Relationship Between Distal Symmetric Polyneuropathy And Muscle Mass Loss In Type 2 Diabetes Mellitus

Objective:(1)Investigate the prevalence of muscle mass loss and sarcopenia in type 2diabetic patients by measuring grip strength,pace,and Appendicular skeletal muscle mass index and compare the clinical characteristics and differences between patients with muscle mass loss and non-muscle mass loss patients.(2)Investigate whether there is a difference in the prevalence of muscle mass loss and sarcopenia in patients with Distal symmetric polyneuropathy(DSPN)in type 2diabetes,and further analyze the correlation between DSPN and muscle mass loss.Promote the understanding of DSPN and muscle mass loss,and strengthen interventions for DSPN patients with muscle mass loss.Method:Research methods using cross-sectional surveys,We selected inpatients from the Department of Endocrinology,Affiliated Hospital of Qingdao University,from January to December 2019.469 patients with type 2 diabetes were eligible and included in this study.According to the diagnostic criteria of the AWGS,2014 edition,the study objects were divided into muscle mass loss group and non-muscle mass loss group.Then the difference between the clinical indicators of the muscle mass loss group and non-muscle mass loss group was compared.According to the guidelines for the prevention and treatment of type2 diabetes in China,2017 edition,we assessed whether there is DSPN,divided the study subjects into DSPN group and non-DSPN group,and compared whether there are statistical differences in the prevalence of muscle mass loss and sarcopenia between the two groups.Further analyze the correlation between DSPN and muscle mass loss.Result:(1)In T2 DM patients,the prevalence of muscle mass loss was 36.03%,and the prevalence of sarcopenia was 11.09%.No difference in gender between the two groups(P>0.05).The age of the muscle mass loss group was higher(P<0.05),and the body mass index(BMI),fasting insulin(FINS),uric acid(UA),25-hydroxyvitamin D(25-(OH)D)and T-score were lower than those of the non-muscle mass loss group(P<0.05).Fatty liver in the muscle mass loss group was lower than that in the non-muscle mass loss group(P<0.05).The regression analysis said that age was a risk factor for muscle mass loss;BMI,25-(OH)D,and T-score were the protective factors for muscle mass loss.Disease duration,SBP,DBP,fasting blood glucose(FPG),C peptide,glycated hemoglobin(Hb A1c),total fat mass,grip strength,pace,high-density lipoprotein cholesterol(HDL-C),triglycerides(TG),total cholesterol(TC),low-density lipidprotein cholesterol(LDL-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT),urea nitrogen(BUN),creatinine(Cr),blood calcium(Ca),blood phosphorus(P),C-reactive protein(CRP),osteocalcin,smoking and drinking have no significant difference.(2)The prevalence of muscle mass loss in the DSPN group was 40.88%,and the prevalence of muscle mass loss in the non-DSPN group was 27.75%.The prevalence of muscle mass loss in the DSPN group was higher than that in the non-DSPN group(P<0.05).The prevalence of sarcopenia in the DSPN group was 12.5%,and the prevalence of sarcopenia in the non-DSPN group was 8.67%.There was no statistical difference in the prevalence of sarcopenia between the two groups(P>0.05);DSPN has a positive correlation with the prevalence of muscle mass loss(R>0,P<0.05);DSPN univariate regression results show that combined DSPN is an independent risk factor for T2 DM muscle mass loss [OR=1.801,95%CI(1.200-2.701),P=0.004].After adjusting for age,BMI,FINS,UA,25-(OH)D,T-score,fatty liver and other confounding factors,the correlation between DSPN and muscle mass reduction still exists [OR=2.082,95%CI(1.319-3.288),P=0.002].Conclusion:(1)Age is a risk factor for muscle mass loss in the population of this study.BMI,25-(OH)D and T are the protective factors for muscle mass loss.Therefore,for elderly patients with type 2 diabetes with reduced BMI,25-hydroxyvitamin D levels and decreased bone mineral density,a high degree of attention and monitoring should be given to these high-risk patients for muscle mass loss screening and intervention as soon as possible to prevent stop or delay the occurrence of muscle mass loss,and improve the patient’s body function.(2)The prevalence of muscle mass loss in patients with type 2 diabetes mellitus complicated by DSPN is significantly increased,and the two have a significant positive correlation.DSPN is a risk factor for muscle mass loss.In clinical practice,DSPN should be promptly intervented for muscle mass loss.