男性2型糖尿病患者血尿酸水平与骨骼肌质量的相关性研究

目的探讨男性2型糖尿病患者血尿酸水平与骨骼肌质量的相关关系。方法选取2018年3月至2019年3月于我院内分泌科住院的男性2型糖尿病患者,共计222人,平均年龄(52.2±9.8)岁。进行一般资料调查、生化指标及血压测定,利用人体成分测试仪采用生物电阻测量法(BIA)测定骨骼肌质量(ASM)。计算骨骼肌相对质量指数(RSMI)=ASM/身高~2。低RSMI定义为7.0 kg/m~2,多因素相关分析RSMI与年龄、糖尿病病程、体质量指数(BMI)、腰围(WC)、肌酐(Cr)、白蛋白(ALB)、糖化血红蛋白(HbA_1c)、尿酸(UA)等指标的相关关系,Logistic回归分析男性2型糖尿病患者骨骼肌质量减少的危险因素。结果 Pearson相关分析显示,RSMI与BMI、WC、Cr、ALB呈显著正相关(P0.05),与年龄呈显著负相关(P0.05);正常RSMI组BMI、WC、UA、Cr、ALB、前白蛋白明显高于低RSMI组(P0.05),年龄明显低于低RSMI组(P0.05),两组糖尿病病程、HbA_1c并无统计学差异(P0.05);多因素Logistic回归显示,年龄是男性2型糖尿病患者骨骼肌质量下降的危险因素,BMI、ALB和UA(OR=0.893,95%CI:0.772～0.997)是男性2型糖尿病患者骨骼肌质量下降的保护因素(P0.05),调整年龄、BMI、ALB后,随着UA水平升高,男性2型糖尿病发生骨骼肌质量下降的风险逐渐降低。结论男性2型糖尿病患者中血尿酸水平与骨骼肌质量关系密切,正常偏高的血尿酸水平可能会减少骨骼肌质量下降的发生风险。

Correlation between serum uric acid level and skeletal muscle mass in male patients with type 2 diabetes mellitus

Objective To investigate the correlation between serum uric acid level and skeletal muscle mass in male patients with type 2 diabetes. Methods A total of 222 male patients with type 2 diabetes who were admitted to the Department of Endocrinology of our hospital from March 2018 to March 2019 were selected, with an average age of 52.2±9.8 years. General data survey, biochemical indicators, and blood pressure measurement were performed. Biological resistance measurement (BIA) was used to determine skeletal muscle mass (ASM). The skeletal muscle relative mass index (RSMI) =ASM / height2.was calculated. Low RSMI was defined as <7.0 kg/m2. Multivariate correlation analysis was performed on the correlation between RSMI and age, diabetes course, body mass index (BMI), waist circumference (WC), creatinine (Cr), albumin (ALB), glycosylated hemoglobin (HbA1c), uric acid (UA), and other indicators. Logistic regression analysis was performed on the risk factors for skeletal muscle mass loss in male patients with type 2 diabetes. Results Pearson correlation analysis showed that RSMI was positively correlated with BMI, WC, Cr, and ALB (P<0.05), but was significantly negatively correlated with age (P<0.05). BMI, WC, UA, Cr, ALB, and prealbumin in the normal RSMI group were significantly higher than those in the low RSMI group (P<0.05, and age was significantly lower than that in the low RSMI group ((P<0.05). There was no significant difference in the course of diabetes and HbA1c between the two groups (P>0.05). Multivariate Logistic regression showed that age was a risk factor for skeletal muscle mass loss in male patients with type 2 diabetes, and BMI, ALB, and UA (OR=0.893, 95%CI:0.772-0.997) were protective factors for skeletal muscle mass loss in male patients with type 2 diabetes (P<0.05). After adjusting for age, BMI, and ALB, the risk of skeletal muscle mass loss in male type 2 diabetes gradually decreased with the increase of UA level. Conclusion Serum uric acid level is closely related to skeletal muscle mass in male patients with type 2 diabetes. Normal or high serum uric acid level may reduce the risk of skeletal muscle mass decline.