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Objective To investigate the relationship between appendicular skeletal muscle composition (muscle mass and muscle index) and glycosylated hemoglobin A1c (HbA1c) level in type 2 diabetes mellitus (T2DM) patients. Methods A total of 459 adult T2DM patients hospitalized in the Department of Endocrinology, Tangdu Hospital of Air Force Medical University from April 2021 to June 2022 were selected as the research objects. Bioelectrical impedance analysis was used to evaluate the body composition of the patients. The patients were divided into two groups according to HbA1c level: standard glycation group (HbA1c ≤7.0%, n=145) and unqualified glycation group (HbA1c >7.0%, n=314). The two groups' general data, biochemical indexes, muscle content, fat content and other body composition were analyzed. Spearman correlation analysis and multiple logistic regression analysis were used to analyze the relationship between body composition and glycemic control in type 2 diabetic patients. Results The appendicular skeletal muscle mass and its index (ASMI) of the patients in the standard glycation group were better than those in the unqualified glycation group (P<0.05). However, there were no significant differences in gender, history of antidiabetic drugs and body fat (body fat content, limb fat content and visceral fat content) between the two groups (P>0.05). Spearman correlation analysis showed that appendicular skeletal muscle mass and its index were negatively correlated with HbA1c (r=-0.158, P=0.001; r=-0.187, P<0.001). Logistic regression analysis showed that upper limb skeletal muscle mass (OR=3.570, 95%CI 2.293-5.559) and lower limb skeletal muscle mass (OR=1.297, 95%CI 1.146-1.468) were independent protective factors for achieving glycation standard in HbA1c group. Conclusions The skeletal muscle mass of limbs is a protective factor for reaching the standard of HbA1c. With the increase of skeletal muscle mass of limbs, the level of HbA1c gradually decreases. Among them, the increase of upper limb muscle mass has a stronger correlation with reaching the standard of HbA1c.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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