2型糖尿病病人与血糖正常人群体质成分分析

杨梦; 李源; 赵雅桐; 曹营营; 郭凯; 袁永丰; 王中秋

doi:10.13898/j.cnki.issn.2097-5252.2026.04.021

2型糖尿病病人与血糖正常人群体质成分分析

Analysis of body composition in patients with type 2 diabetes mellitus and normal blood glucose individuals

摘要

摘要:
目的： 探讨不同性别2型糖尿病（T2DM）病人和血糖正常者体质成分的差异。
方法： 共纳入292名血糖正常者和178例T2DM病人。分析不同性别T2DM病人和血糖正常者体质成分的差异。采用定量CT（QCT）测量L₁ ~ L₃骨密度（BMD）、L₂层面内脏脂肪面积（VFA）、皮下脂肪面积（SFA）、总腹部软组织。
结果： 男性T2DM病人的VFA和总腹部软组织均高于血糖正常者（P ＜ 0.01）。女性绝经前T2DM病人的SFA、VFA及总腹部软组织高于绝经前血糖正常者（P ＜ 0.01）；绝经后T2DM病人的VFA和总腹部软组织高于绝经后血糖正常者（P ＜ 0.01和P ＜ 0.05）。男性T2DM病人的BMD低于血糖正常者（P ＜ 0.01），而女性T2DM病人与血糖正常者的BMD差异无统计学意义（P ＞ 0.05）。多因素回归分析显示，男性病人BMD降低和总腹部软组织增加是T2DM患病的危险因素（P ＜ 0.01和P ＜ 0.05），而VFA和SFA对T2DM患病的影响无统计学意义（P ＞ 0.05）；女性病人BMD降低和VFA增加是T2DM发生的危险因素（P ＜ 0.05），而SFA和总腹部软组织对T2DM患病的影响无统计学意义（P ＞ 0.05）。
结论： 不同性别T2DM病人体质成分变化不同，男性以总腹部软组织增加显著，女性以内脏脂肪增加显著，同时均伴有不同程度的BMD降低，若能早期进行干预，可以避免骨质疏松、骨折等并发症的发生，进一步提高病人的生活质量。

Abstract:
Objective To explore the difference of body composition between type 2 diabetes mellitus (T2DM) patients and normal blood glucose patients of different sexes.
Methods A total of 292 individuals with normal blood glucose and 178 patients with T2DM were investigated. The difference of physical composition between T2DM patients and patients with normal blood glucose was analyzed. The bone mineral density (BMD) (L₁-L₃), visceral fat area (VFA), subcutaneous fat area (SFA) and total abdominal soft tissue were measured using quantitative CT (QCT).
Results The VFA and total abdominal soft tissue of male T2DM patients were higher than that of those with normal blood glucose levels (P ＜ 0.01). The SFA, VFA and total abdominal soft tissue in the premenopausal T2DM patients were higher than that of premenopausal women with normal blood glucose levels, and the difference was statistically significant (P ＜ 0.01). The VFA and total abdominal soft tissue in the postmenopausal T2DM patients were higher than those in postmenopausal normal blood glucose individuals (P ＜ 0.01 and P ＜ 0.05). The BMD of male patients with T2DM was lower than that of male individuals with normal blood glucose (P ＜ 0.01), but there was no statistical significance in the BMD between female patients with T2DM and normal blood glucose (P ＞ 0.05). The results of multivariate regression analysis showed that BMD decreasing and total abdominal soft tissue increasing were the risk factors of T2DM in male patients (P ＜ 0.01 and P ＜ 0.05), while there was no statistical significance in the effects of VFA and SFA on T2DM disease (P ＞ 0.05). The BMD decreasing and VFA increasing were the risk factors of T2DM in female patients (P ＜ 0.05), while there was no statistical significance in the effects of SFA and total abdominal soft tissue on T2DM morbidity (P ＞ 0.05).
Conclusions Different gender T2DM patients have different changes in body composition. Male patients have a significant increase in total abdominal soft tissue, and female patients have a significant increase in visceral fat, all of which are accompanied by different degrees of BMD reduction. Early intervention can avoid the occurrence of osteoporosis, fracture and other complications, and further improve the quality of life of patients.

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