低肌肉质量的危险因素相关。
