摘要
目的探讨糖尿病肌少症患者不同脂肪因子水平与腹部脂肪之间的相关性。方法本研究连续性纳入2019-05/2020-11月于作者医院就诊治疗的36例糖尿病肌少症患者为肌少症组。另纳入40例年龄和性别相符的糖尿病非肌少症患者作为对照组。所有患者计算步速,检测握力和四肢骨骼肌质量指数(appendicular skeletal muscle mass index,ASMI),检测血清丝氨酸蛋白酶抑制剂(vaspin,VAS)、脂联素(adiponectin,APN)和网膜素1浓度。通过超声检测内脏脂肪组织(visceral adipose tissue,VAT)和皮下脂肪组织(subcutaneous adipose tissue,SAT),评价腹部脂肪情况。结果肌少症组患者步速、握力和ASMI水平均明显低于对照组患者(P<0.05)。肌少症组患者血清VAS水平明显高于对照组患者(13.68±1.21 vs.7.87±2.25 ng/ml,t=13.64,P=0.000),而APN水平明显低于对照组患者(8.54±3.85 vs.14.88±6.92 ng/ml,t=4.803,P=0.000)。肌少症组患者VAT、SAT水平明显高于对照组患者(P<0.05或0.01)。相关性分析提示,APN和糖尿病病程(r=0.426,P=0.000)、ASMI(r=0.480,P=0.000)、VAT(r=0.453,P=0.000)呈明显正相关。受试者工作特征(receiver operating characteristic,ROC)曲线分析提示,APN对于糖尿病肌少症的预警价值最高[曲线下面积(area under the curve,AUC)=0.765,cut-off为5.2 ng/ml,敏感性为81.33%,特异性为76.31%]。结论糖尿病肌少症患者血清脂肪因子水平代谢异常,VAS明显升高,APN明显下降;腹部脂肪分布异常,VAT、SAT明显增加。
Objective To evaluate the correlation between adipokine levels and abdominal fat in diabetes mellitus patients with sarcopenia.Methods A total of 36 diabetes mellitus patients with sarcopenia treated in author′s hospital from May 2019 to November 2020 were enrolled in this study as sarcopenia group.Forty age and gender matched diabetes mellitus patients without sarcopenia were selected as control group.Walking pace was calculated,grip strength and appendicular skeletal muscle mass index(ASMI)were measured,and vaspin(VAS),adiponectin(APN)and omentin 1 concentration were detected among all patients.Visceral adipose tissue(VAT)and subcutaneous adipose tissue(SAT)were examined by ultrasound to evaluate abdominal fat.Results The levels of walking pace,grip strength and ASMI in sarcopenia group were lower than those in control group(P<0.05).The level of serum VAS(13.68±1.21 vs.7.87±2.25 ng/ml,t=13.64,P=0.000)in sarcopenia group was higher than that in control group,while levels of APN(8.54±3.85 vs.14.88±6.92 ng/ml,t=4.803,P=0.000)in sarcopenia group was lower than that in control group.The levels of VAT,STA in sarcopenia group was higher than that in control group(P<0.05 or 0.01).Correlation analysis showed that levels of APN were positively related with duration of diabetes mellitus(r=0.426,P=0.000),ASMI(r=0.480,P=0.000)and VAT(r=0.453,P=0.000).Receiver operating characteristic(ROC)curve analysis showed that APN was most valuable for forecasting of sarcopenia[area under the curve(AUC)=0.765,cut-off value=5.2 ng/ml,sensitivity=81.33%,specificity=76.31%].Conclusion In patients with sarcopenia,the serum adipokine levels is abnoraml metabolized,VAS is significantly increased,and APN is significantly decreased.Abdominal fat distribution is abnormal,and VAT and SAT are significantly increased.
作者
刘春燕
张晓乐
白宁
李颖
毛春谱
LIU Chunyan;ZHANG Xiaole;BAI Ning;LI Ying;MAO Chunpu(Department of Endocrinology,Affiliated Hospital of Jiangnan University,Wuxi Jiangsu 214062,China)
出处
《华南国防医学杂志》
CAS
2021年第7期484-488,共5页
Military Medical Journal of South China
基金
无锡市卫生计生委科技成果与适宜技术推广项目(T201811)
关键词
糖尿病
肌少症
脂肪因子
腹部脂肪
Diabetes mellitus
Sarcopenia
Adipokine
Abdominal fat
