| Objective:The prevalence of in type 2 diabetes is increasing globally year by year.Changes of skeletal muscle in diabetic patients can significantly reduce the quality of their life,increase disability and mortality.,and therefore become an important research hotspot.At present,the pathogenesis of skeletal muscle changes in diabetic patients remains unclear.In addition to age,gender,course of disease,blood glucose,exercise,other factors including insulin resistance,chronic inflammation,mitochondrial dysfunction,neurological complications may also be involved in the pathogenesis.Exploring the influencing factors and striving for early intervention can be promising method to improve the quality of life of diabetic patients with skeletal muscle changes.(1)The purpose of the paper was to investigate the occurrence of changes of skeletal muscle mass,strength and function in outpatients with type 2 diabetes mellitus(T2DM),and to compare the differences of skeletal muscle related indicators between T2DM group and normal(control)group.(2)To further explore the relative influencing of skeletal muscle changes in outpatients with type 2 diabetes mellitus.Methods:A total of 303 subjects was divided into T2DM group(n = 201)and normal control group(n = 102).Detect the fasting plasma glucose and record the duration of T2DM,complication and exercise.Human body parameters such as body weight,height,waist circumference,hip circumference were measured,other related influencing factors including the body mass index(BMI)and waist hip ratio were also calculated.We used the body composition analyzer to measure the skeletal muscle mass,and employed skeletal muscle mass index(SMI)to evaluate skeletal muscle mass.Dynamometer test was used to evaluate the muscle strength.Balance Tests,Gait Speed Test and Chair Stand Test was applied to evaluate muscle function.We analyzed the difference of skeletal muscle mass,muscle strength,muscle function and prevalence of skeletal muscle changes between T2DM group and normal control group.201 case of T2DM group was divided into change group(n=26)and no change group(n=175)examined the related factors of skeletal muscle changes in T2DM group according to the criteria of Asian Sarcopenia Working Group(AWGS)about skeletal muscle changes.Results:1.SMI levels were lower in T2DM group[(8.809±1.793)kg/m2 vs.(9.490±1.989)kg/m2,(P<0.05)]than that in normal control group,difference of age,sex,BMI,exercise,grip strength,Gait Speed Test and Chair Stand Test between two groups had no statistical meaning(P>0.05).2.The prevalence of skeletal muscle changes was higher in T2DM group(12.942%vs.5.882%,P<0.05)than that in normal control group.3.The changes of skeletal muscle in outpatients with T2DM were significantly related to the gender and complications of the patients(P<0.05).4.Single factor Pearson correlation analysis of skeletal muscle changes in outpatients with T2DM:(1)The duration of diabetes was negatively correlated with SMI(Pearson =-0.251,P<0.05).The duration of diabetes was negatively correlated with grip strength(Pearson=-0.259,P<0.05).The Gait Speed Test was positively correlated with the duration of diabetes(Pearson= 0.333,P<0.05).The duration of diabetes was positively related to Chair Stand Test(Pearson=0.237,P<0.05).(2)Patient age was negatively correlated with SMI(Pearson =-0.406,P<0.05),negatively correlated with grip strength(Pearson =-0.400,P<0.05),positively correlated with Gait Speed Test(Pearson =0.515,P<0.05)and positively related to Chair Stand Test(Pearson=0.411,P<0.05).(3)BMI was positively correlated with SMI(Pearson =0.722,P<0.05),positively associated with grip(Pearson=0.238,P<0.05),negatively correlated with Gait Speed Test(Pearson=-0.196,P<0.05)and negatively correlated with Chair Stand Test(Pearson=-0.168,P<0.05).5.Multivariate analysis was performed by Logistic regression analysis in outpatients with T2DM.The results showed that,age、exercise、BMI、gender、complications were the influencing factors of skeletal muscle change in patients with type 2 diabetes mellitus.Conclusion:(1)Compared with normal control group,the muscle mass were lower and the prevalence of skeletal muscle changes were higher in T2DM group.Blood glucose might play a crucial role in the pathogenesis of skeletal muscle changes.(2)Low BMI,long course of disease,the growth of age,high fasting blood glucose,complications will reduce the skeletal muscle mass,skeletal muscle strength and skeletal muscle function in patients with T2DM.Regular exercise will benefit to increase skeletal muscle mass,muscle strength and muscle function in patients with T2DM. |
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