握力与中老年2型糖尿病患者认知障碍的关系

Relationship between grip strength and cognitive impairment in middle aged and elderly patients with type 2 diabetes mellitus

目的探索中老年2型糖尿病患者握力与认知的关系。方法选取2016-04~2016-09首都医科大学宣武医院内分泌科病房收治的中老年2型糖尿病患者100例,通过蒙特利尔认知评估Mo CA进行测试,分为认知障碍组(n=56)及认知正常组(n=44),收集相关资料,比较两组患者的基本资料、实验室检查、体格检查结果、人体成分分析结果、并发疾病和糖尿病并发症。结果认知障碍组患者年龄、下肢/上肢肌肉含量比高于认知正常组;认知障碍组握力、体质量、肌酐清除率、上肢肌肉质量、上肢脂肪质量、四肢肌肉质量、骨骼肌肌肉质量指数、左上肢臂围、右上肢臂围、左下肢大腿围、右下肢大腿围、左股骨颈骨密度低于认知正常组,差异具有统计学意义(P<0.05)。多因素Logistic回归显示握力、上肢脂肪质量是认知障碍的危险因素(分别为OR=0.933,P=0.003;OR=0.51,P=0.014)。结论中老年2型糖尿病患者握力、上肢脂肪质量可能是认知障碍的危险因素,可通过进行握力训练改善认知功能。

Objective To explore the relationship between grip strength and cognition in middle aged and elderly patients with type 2 diabetes mellitus. Methods A total of 100 hospitalized patients with T2 DM in the department of endocrinology from April 2016 to September 2016 were enrolled in the study and divided into cognitive disorder group（ n = 56） and normal cognitive group（ n = 44） according to the Montreal cognitive assessment（ Mo CA） scores. The results of the laboratory tests,physical examination,and body composition analysis,concomitant diseases,and complications of diabetes were collected. Results The age and lower/upper extremity limb muscle content were higher in cognitive disorder group than in normal cognitive group. The grip strength,body weight,creatinine clearance rate,upper limb muscle mass,upper limb fat mass,limb muscle mass,skeletal muscle mass index,left upper arm circumference,right upper limb circumference,thigh circumference,right and left lower extremity thigh circumference,left femoral neck BMD were lower in cognitive impairment group than in normal cognition group（ P〈0. 05）. Multivariate Logistic regression showed that the grip strength and upper limb fat mass were risk factors for cognitive impairment（ OR = 0. 933,P = 0. 003; OR = 0. 51,P = 0. 014）.Conclusion The grip strength and upper limb fat mass may be risk factors for cognitive impairment in type 2 diabetic patients,and the cognitive function can be improved by grip strength training.