【摘要】 目的 探讨血清同型半胱氨酸（Hcy）、25羟维生素D[25(OH)D]及衰弱与T2DM合并肌少症的相关性。方法 选取2021年9月至2023年3月云南省第一人民医院老年医学科住院或门诊治疗的老年T2DM患者210例，将研究对象分为单纯T2DM组（n=99）、轻度肌少症（M-Sar,n=59）组和严重肌少症（S-Sar,n=52）组。收集各组一般资料及生化指标，利用“老年综合评估系统”对入院患者进行老年综合评估，Logistic回归分析T2DM合并肌少症的影响因素，受试者工作特征（ROC）曲线分析Hcy、25(OH)D联合衰弱评估对T2DM合并肌少症的预测价值。结果 T2DM、M-Sar、S-Sar组年龄、Hcy、平衡步态功跌倒风险率、衰弱期率依次升高（P<0.05）,BMI、血红蛋白、25(OH)D、营养良好率、基本日常生活能力正常率、低度跌倒风险率、平衡步态功能良好率、无衰弱状况率依次降低（P<0.05）。Logistic回归分析显示，血清Hcy、衰弱期、25(OH)D是老年T2DM合并肌少症的影响因素。Hcy、25(OH)D和衰弱评估联合预测老年T2DM合并肌少症的ROC曲线下面积为0.815，敏感度为0.811，特异度为0.717。结论 血清Hcy、25(OH)D及衰弱与T2DM合并肌少症密切相关，检测Hcy、25(OH)D并联合衰弱评估有助于基层医院早期诊断老年T2DM合并肌少症。更多还原

【Abstract】 Objective To explore the correlation between serum homocysteine( Hcy),25-hydroxyvitamin D[25(OH)D] and frailty with type 2 diabites mellitus(T2DM) complicated with sarcopenia. Methods From September 2021 to March 2023,210 elderly T2DM patients were selected from the Department of Geriatrics of The First People’s Hospital of Yunnan Province,and divided into simple T2DM(n=99) group,mild sarcopenia(M-Sar,n=59) group and severe sarcopenia(S-Sar,n=52) group. The “Elderly Comprehensive Assessment System” was used to evaluate subjects. The influencing factors of T2DM complicated with sarcopenia were analyzed by Logistic regression. The receiver operating characteristic(ROC) curve was used to analyze the predictive value of Hcy,25(OH)D combined with frailty in evaluating T2DM with sarcopenia. Results In T2DM,M-Sar and S-Sar groups,the age,Hcy,the risk rate of balance gait work falling and the rate of weakness increased in turn(P<0. 05),while BMI,hemoglobin,25(OH)D,the rate of good nutrition,the normal rate of basic daily living,the low risk rate of falling,the rate of good balance gait function and the rate of no weakness decreased in turn(P<0. 05). Logistic regression analysis showed that serum Hcy,frailty and 25(OH)D were the influencing factors of senile T2DM complicated with sarcopenia. Hcy,25(OH)D and frailty combined to predict T2DM with sarcopenia had an area under ROC carve of 0. 815,with a sensitivity of 0. 811 and a specificity of 0. 717. Conclusions Serum Hcy,25(OH)D and frailty are closely related to T2DM combined with sarcopenia. Detection of Hcy and 25(OH)D combined with frailty score is helpful for early diagnosis of sarcopenia in primary hospitals.更多还原