老年2型糖尿病患者肌少症与早期肾功能减退的关系

目的:探讨老年2型糖尿病患者肌少症与早期肾功能减退的关系。方法:回顾性病例对照研究，选取2018年7月至2019年7月在北京医院老年医学科就诊的60岁及以上2型糖尿病患者198例，根据CKD-EPI Cr-Cys公式计算的估计肾小球滤过率分为肾功能正常组(CKD 1期)63例和轻度肾功能减退组(CKD 2-...

The relationship between sarcopenia and early renal dysfunction in elderly with type 2 diabetes mellitus

Objective To investigate the relationship between sarcopenia and early renal dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 198 elderly patients with T2DM aged over 60 years undergoing treatment in the Geriatric Department of Beijing Hospital from July 2018 to July 2019 were enrolled in this retrospective case-control study.The estimated glomerular filtration rate(eGFR)is calculated according to the CKD-EPICr-Cys formula.Based on the eGFR,the patients were divided into normal renal function group(n=63,in CKD 1 stage)and mild renal dysfunction group(n=135,in CKD 2-3a stage).All subjects underwent physical examination,laboratory examination and dual energy X-ray bone density examination.Results The age,weight,body mass index,abdominal circumference,serum creatinine,cystatin C,uric acid,diastolic pressure,the proportions of diabetes and hypertension were lower,and the high-density lipoprotein cholesterol,appendicular skeletal muscle mass(ASM)and skeletal muscle mass index(SMI)were higher,in the normal renal function group than in the mild renal dysfunction group(P<0.05 or 0.01).Spearman correlation analysis showed that eGFR was positively correlated with SMI(r=0.343,P<0.01).Logistic regression analysis showed that body weight(OR=1.318,95%CI:1.091-1.594),uric acid(OR=1.007,95%CI:1.001-1.012),diastolic blood pressure(OR=1.072,95%CI:1.033-1.112),years of diabetes(OR=1.075,95%CI:1.013-1.142)were risk factors,and the LSM(OR=0.136,95%CI:0.047-0.392)and SMI(OR=0.778,95%CI:0.703-0.860)were protective factors for the early renal dysfunction in elderly patients with T2DM.Conclusions Elderly patients with T2DM are often co-existed with sarcopenia.Sarcopenia is associated with early renal dysfunction in elderly patients with T2DM.