Study on the Prediction of Cardiovascular Coronary Artery Disease in Elderly Patients with Type 2 Diabetes Mellitus Based on Muscle Index and Blood Lipid Parameter

YANG Yue; JING Wenjing; QI Decai; YANG Yang; LI Weiru; GUO Yanwei; MA Xin

doi:10.13730/j.issn.2097-2148.2025.04.006

Abstract：Objective To determine the influence and predictive value of muscle index and blood lipid parameter on cardiovascular coronary artery disease in elderly patients with diabetes mellitus type 2(T2DM).Methods A total of 120 elderly patients with T2DM were enrolled from January 2021 to January 2024 in author's hospital.All the participants were underwent coronary angiography(CAG)and assessments of muscle indexes including body fat mass(BFM),upper limb muscle mass(ULMM),lower limb muscle mass(LLMM),appendicular skeletal muscle mass(ASM),appendicu-lar skeletal muscle mass index(ASMI)and handgrip strength(HGS),gait speed.Fasting blood lipid measurement inclu-ding triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholestero(LDL-C)and very low density lipoprotein cholesterol(VLDL-C).The severity score of coronary artery disease was calculated according to the results of Gensini(GS),and the patients were divided into GS low score group,GS medi-um score group and GS high score group.The muscle index and blood lipid parameter of T2DM patients were compared among the three groups.Pearson correlation analysis was used to explore the correlation among muscle indexes,blood lipid parameter and GS score.Receiver operating characteristic(ROC)curve was used to evaluate the pre-dictive value of muscle indexes and blood lipid parameter for cardiovascular coronary artery disease in T2DM patients.Results The ULMM,LLMM,ASM,ASMI,HGS and gait speed of T2DM patients in GS low score group,GS medium score group and GS high score group decreased in se-quence(all P＜0.05),there was no significant difference in BFM among 3 groups(P＞0.05);the levels of TC and LDL-C in T2DM patients in GS low score group,GS medium score group and GS high score group increased in turn(all P＜0.05),while the levels of TG,HDL-C and VLDL-C did not increase significantly(P＞0.05).Pearson correlation analy-sis showed that ASMI and HGS were negatively correlated with GS score(P＜0.05),and TC and LDL-C were positively correlated with GS score(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of ASMI,HGS,TC and LDL-C combined to predict cardiovascular coronary artery disease in T2DM patients was 0.863,which was higher than 0.740,0.730,0.756 and 0.730 for ASMI,HGS,TC and LDL-C detection alone,and the sensitivity and specificity were 79.72％ and 89.17％respectively.Conclusion ASMI,HGS,TC and LDL-C are correlated with the severity of cardiovascular coronary artery disease in elderly patients with T2DM,and the combined detection of the four can play bet-ter predictive role.