中国骨质疏松杂志

系统性炎症指标对老年2型糖尿病发生肌少症的预测价值

Systemic Inflammatory Indicators for Sarcopenia in Elderly T2DM

投稿时间：2025-10-25 修订日期：2026-03-23

DOI：

英文关键词:Type 2 diabetes mellitus sarcopenia Systemic immune inflammation index C-reactive protein

基金项目:扬州市社会发展课题；扬州市基础研究计划（联合专项）卫生健康类项目

作者	单位	邮编
李梓贤	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部	225001
乾贝贝	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部
吴思雨	上海交通大学医学院附属瑞金医院无锡分院特需医疗保健中心
黎越	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部
罗娜	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部
王艳	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部
王金萍	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部
陈静	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部
孙晓芳	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部
张真稳	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部
闫彩凤	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部
佘敦敏^*	1扬州大学附属苏北人民医院内分泌科；2扬州大学医学部	225001

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中文摘要:

目的：本研究旨在探讨系统性炎症指标对老年2型糖尿病合并肌少症的临床预测价值。方法：纳入2023年6月至2025年3月在苏北人民医院内分泌科的老年T2DM住院患者190例，以肌少症为分组依据，患者被归入单纯T2DM组和共病组。收集临床资料并计算SII、PLR、NLR等系统性炎症指标，通过Spearman分析法评估系统性炎症指标与肌少症相关参数的关系，采用二元多因素Logistic回归分析明确老年2型糖尿病患者并发肌少症的独立危险因素，并通过ROC曲线评估预测效能。结果：共病组在多项指标上显示出显著变化，包括年龄、FBG、HbA1c、SII、NLR、PLR和CRP水平均显著高于单纯T2DM组，同时该组BMI和TG水平显著降低，上述差异均具有统计学意义（P＜0.05）。Spearman相关分析结果表明，SII、NLR及CRP与ASMI、ASM、握力（kg）和步速（m）均呈负相关（P＜0.05），PLR与步速（m/s）呈负相关（P＜0.05）。通过Logistic回归分析进一步确定，低BMI、低TG、高龄、高FBG、高SII和高CRP是老年T2DM患者发生肌少症的独立危险因素。受试者工作特征曲线分析表明，SII、CRP和BMI对T2DM患者并发肌少症有预测价值，且三者联合预测效能最佳（AUC=0.913，敏感度=86.79%，特异性=86.67%）（P＜0.01）。结论：本研究表明，SII与老年T2DM发生肌少症风险显著相关，CRP、SII和BMI可能是老年T2DM肌少症的潜在预测指标。

英文摘要:

Objective：To explore the clinical predictive value of systemic inflammatory indicators for sarcopenia in elderly individuals with type 2 diabetes mellitus (T2DM). Methods：This study recruited 190 elderly T2DM patients, who were hospitalized in the endocrinology department of Northern Jiangsu People's Hospital from June 2023 to March 2025. Participants were stratified into two groups based on sarcopenia status. Clinical data were collected, and systemic inflammatory indicators including systemic immune-inflammation index(SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte Ratio (PLR) were calculated. Spearman correlation analysis was performed to evaluate associations between systemic inflammatory indicators and sarcopenia parameters. Multivariate logistic regression analysis was performed to uncover factors independently associated with sarcopenia in elderly T2DM patients. Furthermore, we assessed the predictive performance of the relevant indicators using ROC curves. Results：The T2DM with sarcopenia group demonstrated significantly higher values for age, FBG, HbA1c, SII, NLR, PLR and CRP levels compared to the T2DM-only group, while showing significantly lower BMI and TG levels (all P<0.05). Spearman correlation analysis revealed significant negative correlations between SII，NLR，CRP and ASMI, ASM, grip strength (kg), and gait speed (m/s) (all P<0.05), with PLR also showing negative correlation with gait speed (P<0.05). Multivariate logistic regression analysis identified advanced older age, lower BMI, lower TG, higher FBG, higher SII, and higher CRP as independent risk factors for sarcopenia in T2DM patients. ROC curve analysis indicated that SII, CRP, and BMI each possessed predictive value for sarcopenia in T2DM patients. Notably, the combination of these three indicators yielded the best predictive performance (AUC=0.913, sensitivity=86.79%, specificity=86.67%, P<0.01). Conclusion：This study demonstrated a significant association between SII and the risk of sarcopenia in elderly patients with T2DM. SII, CRP and BMI may serve as potential predictors for sarcopenia in elderly patients with T2DM.

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