摘要
目的探讨老年2型糖尿病(T2DM)患者血清铁蛋白、25羟维生素D[25(OH)D]水平与肌少症的关系。方法收集236例T2DM患者,根据是否合并肌少症分为肌少症组(n=52)和单纯T2DM组(n=184)。收集患者病史资料和实验室指标,分析肌少症组血清铁蛋白、25(OH)D水平与步速、握力、四肢骨骼肌质量指数(ASMI)、肌少症-5(SARC-F)评分的相关性。多因素Logistic回归分析老年T2DM患者合并肌少症的影响因素。ROC曲线分析血清铁蛋白、25(OH)D水平对老年T2DM患者合并肌少症的评估价值。结果与单纯T2DM组比较,肌少症组体质量指数(BMI)、步速、握力、ASMI和25(OH)D水平均降低,病程延长,胰岛素抵抗指数(HOMA-IR)、SARC-F评分和铁蛋白水平均升高(P均<0.05)。肌少症组血清铁蛋白水平与步速、握力、ASMI均呈负相关,与SARC-F评分呈正相关(r/rs=-0.378、-0.356、-0.532、0.467,P均<0.05);25(OH)D水平与步速、握力、ASMI均呈正相关,与SARC-F评分呈负相关(rs=0.511、0.404、0.511、-0.460,P均<0.05)。BMI(OR=0.815)、步速(OR=0.346)、握力(OR=0.793)、25(OH)D(OR=0.891)为老年T2DM患者合并肌少症的独立保护因素(P均<0.05),SARC-F评分(OR=1.431)和血清铁蛋白(OR=1.035)为独立危险因素(P均<0.05)。铁蛋白+25(OH)D评估老年T2DM患者合并肌少症的ROC曲线下面积(AUC)大于血清铁蛋白和25(OH)D单独评估(P均<0.05)。结论老年T2DM合并肌少症患者血清铁蛋白水平升高,25(OH)D水平降低,血清铁蛋白与25(OH)D水平与肌少症发生密切相关。
Objective To investigate the relationship between serum ferritin and 25-hydroxyvitamin D[25(OH)D]levels and sarcopenia in elderly patients with type 2 diabetes mellitus(T2DM).Methods 236 patients with T2DM were divided into sarcopenia group(n=52)and T2DM alone group(n=184)according to whether they were combined with sarcopenia or not.Patient medical history data and laboratory indicators were collected,the correlation between serum ferritin,25(OH)D levels and gait speed,grip strength,appendicular skeletal muscle mass index(ASMI)and sarcopenia-five(SARC-F)scores in the sarcopenia group was analyzed.Multi-factor Logistic regression was used to analyze the factors affecting combined sarcopenia in elderly patients with T2DM.ROC curve was used to analyze the evaluation value of serum ferritin and 25(OH)D levels in elderly T2DM patients with sarcopenia.Results Compared to the T2DM alone group,the sarcopenia group had lower body mass index(BMI),gait speed,grip strength,ASMI and 25(OH)D levels,longer disease duration and elevated insulin resistance index(HOMA-IR),SARC-F score and ferritin levels(P all<0.05).Serum ferritin levels in the sarcopenia group were negatively correlated with gait speed,grip strength and ASMI and positively correlated with SARC-F scores(r/rs=-0.378,-0.356,-0.532,0.467,P all<0.05),and 25(OH)D levels were positively correlated with gait speed,grip strength and ASMI and negatively correlated with SARC-F scores(rs=0.511,0.404,0.511,-0.460,P all<0.05).Body mass index(OR=0.815),gait speed(OR=0.346),grip strength(OR=0.793),25(OH)D(OR=0.891)were independent protective factors for combined sarcopenia in elderly patients with T2DM,and SARC-F score(OR=1.431)and ferritin(OR=1.035)were independent risk factors(P all<0.05).The area under curve(AUC)of ferritin+25(OH)D was greater than that of ferritin,25(OH)D alone(P<0.05).Conclusion The serum ferritin level in elderly T2DM patients with sarcopenia is increased,and the 25(OH)D level is decreased,which is closely related to the occurrence of sarcopenia.
作者
许凌雁
游诗瑶
宁捷
XU Lingyan;YOU Shiyao;NING Jie(Health Management Center,West China Hospital,Chengdu 610041,China)
出处
《宁夏医科大学学报》
2022年第11期1129-1133,共5页
Journal of Ningxia Medical University
基金
四川省卫生和计划生育委员会科研课题(18PJ0071)。
