Sarcopenia Increase The Risk Of Infection In Patients With T2DM

Aims: Many studies have shown that people with sarcopenia have a higher risk of infection than people without sarcopenia.The risk of obesity / overweight and sarcopenia is higher in type 2 diabetes.The aim of this study was to determine whether sarcopenia has a higher risk of infection in patients with type 2 diabetes.Mmethod: A retrospective analysis was made on 2562 patients(1394 males and 1168females)in the Department of Endocrinology,the First Affiliated Hospital of Fujian Medical University from August 12,2013 to May 14,2019.The average age was 60.99± 11.48 years,and the average course of disease was 8.73 ± 6.87 years.They were divided into 4 groups according to whether they were overweight / obese and myopenia :neither overweight/obese nor sarcopenic group(NO / NS group),not overweight/obese but sarcopenic group(NO / S group),not sarcopenic but overweight/obese group(O /NS group),overweight/obese and sarcopenic group(O / S group).All patients were measured body composition,inflammation index and infection evaluation.Among them,275 cases were followed up,the median follow-up time was 1.84 years.The relationship between infection and the changes of limb muscle mass index(ASMI)was compared.Result: Compared with the NO / NS group,the inflammatory indexes such as leukocyte,neutrophil,C-reactive protein(CRP),neutrophil / lymphocyte ratio(NLR),the detection rate of overall infection and respiratory system infection in type 2 diabetic patients with sarcopenia increased to different degrees,especially in the sarcopenia and overweight /obesity group(the detection rate of total infection NO/NS: NO/S: O/NS: O/S=18.4%:24.4% :21.8%:28.1%,P<0.05;the detection rate of respiratory system infection NO/NS: NO/S: O/NS: O/S=9.7%:16.3%:14.3%:18.8%,P<0.05).Adjusted for age,gender,course of disease,smoking,drinking,fasting blood glucose Glycosylated hemoglobin,triglyceride,blood urea,blood uric acid,blood creatinine,total cholesterol,history of hypertension,diabetic peripheral neuropathy,diabetic retinopathy,diabetic nephropathy,metformin and other drug confounding factors,the risk of infection in NO/ S group and O / S group increased by 41.8%(or: 1.418,95% CI:1.013-1.985)and 59.6%(or: 1.596,95% CI: 1.002-2.543),and the risk of respiratory system infection in NO / S group increased by 69.4%(or: 1.694,95% CI: 1.117-2.569)compared with NO / NS group.At the time of follow-up,the proportion of ASMI decrease in the infected group was significantly higher(13.7% vs 39.7%),the proportion of ASMI increase(50.3% vs32.1%)and stable(36% vs 28.2%)was significantly lower than that in the uninfected group(P < 0.001).The risk of infection in ASMI decrease patients was increased than that in ASMI increase patients(OR and 95% CI:4.801(2.13-10.821).ASMI decrease independently predicted the risk of infection.Conclusion: This study shows that the risk of infection is increased in the patients with type 2 diabetes with sarcopenia,especially with overweight / obesity at the same time.Maintaining or improving muscle quality is expected to reduce infection in patients with type 2 diabetes.in the patients with type 2 diabetes,...