血清骨硬化蛋白及戊糖素与2型糖尿病肾病患者并发肌少症的关系OACSTPCD

Objective To investigate the relationship between serum sclerostin(SOST),pentosidine(PTD)and pa-tients with type 2 diabetic nephropathy(T2DN)complicated with sarcopenia.Methods 277 patients with T2DN admitted to the Department of Endocrinology of Changzhi People's Hospital of Shanxi Province,from January 2021 to January 2023 were selected and patients were divided into sarcopenia group(85 cases)and non-sarcopenia group(192 cases)according to whether or not they were complicated with sarcopenia.ELISA was used to detect serum SOST and PTD levels;Spearman's correlation was used to analyze the correlation between serum SOST and PTD levels and the indicators of sarcopenia[ap-pendicular skeletal muscle mass index(ASMI),grip strength,stride speed,and 5 sit-up time]in patients with T2DN compli-cated with sarcopenia;the factors affecting sarcopenia were analyzed by multifactorial Logistic regression;the diagnostic value of serum SOST and PTD levels for T2DN patients complicated with sarcopenia was analyzed by using receiver operat-ing characteristic(ROC)curves.Results Serum SOST and PTD levels were higher in the sarcopenia group than in the non-sarcopenia group(t=7.777,7.854,all P<0.001).Serum SOST and PTD levels were negatively correlated with ASMI,grip strength,and step speed in patients with T2DN complicated with sarcopenia(SOST:rs=-0.734,-0.725,-0.762;PTD:rs=-0.720,-0.732,-0.755,all P<0.001),and positively correlated with the 5 sitting times(rs=0.722,0.729,all P<0.001);Mul-tifactorial Logistic regression analysis showed that increased bone mineral density,increased ASMI,increased grip strength,and accelerated step speed were independent protective factors for the patients with T2DN complicated with sarcopenia[OR(95%CI)=0.875(0.779-0.982),0.716(0.598-0.857),0.509(0.366-0.707),0.824(0.780-0.870)],and that increased time to 5 sitting times,increased SOST,and increased PTD were independent risk factors[OR(95%CI)=1.427(1.159-1.757),1.056(1.023-1.090),1.019(1.006-1.031)];The area under the curve(AUC)for serum SOST,PTD and the combination of the two for the diagnosis of patients with T2DN complicated with sarcopenia was 0.793,0.796,and 0.897,respectively,and the AUC for the combination of the two was greater than that for the serum SOST and PTD levels alone(Z=4.277,3.825,all P<0.001).Conclusion The serum SOST and PTD levels are closely relate to T2DN complicated with sarcopenia,and ele-vated levels of both are independent risk factors for patients with T2DN complicated with sarcopenia.The combined detec-tion of serum SOST and PTD levels have high diagnostic value for patients with T2DN complicated with sarcopenia.