1型糖尿病儿童骨骼肌状态、脂质代谢紊乱与胰岛素抵抗发展的关系

IF 0.1 Q4 MEDICINE, GENERAL & INTERNAL
H. O. Lezhenko, O. Pashkova, N. Chudova
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引用次数: 0

摘要

研究的目的。建立1型糖尿病儿童骨骼肌状态、脂质代谢变化与胰岛素抵抗发展之间的可能联系。材料和方法。对98名11 ~ 17岁的1型糖尿病儿童进行了研究。根据骨骼肌的状态将儿童分为3组:第一组22名无肌肉系统疾病的儿童;第二组,42名患有运动障碍的儿童;第三组为34例糖尿病性肌病患者。对照组为30名条件健康儿童。这些群体在年龄、性别和体重指数方面具有代表性。检查儿童骨骼肌量和脂肪量,计算骨骼肌指数和体脂率,测定大腿前群肌群厚度,测量肌肉萎缩程度和系数、空腹血糖水平、血清胆固醇、甘油三酯和甘油三酯-葡萄糖(TyG)指数。当TyG指数高于4.33 c时,诊断为胰岛素抵抗。研究发现,糖尿病性肌病的发展,除了肌肉量减少外,其特征是由于脂肪量比例的增加而导致身体成分成分的重新分配。这些变化伴有脂质代谢紊乱,表现为血清胆固醇水平、甘油三酯和TyG指数升高,32.4%的糖尿病性肌病患儿和9.5%的运动障碍患儿的血清胆固醇、甘油三酯和TyG指数升高4.33 c.u.,而在肌肉系统正常的患者中,TyG指数均未超过阈值。根据TyG指数水平比较临床和实验室指标,发现脂肪质量比例增加、血糖控制不达标、胰岛素日剂量增加、出现合并高脂血症和黎明现象,指标高于4.33 c.u,提示胰岛素抵抗发展。1型糖尿病儿童骨骼肌功能障碍是胰岛素抵抗发生的一个因果危险因素,而胰岛素抵抗的一个敏感指标是TyG指数。计算该指标的简单性使其可用于日常临床实践。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The association between the skeletal muscle state, lipid metabolism disorders and the development of insulin resistance in children with type 1 diabetes mellitus
The aim of the study. To establish a possible association between the skeletal muscles state, changes in lipid metabolism and the development of insulin resistance in children with type I diabetes mellitus. Materials and methods. 98 children with type 1 diabetes, aged from 11 to 17 years, were examined. Children were divided into 3 groups depending on the state of skeletal muscles: the first group – 22 children without disorders of the muscular system; the second group – 42 children with dynapenia; the third group – 34 patients with diabetic myopathy. The control group – 30 conditionally healthy children. The groups were representative by age, sex, and body mass index. Children were subjected to examinations of skeletal muscle mass and fat mass, followed by calculation of the skeletal muscle index and body fat percentage, sonomyography of the anterior group of thigh muscles with their thickness determination, measurements of the degree and coefficient of muscle hypotrophy, fasting blood glucose level, serum cholesterol, triglycerides and triglyceride-glucose (TyG) index. Insulin resistance was diagnosed when the TyG index was higher than 4.33 c. u. Results. It was found that the development of diabetic myopathy, in addition to a decrease in muscle mass, was characterized by a redistribution of the body component composition due an increase in the fat mass proportion. These changes were accompanied by a disturbance of lipid metabolism in the form of increase in serum cholesterol level, triglycerides and TyG index, which was 4.33 c. u. higher in 32.4 % of children with diabetic myopathy, and in 9.5 % of children with dynapenia, while among patients with normal state of the muscular system, the TyG index exceeded the threshold value in no case. Comparison of clinical and laboratory indicators depending on the TyG index level found an increase in the fat mass proportion, a violation of glycemic control, an increase in the daily dose of insulin, appearance of combined hyperlipidemia and the dawn phenomenon in children with an indicator that was higher than 4.33 c. u. All these were indicative of the insulin resistance development. Conclusions. Skeletal muscle dysfunction in children with type 1 diabetes is a causal risk factor for the development of insulin resistance, a sensitive marker of which is the TyG index. The simplicity of calculating this indicator allows it to be used in daily clinical practice.
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来源期刊
Zaporozhye Medical Journal
Zaporozhye Medical Journal MEDICINE, GENERAL & INTERNAL-
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