摘要
目的了解中老年2型糖尿病(T2DM)患者肌肉质量和力量的变化特点。方法采用系统随机抽样法选取北京9家医院内分泌科就诊的≥50岁T2DM患者670例(男320例,女350例)为T2DM组,随机抽取年龄相匹配的无T2DM的北京医院退休职工214例(男54例,女性75例)为对照组。采用生物阻抗法进行身体成分检测。肌肉含量减少诊断截值为四肢骨骼肌指数(ASMI)男性<7.18 kg/m2,女性<5.73 kg/m2;肌肉力量降低诊断截值为握力男性<29.5 kg,女性<21.2 kg;肌肉含量下降和力量降低诊断为肌少症;计算肌肉质量(握力/优势侧上肢肌肉含量),比较单位重量的肌肉力量。多因素线性回归和Logistic回归分析进行相关性分析。结果T2DM组患者空腹血糖、腰臀比、吸烟、饮酒、合并高血压、冠心病高于对照组人群(P<0.05或P<0.01)。男性T2DM组患者握力、肌肉质量低于对照组(t=4.408、3.972,均P<0.01);男性受试者中体质指数(t=-5.567,95%CI:-0.375^-0.179,P<0.01)和糖化血红蛋白(t=-2.322,95%CI:-0.420^-0.035,P<0.05)与肌肉质量呈负相关。增龄(OR=1.062,95%CI:1.023~1.103,P<0.01;OR=1.074,95%CI:1.027~1.122,P<0.01)和糖化血红蛋白升高(OR=1.353,95%CI:1.150~1.591,P<0.01;OR=1.269,95%CI:1.044~1.543,P<0.05)是肌肉力量降低和肌少症发生的相关危险因素。结论与非T2DM者比较,中老年男性T2DM患者肌肉力量和质量下降更明显,除增龄外,糖化血红蛋白和体质指数升高是肌肉力量和质量下降的危险因素。
Objective To investigate the characteristics of changes in muscle quality and strength in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 670 patients(320 males and 350 females)aged 50 years and over from the endocrinology departments of 9 hospitals in Beijing were recruited as the type 2 diabetes mellitus group(T2DM group)by using systematic random sampling,and 214(54 males and 75 females)age-matched Beijing Hospital retirees without T2DM were randomly enrolled as the control group.Body composition was measured by using bioimpedance analysis.Low muscle mass was defined as appendicular skeletal muscle mass index(ASMI)below 7.18 kg/m2 in men and 5.73 kg/m2 in women.Low muscle strength was defined as grip strength below 29.5 kg in men and 21.2 kg in women.Sarcopenia was defined by the presence of low muscle mass with low grip strength.Muscle quality was calculated by grip strength divided by muscle mass of the dominant upper limb,and muscle strength per mass unit was compared.Multivariate Logistic regression was used for correlation analysis.Results The fasting blood glucose(FPG)level,the waist to hip ratio,the percentages of smokers and drinkers,and the proportions of subjects with concurrent hypertension and coronary heart disease were higher in the T2DM group than in the control group(P<0.05 or 0.01).Compared with the control group,grip strength and muscle quality decreased significantly in male T2DM patients(t=4.408 and 3.972,P<0.01).In male participants,BMI(t=-5.567,95%CI:-0.375^-0.179,P<0.01)and glycated hemoglobin(HbA1c)(t=-2.322,95%CI:-0.420^-0.035,P<0.05)were negatively correlated with muscle quality,while old age(OR=1.062,95%CI:1.023~1.103,P<0.01;OR=1.074,95%CI:1.027~1.122,P<0.01)and increased HbA1c level(OR=1.062,95%CI:1.023~1.103,P<0.01;OR=1.074,95%CI:1.027~1.122,P<0.01)were risk factors for low muscle strength and sarcopenia.Conclusions Compared with non-diabetes patients,muscle quality and strength decrease significantly in middle-aged and elderly male T2DM pati
作者
何清华
常鑫淼
孙明晓
程博
郭立新
He Qinghua;Chang Xinmiao;Sun Mingxiao;Cheng Bo;Guo Lixin(Department of Endocrinology,Beijing Hospital,National Center of Gerontology,Institue of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Geriatrics,Beijing Hospital,National center of Gerontlogy;Department of Endocrinology,Beijing Yide Hospital,Beijing 100195,China;Department of Nutrition,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2020年第5期550-554,共5页
Chinese Journal of Geriatrics
基金
北京市科委"糖尿病特定人群诊疗规范和临床路径研究"(D141107005314005)。
关键词
糖尿病
2型
肌少症
年龄因素
Diabetes mellitus
type 2
Sarcopenia
Age factors
