Insulin Treatment Attenuates Decline of Muscle Mass in Japanese Patients with Type 2 Diabetes.
Insulin Treatment Attenuates Decline of Muscle Mass in Japanese Patients with Type 2 Diabetes.
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DOI：
10.1007/s00223-017-0251-x
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发表时间：
2017-07
影响因子：
4.2
通讯作者：
Ogawa Y
中科院分区：
文献类型：
--
作者：
Bouchi R;Fukuda T;Takeuchi T;Nakano Y;Murakami M;Minami I;Izumiyama H;Hashimoto K;Yoshimoto T;Ogawa Y
肌肉减少症被定义为与年龄相关的骨骼肌质量和力量的损失，并且是残疾和移动限制的主要原因。最近的研究表明，2型糖尿病和胰岛素信号转导缺陷有助于肌肉减少症的进展，这表明骨骼肌充足的胰岛素供应可能对维持肌肉功能很重要;然而，关于胰岛素治疗是否可以预防肌肉减少症的报道很少。我们进行了一项回顾性观察研究，以检查胰岛素治疗对2型糖尿病患者肌肉质量的影响。在这项回顾性观察性研究中，共研究了312例患者（平均年龄：64 ± 11岁; 40.8%为女性; 27.6%接受胰岛素治疗）。以骨骼肌指数（SMI）和握力（kg）评价骨骼肌减少症。肌肉减少症的患病率为18.0%。即使在调整协变量（包括年龄、性别、糖尿病持续时间和体重指数）后，胰岛素治疗仍显示出对SMI的年度下降具有保护作用（标准化β 0.195; p = 0.025）。在与倾向评分匹配的队列中，与非胰岛素治疗组相比，胰岛素治疗显着增加了SMI的1年变化（平均值± SE）（2.40 ± 0.98%与-0.43 ± 0.98%; p = 0.050）。我们的数据表明，胰岛素治疗可以减缓2型糖尿病患者肌肉减少症的进展。
Sarcopenia is defined as an age-related loss of skeletal muscle mass and strength, and is a major cause of disability and mobility limitations. Recent studies have demonstrated that type 2 diabetes and insulin signaling deficiencies contribute to the progression of sarcopenia, suggesting that a sufficient supply of insulin to the skeletal muscles may be important for the maintenance of muscle function; however, little has been reported regarding whether insulin treatment can protect against sarcopenia. We conducted a retrospective observational study to examine the impact of insulin treatment on the muscle mass of patients with type 2 diabetes. A total of 312 patients (mean age: 64 ± 11 years; 40.8% female; 27.6% treated with insulin) were studied in this retrospective observational study. Skeletal muscle index (SMI) and grip strength (kg) were used to assess sarcopenia. The prevalence of sarcopenia was 18.0%. Insulin treatment was shown to be protective against the annual decline of SMI (standardized β 0.195; p = 0.025) even after adjusting for covariates, including age, gender, duration of diabetes, and body mass index. In a cohort matched by propensity scores, insulin treatment significantly increased the 1-year change in SMI (mean ± SE) compared with non-insulin-treated group (2.40 ± 0.98% vs. −0.43 ± 0.98%; p = 0.050). Our data suggest that insulin treatment could attenuate the progression of sarcopenia in patients with type 2 diabetes.