Sarcopenic Obesity with Normal Body Size May Have Higher Insulin Resistance in Elderly Patients with Type 2 Diabetes Mellitus.
Sarcopenic Obesity with Normal Body Size May Have Higher Insulin Resistance in Elderly Patients with Type 2 Diabetes Mellitus.
复制标题
体型正常的肌少症肥胖老年 2 型糖尿病患者可能具有较高的胰岛素抵抗
DOI：
10.2147/dmso.s360942
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Hu, Yaomin
中科院分区：
文献类型：
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作者：
Han, Tingting;Yuan, Ting;Liang, Xinyue;Chen, Ningxin;Song, Jia;Zhao, Xin;Weng, Yurong;Hu, Yaomin
目的了解老年2型糖尿病（T2 DM）患者的身体成分与胰岛素抵抗的关系。我们研究了老年T2 DM患者的身体成分与胰岛素抵抗之间的关系。方法对488例老年2型糖尿病患者进行横断面研究。受试者根据身体组成分为四组：正常身体组成（NBC），低肌肉质量（LMM），高体脂（HBF），低肌肉质量和高体脂（LMMHBF）。结果LMMHBF的检出率为14.5%，其中男性为11.9%，女性为17.7%。胰岛素抵抗的稳态模型评估（HOMA 2-IR）在LMMHBF组中高于HBF组（p = 0.045），并且在LMMHBF或HBF组中也显著高于NBC或LMM组。HBF组的体重指数（BMI）最高，LMMHBF组的BMI低于HBF组，但LMMHBF组和NBC组的BMI和腰臀比（WHR）差异无统计学意义。与NBC组相比，LMMHBF和HBF组与胰岛素抵抗风险增加显著相关，即使在调整协变量后，比值比（OR）分别为4.47 [95%置信区间（CI）2.06-9.68，p < 0.001]和1.76（95% CI 1.02-3.02，p = 0.041）。结论我国老年T2 DM患者中，肌肉减少型肥胖（低肌和高脂并存）患者虽然体型正常，但其胰岛素抵抗程度最重，发生胰岛素抵抗的风险最高。
Objective Data are limited regarding how body composition is linked to insulin resistance in elderly patients with type 2 diabetes mellitus (T2DM). We examined the association between body composition and insulin resistance in elderly T2DM patients. Methods The cross-sectional study included 488 Chinese elderly patients wth T2DM. Subjects were classified into four groups based on body composition: normal body composition (NBC), low muscle mass alone (LMM), high body fat alone (HBF), both low muscle mass and high body fat (LMMHBF). Results The percentage of subjects with LMMHBF was 14.5% (11.9% in men and 17.7% in women). Homeostasis model assessment of insulin resistance (HOMA2-IR) was higher in the LMMHBF group than in the HBF group (p = 0.045), and was also significantly higher in the LMMHBF or HBF group than in the NBC or LMM group. The HBF group showed the highest body mass index (BMI) of the four groups of different body compositions, and the LMMHBF group showed lower BMI than the HBF group; however, there was no significant difference in BMI or waist to hip ratio (WHR) between the LMMHBF group and the NBC group. The LMMHBF and HBF groups were significantly associated with increased risk of insulin resistance compared to the NBC group, with odds ratios (ORs) of 4.47 [95% confidence interval (CI) 2.06–9.68, p < 0.001] and 1.76 (95% CI 1.02–3.02, p = 0.041) respectively, even after the adjustment for covariates. Conclusion In China, though elderly T2DM patients with the body composition of sarcopenic obesity (as defined by coexistence of low muscle mass and high body fat) seemed to have normal body size, they exhibited the most severe degree and the highest risk of insulin resistance.