住院2型糖尿病患者血尿酸水平与肌量减少的相关性

目的 探讨2型糖尿病患者血清尿酸水平（serum uric acid，SUA）与肌量减少的相关性。方法 采用横断面调查法，选取2017年1月至2019年12月南京医科大学附属常州第二人民医院内分泌科收治的2120例2型糖尿病患者为研究对象，通过生物电阻抗法检测四肢骨骼肌含量并计算四肢骨骼肌质量指数（appendicular skeletal muscle index，ASMI），据亚洲肌少症工作组诊断标准，将研究对象分为肌量减少组（n=366）与非肌量减少组（n=1754），收集年龄、性别、糖尿病病程、BMI、SUA等指标，通过t检验比较两组各指标的差异，Pearson相关性分析ASMI与各指标的相关性，多元线性回归和Logistic回归分析SUA对肌量减少的影响。结果 肌量减少组BMI、SUA均显著低于非肌量减少组，年龄高于非肌量减少组；ASMI与SUA、BMI显著正相关，与年龄负相关；多元线性回归分析显示，在分别校正年龄、BMI后，SUA与ASMI仍存在正相关性；二项Logistic回归分析显示，在校正年龄后，SUA每增加1umol/L，肌量减少风险降低0.5%。结论 SUA水平升高可能是2型糖尿病患者肌量减少的保护性因素。

Relationship between serum uric acid and decreased skeletal muscle mass in hospitalized patients with type 2 diabetes

Objective To investigate the relationship between serum uric acid (SUA) level and low skeletal muscle mass in patients with type 2 diabetes. Methods A cross-sectional study was used to select 2120 patients with type 2 diabetes admitted to the Department of Endocrinology, Changzhou Second People''s Hospital, Affiliated Hospital of Nanjing Medical University from January 2017 to December 2019. The appendicular skeletal muscle relative mass index (ASMI) was evaluated using biological resistance measurement. According to the diagnostic criteria of the Asian Sarcopenia Working Group, the study subjects were divided into two groups, the low ASMI group (n=366) and the normal ASMI group (n=1754). Age, gender, diabetes duration, body mass index (BMI), SUA, and other blood index were collected. The differences between the two groups were analyzed using t test. The correlation between ASMI and different indexes was analyzed using Pearson correlation analysis. Multivariate linear regression and logistic regression analysis were used to find out the impact of serum uric acid level on ASMI. Results BMI and SUA were significantly lower in the low ASMI group, while age was significantly higher in the low ASMI group than those in the normal ASMI group. ASMI was positively correlated with SUA and BMI, negatively with age. Multiple linear regression analysis showed that after adjusting for age and BMI, there was still a positive correlation between serum uric acid and ASMI. Binary logistic regression analysis showed that the risk of low ASMI decreased by 0.5 percent for every 1mmol/L increase in serum uric acid after adjusting for age. Conclusion The increase of SUA may be a protective factor for skeletal muscle loss in patients with type 2 diabetes.