2型糖尿病患者膳食酸负荷与肌肉减少症的关系

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-09-15 DOI:10.1016/j.clnesp.2025.09.014

Shinta Yamamoto , Yoshitaka Hashimoto , Fuyuko Takahashi , Ryosuke Sakai , Yuto Saijyo , Chihiro Munekawa , Hanako Nakajima , Noriyuki Kitagawa , Eriko Nakatani , Takafumi Osaka , Hiroshi Okada , Naoko Nakanishi , Saori Majima , Emi Ushigome , Masahide Hamaguchi , Michiaki Fukui

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引用次数: 0

摘要

目的：肌肉减少症是2型糖尿病（T2DM）患者常见且严重的并发症。膳食酸负荷与代谢紊乱有关；然而，其与2型糖尿病患者肌肉减少症的关系尚不清楚。本研究旨在探讨老年2型糖尿病患者饮食酸负荷与肌肉减少症的关系。方法：对年龄≥60岁的患者进行横断面分析。肌肉减少症被定义为肌肉力量低（通过握力来评估）和骨骼肌质量指数低（通过生物电阻抗分析来评估）。以潜在肾酸负荷（PRAL）和净内源性产酸量（NEAP）评价饲粮酸负荷。使用多变量线性和逻辑回归模型来评估与肌肉质量、肌肉力量和肌肉减少症的关系。结果：298例老年T2DM患者（平均年龄70.8±6.0岁）中，13.1%的患者存在肌肉减少症。多变量回归分析显示，PRAL和NEAP均与骨骼肌质量指数显著相关。在肌力方面，NEAP与PRAL呈显著相关，而PRAL呈相似但不显著的负相关趋势。与最低分位数相比，PRAL最高分位数(比值比(OR) = 3.09, 95% CI: 1.13 ~ 9.00；p为趋势= 0.02)或NEAP （or = 3.07, 95% CI: 1.21-8.30； p为趋势= 0.01）与肌少症的存在相关。结论：较高的膳食酸负荷与老年T2DM患者的肌肉减少症有关。

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Association between dietary acid load and sarcopenia in patients with type 2 diabetes mellitus

Aim

Sarcopenia is a common and serious complication in individuals with type 2 diabetes mellitus (T2DM). Dietary acid load has been linked to metabolic disturbances; however, its relationship with sarcopenia in T2DM remains unclear. This study aimed to investigate the associations of dietary acid load with sarcopenia in older adults with T2DM.

Methods

A cross-sectional analysis with aged ≥60 years was conducted. Sarcopenia was defined as both having low muscle strength, evaluated by handgrip strength, and low skeletal muscle mass index, evaluated by bioelectrical impedance analysis. Dietary acid load was evaluated by potential renal acid load (PRAL) and net endogenous acid production (NEAP). Multivariable linear and logistic regression models were used to evaluate associations with muscle mass, muscle strength, and sarcopenia.

Results

Among 298 older adults with T2DM (mean age 70.8 ± 6.0 years), sarcopenia was identified in 13.1 %. Multivariable regression analyses showed that both PRAL and NEAP were significantly associated with skeletal muscle mass index. Regarding muscle strength, NEAP remained significantly associated, while PRAL showed a similar but non-significant negative trend. Compared with lowest tertile, highest tertile of PRAL (odds ratio (OR) = 3.09, 95 % CI: 1.13–9.00; p for trend = 0.02) or NEAP (OR = 3.07, 95 % CI: 1.21–8.30; p for trend = 0.01) was associated with the presence of sarcopenia.

Conclusion

Higher dietary acid load is associated with sarcopenia among older individuals with T2DM.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.