2型糖尿病患者甘油三酯葡萄糖指数及其衍生指标与肌肉质量的相关性研究

Association between the Triglyceride-Glucose Index and Its Derived Indices with Muscle Mass in Patients with Type 2 Diabetes Mellitus

摘要: 目的：探讨2型糖尿病(type 2 diabetes mellitus, T2DM)患者甘油三酯葡萄糖(triglyceride-glucose, TyG)指数及其衍生指标(TyG-体质指数(body mass index, BMI)、TyG-腰围(waist circumference, WC)、TyG-腰高比(waist-to-height Ratio, WHtR)、TyG-腰臀比(waist-to-Hip Ratio, WHR))与肌肉质量的相关性，为临床在识别T2DM患者合并低肌肉质量的发生方面提供客观的指标。方法：选取2024年12月至2025年9月于承德市中心医院内分泌风湿免疫科住院治疗的316例T2DM患者为研究对象，收集其一般资料、实验室检查指标及身体成分检测结果，计算TyG指数及其衍生指标，根据是否合并四肢骨骼肌质量指数(appendicular skeletal muscle mass index, ASMI)减少分成ASMI正常组和ASMI减少组，通过二元Logistic回归分析探讨甘油三酯葡萄糖指数及其衍生指标与肌肉质量的相关性。结果：ASMI降低组的体重、BMI、腰围、臀围、空腹C肽(FCP)、TyG指数及衍生指标水平均低于ASMI正常组，而年龄、男性占比、吸烟史、饮酒史及糖尿病周围神经病变、糖尿病周围血管病变、糖尿病视网膜病变合并率高于ASMI正常组(P < 0.05)。多因素校正后，TyG-BMI、TyG-WC、TyG-WHtR与T2DM发生低肌肉质量呈负相关(P < 0.05)。结论：低TyG-BMI、低TyG-WC、低TyG-WHtR可作为T2DM患者发生低肌肉质量的独立危险因素。

Abstract: Objective: To investigate the correlation between the triglyceride-glucose (TyG) index and its derived indicators (TyG-body mass index (BMI), TyG-waist circumference (WC), TyG-waist-to-height ratio (WHtR), TyG-waist-to-hip ratio (WHR)) and muscle mass in patients with type 2 diabetes mellitus (T2DM), aiming to provide objective indicators for identifying low muscle mass in this population. Methods: A total of 316 T2DM patients hospitalized in the Department of Endocrinology, Rheumatology, and Immunology at Chengde Central Hospital from December 2024 to September 2025 were enrolled. General data, laboratory parameters, and body composition measurements were collected. The TyG index and its derived indicators were calculated. Patients were divided into a normal appendicular skeletal muscle mass index (ASMI) group and a low ASMI group. Binary Logistic regression analysis was used to explore the correlation between the TyG index and its derived indicators and muscle mass. Results: The low ASMI group had lower levels of body weight, BMI, WC, hip circumference, fasting C-peptide (FCP), TyG index, and its derived indicators compared to the normal ASMI group. In contrast, age, the proportion of males, history of smoking and alcohol consumption, as well as the prevalence of diabetic peripheral neuropathy, diabetic peripheral vascular disease, and diabetic retinopathy were higher in the low ASMI group (P < 0.05). After multivariate adjustment, TyG-BMI, TyG-WC, and TyG-WHtR were negatively correlated with low muscle mass in T2DM patients (P < 0.05). Conclusion: Low TyG-BMI, low TyG-WC, and low TyG-WHtR can serve as independent risk factors for low muscle mass in patients with T2DM.