我国社区中老年人群肌肉量及肌肉力量与糖尿病的相关性
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(1.首都医科大学附属北京朝阳医院 综合科,北京100020;2.首都医科大学附属北京朝阳医院 肾内科,北京100020;3. 中国人民解放军总医院医学创新研究部,医学大数据研究中心,北京100853)

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R592

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国家重点研发计划(2020YFC2006205)


Muscle mass and strength in community-dwelling middle-aged and older Chinese population and their correlation with diabetes mellitus
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(1.Department of General Medicine, Beijing 100020, China ;2. Department of Nephrology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;3. Research Center of Medical Big Data, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing 100853, China)

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    摘要:

    目的 探讨我国社区中老年人群肌肉量及肌肉力量与糖尿病患病风险的相关性。方法 基于2011年中国健康与养老追踪调查(CHARLS)全国基线数据,共纳入年龄≥45岁数据完整的受试者8680例,其中糖尿病患者1461例。收集一般资料及实验室指标。肌肉量用四肢骨骼肌肌肉量(ASM)表示,手部握力(HGS)用握力计测量。根据体质量(BM)校正的肌肉量(ASM/BM)、BM校正的握力(HGS/BM)进行三分位,并赋予相应分值(Q1、Q2、Q3分别赋分为2、1、0分),计算综合评分。应用logistic回归探讨ASM/BM、HGS/BM对糖尿病患病风险的影响,限制性立方样条曲线拟合ASM/BM、HGS/BM与糖尿病患病风险的剂量反应关系。采用SPSS 22.0及R 4.2软件进行数据分析。根据数据类型,组间比较分别采用t检验、Mann-Whitney U检验及χ2检验。结果 糖尿病患者的ASM/BM、HGS/BM均明显低于非糖尿病人群[(27.49±3.90)%和(29.30±4.51)%,(0.52±0.16)和(0.57±0.16);均P<0.05]。多因素logistic回归结果显示:Q1组的ASM/BM、HGS/BM发生糖尿病的风险分别是Q3组的1.260倍(95%CI 1.025~1.548;P<0.05)及1.496倍(95%CI 1.270~1.763;P<0.05)。二者的综合评分分数越高,糖尿病患病风险越高,最高得分是最低得分的1.743倍(95%CI 1.333~2.279;P<0.05)。ASM/BM和HGS/BM均与糖尿病患病风险存在线性剂量反应关系(非线性P=0.138,0.570)。亚组分析结果显示:在非肥胖人群中,高综合评分显著增加了糖尿病的患病风险(P<0.05),但在肥胖人群中无统计学差异。结论 在社区中老年人群中,肌肉量、肌肉力量是糖尿病患病风险的重要影响因素,二者的综合评分越高,糖尿病患病风险越高,尤其在非肥胖人群中作用更为显著。

    Abstract:

    Objective To explore the correlation of muscle mass and strength with diabetes mellitus in community-dwelling middle-aged and older Chinese population. Methods Based on the baseline data of the China Health and Retirement Longitudinal Study (CHARLS) in 2011,8680 eligible subjects aged ≥45 years with complete data were enrolled, including 1461 subjects diagnosed with diabetes mellitus. The general data and laboratory indicators of all participants were collected. Their muscle mass is represented by appendicular skeletal muscle mass (ASM), and hand grip strength (HGS) is measured using a grip meter. The skeletal muscle mass adjusted by body weight (ASM/BM) and hand grip strength adjusted by body mass (HGS/BM) were both categorized into tertiles (Q1, Q2 and Q3), and were assigned 2, 1 and 0 points, respectively. The composite score was calculated as the sum of ASM/BM and HGS/BM scores. The effect of ASM/BM and HGS/BM on risk for diabetes was investigated by logistic regression analysis, and the dose-response relationship of ASM/BM and HGS/BM with diabetes risk was fitted by restricted cubic spline curve. SPSS statistics 22.0, R 4.2 were used for statistical analysis. Data comparison between two groups was performed using student′s t test, Mann-Whitney U test or Chi-square test depending on data type. Results The ASM/BM and HGS/BM were significantly lower in the diabetic patients than the non-diabetic subjects [(27.49±3.90)% vs (29.30±4.51)%, (0.52±0.16) vs (0.57±0.16); P<0.05]. Multivariate logistic regression analysis showed that compared with the individuals from the Q3 group of ASM/BM and HGS/BM, those in Q1 group had 1.260-time (95%CI 1.025~1.548; P<0.05) and 1.496-times (95%CI 1.270-1.763; P<0.05) higher risk of diabetes, respectively. Moreover, the participants in the highest composite score group had a 1.743-times (95%CI 1.333-2.279; P<0.05) higher risk of diabetes than those in the lowest score group. Restricted cubic spline curve revealed that both ASM/BM and HGS/BM had a linear dose-response relationship with the risk of diabetes (non-linear P=0.138,0.570). Subgroup analysis showed that higher composite score significantly increased the risk of diabetes in the non-obese population (P<0.05), but not in the obese population. Conclusion In community-dwelling middle-aged and older Chinese population, muscle mass and strength are influencing factors for diabetes. The higher the composite score is, the higher risk of diabetes will be, especially in the non-obese people.

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何云云,金美玲,常晶,方向阳,何昆仑,王晓娟.我国社区中老年人群肌肉量及肌肉力量与糖尿病的相关性[J].中华老年多器官疾病杂志,2023,22(8):561~566

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  • 收稿日期:2022-12-28
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  • 在线发布日期: 2023-08-22
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