The Study Of The Body Composition Changes Of Different Levels Of HbA1c In Type2Diabetes

ObjectiveThe purpose of this article was to explore what’s the difference of the body composition in different HbAlc levels’ patients with type2diabetes, and combining with clinical serum markers, to analysis the correlation of body composition indicators and serological indicators in order to understand diabetes body composition changes, as references for the clinical treatmentand and nutrition therapy.MethodsAll171type2diabetes patients hospitalized in the Endocrinology of Tianjin Third Central Hospital between2012.1and2012.12were chosen,(excluding①type1diabetes, gestational diabetes, or other special type2diabetes;②there ketoacidosis, hyperosmolar coma, infection, etc.acute complications of diabetes;③the serious liver and kidney disease, thyroid function abnormalities, cortisol increased psychosis endocrine diseases;④serious respiratory system, cardiovascular system diseases;⑤menstrual period and lactating women;⑥in patients with malignant tumors;⑦surgical trauma patients;⑧Anemia with edema;⑨Patients with edema), are in line with the1999WHO diabetes diagnosis and classification standards. Patients were divided into five groups according to the level of HbAlc:group A (HbAlc<7.0%), group B (7.0%<HbAlc<8.0%), group C (8.0%<HbAlc<9.0%), group D (9.0%<HbAlc<10.0%), group E (HbAlc>10.0%). Body water, protein, inorganic salts, body fat and other body composition indicators were measured by using InBody720body composition analyzer, to explore the different of the body composition in different HbAlc levels’ patients with type2diabetes; and combining with clinical serum markers, to analysis the correlation of body composition indicators and serological indicators, making it a better guide to clinical treatment.Results1. The body composition analysis of different gender’s patients with type2diabetesArm muscle circumference and the standard water, protein, muscle mass, skeletal muscle mass of men with the standard weight correction are higher than women, the difference was statistically significant (P<0.05); Percentage of body fat, waist-hip ratio, the body fat with the standard weight correction, the left and right arm muscle tissue with ideal muscle tissue correction, women are higher than men, the difference was statistically significant (P<0.05). Age, visceral fat area, inorganic salts with the standard weight correction and the trunk muscle tissue, the left and right leg muscle tissue with ideal muscle tissue correction was no significant difference (P>0.05) between men and women.2. The body composition analysis in different HbAlc levels’ patients with type2diabetes2.1Compare of water、protein inorganic salts、fat of different levels of HbAlc in patientsFor men, each index corrected by the standard weight, water, protein group A and group B was significantly higher than the group E (P<0.05); Inorganic salts of Group A, B and D were significantly higher than in group E (P<0.05); Fat between the groups was not statistically significant (P>0.05). For women, each index corrected by the standard weight, the fat of group B was lower than group A, group C and group D (P<0.05), group C and D was higher than E group (P<0.05);Moisture, protein, inorganic salt between the groups showed no significant difference (P>0.05).2.2Compare of the fat tissue of different levels of HbAlc in patientsMale’s percentage of body fat, waist-hip ratio, visceral fat area among the groups the differences were not statistically significant (P>0.05). A group of female body fat percentage was significantly higher than that in group B and E, group B was significantly lower than in group C was significantly higher than that in group E and group C and D, the differences were statistically significant (P<0.05); the differences of waist-to-hip ratio, visceral fat area among the groups were not statistically significant (P>0.05).2.3Compare of the muscle tissue of different Levels of HbAlc in patientsFor men, with the standard weight correction, muscle mass, skeletal muscle mass of group A and group B were higher than group E (P<0.05); with ideal muscle tissue correction, the left and right arm muscle tissue, the trunk muscle tissue in A group was higher than that in C and D groups, the differences were statistically significant (P<0.05); the differences of arm muscle circumference, the left and right leg muscle tissue with ideal muscle tissue correction among the groups were not statistically significant (P>0.05). For women, the differences of arm muscle circumference, and muscle mass, skeletal muscle mass, the left and right arm muscle tissue, the trunk muscle tissue, the left and right leg muscle tissue with ideal muscle tissue correction among the groups were not statistically significant (P>0.05).3. The correlation of body composition indicators and serological markersProtein, muscle mass, skeletal muscle mass corrected by the standard weight and albumin, creatinine showed a positive correlation (P<0.05). Corrected by the standard weight of the protein, muscle mass, skeletal muscle mass and total protein were not correlated (P>0.05). Body fat percentage, waist-to-hip ratio, visceral fat area and TG, CHO, VLDL were all not correlated; HDL, LDL and body fat percentage was positively correlated (P<0.05), and waist-to-hip ratio, visceral fat area was no correlation.Conclusion1. The body composition of patients with type2diabetes with increasing HbAlc change:mainly the reduction of waster, protein, inorganic salts, muscle mass, skeletal muscle content for male, while women are more obvious changes in fat.2. Protein, muscle mass, skeletal muscle mass and serum albumin, creatinine was positively correlated, which reflect the synthetic capacity of the liver indirectly.3. Body fat content and lipid concentrations is not a simple positive and negative relationship, but showed a hyperbolic relationship of interdependence.4. Body composition analysis can detect patients water, protein, fat, salt and other components as well as the distribution of body composition, nutritional assess-ment, diagnosis and treatment of patients with diabetes is of certain guiding significance.