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肾脏病与透析肾移植杂志 ›› 2026, Vol. 35 ›› Issue (5): 427-433.DOI: 10.3969/j.issn.1006-298X.2026.05.005

• 论著 • 上一篇    下一篇

腹部CT体成分定量分析与早期糖尿病肾病的关联

  

  • 出版日期:2026-10-27 发布日期:2026-10-27

Quantitative analysis of body composition on abdominal CT in early diabetic kidney disease patients

  • Online:2026-10-27 Published:2026-10-27

摘要:

目的:基于腹部CT定量分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者体成分特征,探讨其与早期糖尿病肾病(diabetic kidney disease,DKD)的相关性。方法:本横断面研究共纳入2021年1月至2025年6月在宁波市中西医结合医院就诊的298例T2DM患者,分为早期DKD组(n=114)和单纯T2DM组(n=184)。采用SliceOmatic软件获取L3椎体层面体成分参数。运用Logistic回归分析早期DKD的独立相关因素,并通过亚组分析及敏感性分析评估关联的稳健性。结果:多因素Logistic回归分析表明,骨骼肌密度(OR=0.91)、T2DM病程(OR=1.08)、ln C反应蛋白(C-reactive protein,CRP)(OR=1.55)与早期DKD独立相关。亚组分析显示,性别、年龄及体重指数(body mass index,BMI)对骨骼肌密度与早期DKD的关联存在显著效应修饰作用(均P交互<0.05)。敏感性分析进一步证实该关联具有较好稳健性。结论:骨骼肌密度与早期DKD显著相关,但其临床价值仍需前瞻性研究加以验证。

关键词:

2型糖尿病,糖尿病肾病,骨骼肌密度,体成分分析,计算机体层摄影,横断面研究

Abstract: Objective: To investigate the association between quantitative abdominal CT-based body composition characteristics and early diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study enrolled 298 patients with T2DM who visited Ningbo Hospital of Integrated Traditional Chinese and Western Medicine between January 2021 and June 2025. Patients were divided into an early DKD group (n=114) and a T2DM group without DKD (n=184). Body composition parameters at the L3 vertebral level were obtained using SliceOmatic software. Logistic regression analysis was performed to identify factors independently associated with early DKD, and subgroup and sensitivity analyses were conducted to evaluate the robustness of the associations. Results: Multivariate logistic regression demonstrated that skeletal muscle density (SMD, OR=0.91), T2DM duration (OR=1.08), and natural log-transformed C-reactive protein (ln CRP) (OR=1.55) were independently associated with early DKD. Subgroup analysis revealed significant effect modification by sex, age, and BMI on the association between SMD and early DKD (all P for interaction<0.05). Sensitivity analysis further corroborated the robustness of this association. Conclusion: Cross-sectional findings indicate that SMD is significantly associated with early DKD. However, its clinical value warrants further validation through prospective studies.

Key words:

type 2 diabetes mellitus, diabetic kidney disease, skeletal muscle density, body composition analysis, computed tomography, cross-sectional study

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