Combined association of skeletal muscle mass and grip strength with cardiovascular diseases in patients with type 2 diabetes

Appendicular skeletal muscle mass (ASM) and grip strength (GS) have been suggested to be related to cardiovascular diseases (CVDs), but their association with type 2 diabetes (T2D) remains unclear. Therefore, we examined the combined association of ASM and GS with the prevalence of CVD in patients with T2D.A total of 1230 patients with T2D were recruited and divided into four groups based on the sex-specific median values of ASM adjusted for body mass index (ASM/BMI; short: SM) and GS: high SM/high GS (HSM/HGS), high SM/low GS (HSM/LGS), low SM/high GS (LSM/HGS), and low SM/low GS (LSM/LGS).The LSM/LGS group was older and had higher values of systolic blood pressure, homeostasis model assessment of insulin resistance, waist circumference, and C-reactive protein but lower high-density lipoprotein cholesterol concentrations than the HSM/HGS group. After adjusting for potential confounders, the odds ratios (ORs) and 95% CIs for CVD, coronary heart disease (CHD), ischemic stroke, and peripheral arterial disease (PAD) in the LSM/LGS group were 2.90 (1.89-4.47), 2.39 (1.46-3.92), 1.77 (0.84-3.71), and 5.83 (1.58-21.48), respectively. After adjusting for variable confounders among patients with higher glycosylated hemoglobin (HbA1c) (≥7.1%), the ORs and 95% CIs for CVD and CHD in the LSM/LGS group were 7.27 (3.37-15.67) and 6.17 (2.65-14.37), respectively.The combination of low SM and GS was strongly associated with CVD, CHD, and PAD in patients with T2D, especially in those with higher HbA1c levels.背景: 四肢骨骼肌质量(ASM)和握力(GS)已被认为与心血管疾病(CVD)有关, 但它们与2型糖尿病(T2D)的关系尚不清楚。因此, 我们研究了ASM和GS与T2D患者心血管疾病患病率的联合关系。 方法: 将1230例T2D患者根据体重指数(BMI)和GS校正后的ASM性别中值分为4组:高SM/高GS组(HSM/HGS)、高SM/低GS组(HSM/LGS)、低SM/高GS组(LSM/HGS)、低SM/低GS组(LSM/LGS)。 结果: 与HSM/HGS组相比, LSM/LGS组年龄更大, 收缩压、胰岛素抵抗的稳态、腰围和C反应蛋白水平更高, 而高密度脂蛋白胆固醇浓度更低。调整潜在混杂因素后, LSM/LGS组心血管疾病、冠心病、缺血性卒中和外周动脉疾病的OR值和95%CI分别为2.90(1.89~4.47)、2.39(1.46~3.92)、1.77(0.84~3.71)和5.83(1.58~21.48)。调整高糖化血红蛋白(≥7.1%)患者的变量混杂因素后, LSM/LGS组心血管疾病和冠心病的OR值和95%CI分别为7.2 7(3.37~15.6 7)和6.17(2.6 5~14.37)。 结论: 在T2D患者中, 低SM和GS的组合与CVD、CHD和PAD密切相关, 尤其是在HbA1c水平较高的患者。.