Relationship Between Low Muscle Mass And Albuminuria In Elderly Patients With Type 2 Diabetes Mellitus

Objective:Sarcopenia is an age-associated syndrome that interacts with type 2 diabetes mellitus(T2DM).Sarcopenia can aggravate the condition of T2DM.Diabetic nephropathy,characterized by albuminuria,is the most common complication in the progression of T2DM.Studies have shown that albuminuria is independently associated with T2DM,sarcopenia is also independently associated with T2DM.Albuminuria and sarcopenia have a common pathophysiological mechanism.Therefore,the direct relationship between low muscle mass and albuminuria is increasingly valued by clinical research.This article analyzes the general condition and clinical data of 96 elderly patients with T2DM to investigate the relationship between albuminuria and low muscle mass.Methods:According to the diagnostic criteria of T2DM,inclusion criteria and exclusion criteria,we selected 96 elderly T2DM patients who were admitted to the department of endocrinology,First Hospital of ShanXi Medical University from May 2017 to October2017,and collected general information and clinical data.Albumin creatinine ratio(ACR)was a measure of albuminuria.Low muscle mass was defined as the skeletal muscle mass index(SMI),which lower than 7.01 kg/m~2 for males and 5.42 kg/m~2 for females.According to ACR,the subjects were divided into two groups:albuminuria group(ACR≥30μg/mg)and non-albuminuria group(ACR<30μg/mg).We analyzed the data of each group and observed the detection rate of low muscle mass in each group,furthermore,we explored the relationship between albuminuria and low muscle mass.Results:1)Subjects in the albuminuria group,age and sCr were higher than non-albuminuria,SMI and eGFR were lower。As for eight,weight,BMI,SBP,DBP,ALT,AST,uric acid,urea,FPG,HbA1c,body had no significant difference(P<0.05).2)55 patients in the non-albuminuria group and 41 patients in the albuminuria group.A total of 14 patients of low muscle mass were detected,including 4 patients(7.3%)in the non-albuminuria group and 10 patients(24.4%)in the albuminuria group.The difference was statistically significant(χ~2=5.525,P=0.019).Among the subjects with low muscle mass(n=14),ACR was higher than those without low muscle mass(n=82)(P=0.004).3)After adjusting for age,the correlation analysis of SMI and cardiovascular disease risk showed that,in the total group and males group,SMI was negatively correlated with ACR,but females group not(P<0.05).4)Adjust gender,age,BMI,duration of disease,SBP,DBP,ALT,AST,uric acid,urea,FPG,HbA1c,body fat,sCr,plasma albumin,HDL-C,LDL-C,TC,TG,use albuminuria as the dependent variable to analyze the impact of SMI on albuminuria.Logistic regression stepwise analysis,inclusion criteria 0.05,exclusion criteria 0.10,the results showed that the SMI itemβvalue was a negative number,OR was 0.438(95%CI:0.292~0.658),P<0.001.Conclusion:Through the analysis of the relationship between albuminuria and low muscle mass in elderly T2DM patients,the results show that in elderly T2DM patients with albuminuria,the detection rate of low muscle mass is higher than that of non-albuminuria,and low muscle mass is an independent risk factor for albuminuria.In the clinical work,ACR is a sensitive indicator of early kidney injury in diabetic patients,and we should pay enough attention to its detection.When albuminuria is detected in patients with T2DM,it should be considered that there may be a decrease in muscle mass.We need to focus on the diagnosis and treatment of sarcopenia to slow down the progress of albuminuria.