Abstract：
OBJECTIVE: To investigate the association between computed tomography-measured quality characteristics of skeletal muscle (SM) and early diagnosis of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).
METHODS: This retrospective study included patients diagnosed with T2DM, with and without early DKD, between January 2019 and December 2021. To reduce potential bias, propensity score matching (PSM) was performed. The area and computed tomography attenuation values for SM and different abdominal adipose depots were measured. After PSM, logistic and multiple linear regression analyze were performed to analyse risk factors for early DKD.
RESULTS: A total of 267 patients were enrolled (mean age, 61.67 years ± 10.87; 155 men) and divided into two groups: T2DM with early DKD (n = 133); and T2DM without DKD (n = 134). After PSM, 230 patients were matched (T2DM with early DKD [n = 115]; and T2DM without DKD [n = 115]), with no statistical differences in general characteristics between the two groups (P > .05). In multivariate logistic regression analysis, high-density lipoprotein cholesterol (odds ratio [OR] 0.14; 95% confidence interval [CI] 0.04-0.49; P = .002), uric acid (OR 1.01; 95% CI 1.00-1.01; P = .006), and SM attenuation value (OR 0.94; 95% CI 0.90-0.98; P = .003) were independent risk factors for early DKD. Multiple linear regression analysis revealed significant correlations between SM attenuation value and cystatin C (β = -0.39, P = .004), urine albumin-to-creatinine ratio (β = -0.26, P = .026), and estimated glomerular filtration rate (β = 0.31 P = .009) after adjustment for confounders.
CONCLUSIONS: Patients with T2DM and lower SM attenuation values may exhibit a higher risk for early DKD than those with higher values, which provides a potential imaging biomarker for early DKD diagnosis.
METHODS: This retrospective study included patients diagnosed with T2DM, with and without early DKD, between January 2019 and December 2021. To reduce potential bias, propensity score matching (PSM) was performed. The area and computed tomography attenuation values for SM and different abdominal adipose depots were measured. After PSM, logistic and multiple linear regression analyze were performed to analyse risk factors for early DKD.
RESULTS: A total of 267 patients were enrolled (mean age, 61.67 years ± 10.87; 155 men) and divided into two groups: T2DM with early DKD (n = 133); and T2DM without DKD (n = 134). After PSM, 230 patients were matched (T2DM with early DKD [n = 115]; and T2DM without DKD [n = 115]), with no statistical differences in general characteristics between the two groups (P > .05). In multivariate logistic regression analysis, high-density lipoprotein cholesterol (odds ratio [OR] 0.14; 95% confidence interval [CI] 0.04-0.49; P = .002), uric acid (OR 1.01; 95% CI 1.00-1.01; P = .006), and SM attenuation value (OR 0.94; 95% CI 0.90-0.98; P = .003) were independent risk factors for early DKD. Multiple linear regression analysis revealed significant correlations between SM attenuation value and cystatin C (β = -0.39, P = .004), urine albumin-to-creatinine ratio (β = -0.26, P = .026), and estimated glomerular filtration rate (β = 0.31 P = .009) after adjustment for confounders.
CONCLUSIONS: Patients with T2DM and lower SM attenuation values may exhibit a higher risk for early DKD than those with higher values, which provides a potential imaging biomarker for early DKD diagnosis.
摘要：
目的：探讨2型糖尿病(T2DM)患者计算机断层扫描(CT)测量的骨骼肌(SM)质量特征与糖尿病肾病(DKD)早期诊断的关系。
方法：这项回顾性研究包括诊断为T2DM的患者，有和没有早期的DKD，2019年1月至2021年12月。为了减少潜在的偏差，进行倾向评分匹配(PSM).测量SM和不同腹部脂肪库的面积和CT衰减值。PSM之后,采用logistic和多元线性回归分析早期DKD的危险因素。
结果：共纳入267例患者（平均年龄，61.67岁±10.87；155名男性），分为两组：伴有早期DKD的T2DM（n=133）；和不伴有DKD的T2DM（n=134）。PSM之后,230例患者匹配（T2DM伴早期DKD[n=115]；T2DM不伴DKD[n=115]），两组一般特征无统计学差异(P>0.05)。在多变量逻辑回归分析中，高密度脂蛋白胆固醇（比值比[OR]0.14;95％置信区间[CI]0.04-0.49;P=0.002），尿酸（OR1.01；95%CI1.00-1.01；P=0.006），和SM衰减值（OR0.94；95％CI0.90-0.98；P=0.003）是早期DKD的独立危险因素。多元线性回归分析显示SM衰减值与胱抑素C呈显著相关(β=-0.39,P=0.004),尿白蛋白与肌酐比值（β=-0.26，P=0.026），和校正混杂因素后估计的肾小球滤过率(β=0.31P=0.009)。
结论：具有较低SM衰减值的T2DM患者可能比具有较高值的T2DM患者表现出更高的早期DKD风险。这为早期DKD诊断提供了潜在的影像学生物标志物。
方法：这项回顾性研究包括诊断为T2DM的患者，有和没有早期的DKD，2019年1月至2021年12月。为了减少潜在的偏差，进行倾向评分匹配(PSM).测量SM和不同腹部脂肪库的面积和CT衰减值。PSM之后,采用logistic和多元线性回归分析早期DKD的危险因素。
结果：共纳入267例患者（平均年龄，61.67岁±10.87；155名男性），分为两组：伴有早期DKD的T2DM（n=133）；和不伴有DKD的T2DM（n=134）。PSM之后,230例患者匹配（T2DM伴早期DKD[n=115]；T2DM不伴DKD[n=115]），两组一般特征无统计学差异(P>0.05)。在多变量逻辑回归分析中，高密度脂蛋白胆固醇（比值比[OR]0.14;95％置信区间[CI]0.04-0.49;P=0.002），尿酸（OR1.01；95%CI1.00-1.01；P=0.006），和SM衰减值（OR0.94；95％CI0.90-0.98；P=0.003）是早期DKD的独立危险因素。多元线性回归分析显示SM衰减值与胱抑素C呈显著相关(β=-0.39,P=0.004),尿白蛋白与肌酐比值（β=-0.26，P=0.026），和校正混杂因素后估计的肾小球滤过率(β=0.31P=0.009)。
结论：具有较低SM衰减值的T2DM患者可能比具有较高值的T2DM患者表现出更高的早期DKD风险。这为早期DKD诊断提供了潜在的影像学生物标志物。
