| Objective:The changes of skeletal muscle mass index(ASMI)of limbs in patients with type 2diabetes mellitus and non-type 2 diabetes mellitus were discussed by comparing the general indexes,body composition indexes and glucose and lipid metabolism indexes of patients with type 2 diabetes mellitus and non-type 2 diabetes mellitus.The correlation between ASMI and general indicators,body composition analysis and glucose and lipid metabolism indicators in patients with type 2 diabetes mellitus was analyzed,and the statistically significant indicators were analyzed by multiple stepwise linear regression to discuss the influencing factors of ASMI in the process of muscle mass reduction in patients with type 2 diabetes mellitus.Methods:1.Subjects and subgroups:Select 116 outpatients aged 30-75 from the Department of Endocrinology,Second Hospital of Shanxi Medical University from January 2022 to January 2023,among whom 64 patients were divided into type 2 diabetes group(T2DM group)according to the diagnostic criteria of diabetes,and select 52 healthy physical examination personnel,that is,non-type 2 diabetes group(control group).2.Acquisition of baseline parameters:Baseline parameters acquisition:gender,age,height,weight,BMI,presence of hypertension,diabetes,and biochemical indicators acquisition:indicators were measured by dry chemical analysis:fasting blood glucose(FPG),fasting insulin(FINS),glycated hemoglobin(Hb A1C),hemoglobin(Hb),uric acid(UA),albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),Total cholesterol(CHO),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C).Among them,gender,age,presence of hypertension,UA,CHO,and LDL-C were examined by independent sample t test.Hb,ALB,ALT,AST,TG,and HDL-C comparisons were compared using the Mann-Whitney U nonparametric rank sum test.3.Collection of body composition indexes:Body composition analysis was performed on all subjects using BCA-2A:muscle content,fat content,visceral fat,and percentage of waist and hip.The height,weight,BMI and fat content were tested by independent sample t test.Muscle content,visceral fat,and percentage of waist to hip were compared using the Mann-Whitney U nonparametric rank sum test.4.Pearson correlation analysis was used to analyze the correlation between ASMI and general indicators,body composition analysis and glucolipid metabolism indicators in T2DM patients,and multivariate stepwise linear regression analysis was used to explore the influencing factors of ASMI in the process of muscle mass reduction in patients with type 2 diabetes.P<0.05 was considered as the difference with statistical significance.5.Calculation of BMI,ASMI and HOMA-IR:BMI=weight(Kg)/height ~2(m~2);ASMI=content of skeletal muscle in extremities(Kg)/height~2(m~2);HOMA-IR=FPG×FINS/22.5。1.Results:1.Comparison of baseline data between the two groups:Compared with the control group,there were no significant differences in age,gender,hypertension or not,height,HB,UA,ALB,ALT,AST,TG,TC,HDL-C and LDL-C(P≥0.05),which were comparable between groups at baseline.2.Comparison of body composition analysis indexes between the two groups:Compared with the control group,fat content(19.88±3.53 vs 17.09±2.45)and visceral fat[12.14(8.65,15.75)vs9.49(7.33,10.30)in the T2DM group were increased,and the differences were statistically significant(P<0.05);The contents of skeletal muscle[21.74(19.03,24.28)vs 23.86(21.63,26.48)]and ASMI[7.95(7.28,8.56)vs8.71(8.43,9.49)]in four limbs were decreased,and the differences were statistically significant(P<0.05).There was no significant difference in muscle content and waist-to-hip ratio(P≥0.05).3.Analysis and comparison of human components in two groups of people of different ages:For the patients younger than 45 years old,compared with the control group,the content of skeletal muscle in four limbs of the T2DM group was decreased,with statistical significance(P<0.05),while the differences in muscle content,fat content,ASMI,visceral fat and waist-to-hip ratio were not statistically significant(P≥0.05).The content of skeletal muscle in four limbs was(22.20±2.92 vs 22.22±4.94).At the age range of 45–54.9 years old,compared with the control group,the fat content(20.63±3.93 vs 16.53±2.02)and the percentage of waist and hip(0.92±0.071vs 0.90±0.039)in the T2DM group were increased,while the ASMI(7.91±0.94 vs9.18±0.67)was decreased,and the differences were statistically significant(P<0.05).There was no significant difference in muscle content,limb skeletal muscle content and visceral fat(P≥0.05).For the age group 55–64.9 years old,compared with the control group,the fat content(19.20±3.30 vs 16.51±2.00)and the percentage of waist and hip(0.92±0.07vs 0.91±0.04)in the T2DM group were increased,while the skeletal muscle content(21.94±2.88 vs 24.46±2.63)and ASMI(8.00±0.72 vs 8.91±0.69)of the four limbs were decreased,with statistically significant differences(P<0.05).There was no significant difference in muscle content and visceral fat(P≥0.05).In the 65–75 age group,compared with the control group,T2DM group exhibited significantly lower limb skeletal muscle content(20.62±2.61 vs 23.04±2.61)and ASMI(8.12±0.66 vs 8.53±1.06),(P<0.05).There was no significant difference in muscle content,fat content,visceral fat and waist-to-hip ratio(P≥0.05).4.Analysis and comparison of body composition between two groups of people of different genders:Among the male patients,compared with the control group,the T2DM group had lower muscle content(50.06±8.01 vs 55.95±5.34),limb skeletal muscle content(23.46±2.53 vs 24.66±3.31)and ASMI(7.90±0.75 vs 8.59±1.17),with statistical significance(P<0.05).There was no significant difference in fat content,visceral fat and waist-to-hip ratio(P≥0.05).In female patients,compared with the control group,the fat content(20.23±3.53vs 16.77±1.93)and the percentage of waist and hip(0.91±0.075 vs 0.91±0.045)in the T2DM group were increased,while the skeletal muscle content(20.21±2.45 vs 22.77±2.31)and ASMI(8.00±0.95 vs 8.88±0.85)of the four limbs were decreased,with statistical significance(P<0.05).There was no significant difference in muscle content and visceral fat(P≥0.05).5.In T2DM group,ASMI was correlated with general indexes,body composition analysis indexes and glycolipid metabolism:ASMI was positively correlated with body weight,BMI and skeletal muscle content of limbs,with statistically significant differences(P<0.05,r=0.333,0.540,0.636,respectively);It was negatively correlated with fat content,visceral fat,waist-hip percentage,Hb A1C and HDL-C,and the differences were statistically significant(P<0.05,r was-0.862,-0.750,-0.878,-0.353,-0.565,respectively).There was no significant difference in correlation with sex,age,hypertension,height,muscle content,FPG,FINS,HOMA-IR,Hb,UA,ALB,ALT,AST,CHO,TG and LDL-C(P≥0.05).The results of multiple stepwise linear regression analysis with ASMI as the dependent variable showed that the skeletal muscle content,waist-hip ratio and visceral fat of limbs entered the regression equation,and the regression equation ASMI=3.320+0.267 skeletal muscle content of limbs-1.259*waist-hip ratio-0.014*visceral fat(R~2=0.983).Conclusion:1.2 Compared with non-type 2 diabetes,patients with type 2 diabetes have changed body composition,increased fat content,decreased muscle content,and decreased limb skeletal muscle mass index,which are prone to concomitant myopathy.2.In the process of muscle mass reduction in patients with type 2 diabetes,ASMI is related to fat content,visceral fat,percentage of waist and hip,HDL-C,body weight,BMI and content of skeletal muscle in four limbs.Among them,fat content,visceral fat,percentage of waist and hip,and HDL-C are risk factors for ASMI reduction,while body weight,BMI and content of skeletal muscle in four limbs are protective factors for ASMI. |
PDF Full Text Request