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超声方法预测 2 型糖尿病合并肌少症患者:B 型超声及剪切波弹性成像。

Sonographic methods to predict type 2 diabetes patients with sarcopenia: B mode ultrasound and shear wave elastography.

机构信息

Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Clin Hemorheol Microcirc. 2024;87(1):13-26. doi: 10.3233/CH-231822.

Abstract

BACKGROUND

Type 2 diabetes accelerates the loss of muscle mass and strength. Sarcopenia is also one of the chronic complications of diabetes.

OBJECTIVE

To investigate the clinical value of B mode ultrasound (BMUS) and shear wave elastography (SWE) for predicting type 2 diabetic sarcopenia.

METHODS

We recorded Skeletal Muscle Mass Index (ASMI), grip strength, muscle thickness (MT), pinna angle (PA), fascicle length (FL), and the difference of Young's modulus in the relaxed states and tense states (ΔSWE). The correlations between clinical indicators and ultrasound characteristics were compared. A diagnostic model of sarcopenia was developed to assess the independent correlates and evaluate the diagnostic efficacy of sarcopenia.

RESULTS

ASMI was significantly and positively correlated with MT and ΔSWE (r = 0.826, 0.765, P < 0.01), and grip strength was significantly and positively correlated with MT and ΔSWE (r = 0.797, 0.818, P < 0.01). MT was the most significant predictor of sarcopenia (OR = 4.576, P < 0.001), and the cut-off value of MT was 11.4 mm (AUC: 0.952).

CONCLUSION

BMUS and SWE can quantitatively assess muscle mass and strength, and are effective methods to predict the occurrence of sarcopenia in elderly patients with type 2 diabetes.

摘要

背景

2 型糖尿病会加速肌肉质量和力量的丧失。肌少症也是糖尿病的慢性并发症之一。

目的

探讨 B 型超声(BMUS)和剪切波弹性成像(SWE)对预测 2 型糖尿病性肌少症的临床价值。

方法

记录骨骼肌质量指数(ASMI)、握力、肌肉厚度(MT)、耳屏角度(PA)、肌束长度(FL)以及弛豫状态和紧张状态下杨氏模量的差异(ΔSWE)。比较临床指标与超声特征的相关性。建立肌少症诊断模型,评估肌少症的独立相关因素,并评价肌少症的诊断效能。

结果

ASMI 与 MT 和 ΔSWE 呈显著正相关(r = 0.826,0.765,P < 0.01),握力与 MT 和 ΔSWE 呈显著正相关(r = 0.797,0.818,P < 0.01)。MT 是肌少症的最显著预测因子(OR = 4.576,P < 0.001),MT 的截断值为 11.4 mm(AUC:0.952)。

结论

BMUS 和 SWE 可定量评估肌肉质量和力量,是预测老年 2 型糖尿病患者肌少症发生的有效方法。

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