Association between macro- and microvascular damage and sarcopenia index in individuals with type 2 diabetes mellitus.

Hui Xu, Qun-Yan Xiang, Jun-Kun Zhan, Yi Wang, Yan-Jiao Wang, Shuang Li, You-Shuo Liu
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Abstract

Sarcopenia was recently reported to be relevant to an increased macro-and microvascular disease risk. Sarcopenia index (SI) has been identified as a surrogate marker for sarcopenia. The aim of the present study was to investigate the association between macro- and microvascular disease and SI in patients with type 2 diabetes mellitus (T2DM). A total of 783 patients with T2DM were enrolled in this cross-sectional study. The SI was calculated by (serum creatinine [mg/dL]/cystatin C [mg/L]) × 100. The subjects were divided into three groups according to SI tertiles: T1 (41.27-81.37), T2 (81.38- 99.55), and T3 (99.56-192.31). Parameters of macro- and microvascular complications, including diabetic retinopathy (DR), micro- and macroalbuminuria (MAU), diabetic peripheral neuropathy (DPN), and lower extremity peripheral artery disease (LEAD) were evaluated. Multivariate logistic regression analysis revealed that when taking the top tertile of SI as a reference, an increasing trend of the prevalence of DR, MAU, DPN, and LEAD were presented (all P for trend  < 0.05), where the OR (95% CI) for DR prevalence was 1.967 (1.252-3.090) in T2, 2.195 (1.278-3.769) in T1, for MAU was 1.805 (1.149-2.837) in T2, 2.537 (1.490-4.320) in T1, for DPN was 2.244 (1.485-3.391) in T2, 3.172 (1.884-5.341) in T1, and for LEAD was 2.017 (1.002-4.057) in T2, 2.405 (1.107-5.225) in T1 (all P < 0.05). Patients with lower SI were more inclined to have an increased risk of macro- and microvascular damage in T2DM population, which may be related to sarcopenia.

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2 型糖尿病患者的大血管和微血管损伤与肌肉疏松指数之间的关系。
最近有报告称,肌肉疏松症与大血管和微血管疾病风险的增加有关。肌少症指数(SI)被认为是肌少症的替代标志物。本研究旨在调查 T2DM 患者的大血管和微血管疾病与 SI 之间的关系。共有 783 名 T2DM 患者参与了这项横断面研究。SI以(血清肌酐[mg/dL]/胱抑素C[mg/L])×100计算。受试者根据 SI tertiles 分为三组:T1(41.27-81.37)、T2(81.38- 99.55)和 T3(99.56-192.31)。评估了大血管和微血管并发症的参数,包括糖尿病视网膜病变(DR)、微量和大量白蛋白尿(MAU)、糖尿病周围神经病变(DPN)和下肢周围动脉疾病(LEAD)。多变量逻辑回归分析显示,以 SI 的最高三分位数为参考,DR、MAU、DPN 和 LEAD 的患病率呈上升趋势(趋势值均小于 0.05),其中 DR 患病率的 OR 值(95% CI)为 1.967(1.252-3.090),T1为2.195(1.278-3.769);MAU在T2为1.805(1.149-2.837),T1为2.537(1.490-4.320);DPN在T2为2.244(1.T2为2.244(1.485-3.391),T1为3.172(1.884-5.341);LEAD为2.017(1.002-4.057),T1为2.405(1.107-5.225)(所有P均<0.05)。在T2DM人群中,SI较低的患者发生大血管和微血管损伤的风险更高,这可能与肌肉疏松症有关。
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