老年糖尿病患者体质量、人体脂肪和肌肉状况

Body weight, body fat and skeletal muscle status in elderly patients with diabetes

目的探讨老年糖尿病患者的人体脂肪和肌肉状况。方法连续选取符合研究标准并获知情同意的老年糖尿病患者71例（研究组）与年龄、性别相匹配的健康老年人70名（对照组），采用人体测量和多频生物电阻抗法测定体质量、体质量指数（BMI）、腰臀围比值（WHR）、总体脂肪（TBF）、腹部脂肪（AF）、内脏脂肪（VF）、内脏脂肪面积（VFA）、非脂肪组织（FFM）、肌肉总量（TBM）、骨骼肌（SM）、骨骼肌身高指数（SMHI）和握力（GS）等。以BMI判定低体质量、超重和肥胖发生率，以WHR判定腹型肥胖发生率，以TBM、SM、SMHI和GS判定肌肉状况。结果两组基线值具有可比性。与对照组比较，研究组低体质量率明显增高[36.6%（26/71）比20.0%（14/70），χ^2=4.791，P＝0.039]，体质量下降量[（1.37±1.57）kg比（0.82±1.12）kg，t＝2.402，P＝0.018]和体质量下降人数百分率[22.5%（16/71）比8.6%（6/70），χ^2=5.219，P＝0.035]均显著增高，差异均有统计学意义；TBF%[（32.3±5.0）%比（30.3±5.2）%，t＝2.294，P＝0.023]、WHR（0.91±0.55比0.87±0.51，t＝2.661，P＝0.009）、腹型肥胖率[49.3%（35/71）比25.7%（18/70），χ^2=8.355，P＝0.005]、AF[（12.1±3.4）kg比（10.3±3.6）kg，t＝2.981，P＝0.003]、VF[（2.9±0.8）kg比（2.5±0.9）kg，t＝2.853，P＝0.005]和VFA[（99.8±26.3）cm^2比（84.9±31.1）cm^2，t＝3.045，P＝0.003]均显著增高，差异均有统计学意义；FFM[（34.9±7.5）kg比（37.9±5.6）kg，t＝－2.691，P＝0.008]、SM[（25.8±4.5）kg比（27.3±3.5）kg，t＝－2.140，P＝0.034]、SMHI[（9.4±1.8）kg/m^2比（10.2±1.5）kg/m^2，t＝－3.081，P＝0.002]和GS[（29.3±6.6）kg比（31.8±5.7）kg，t＝－2.406，P＝0.017]均显著降低，差异均有统计学意义。结论老年糖尿病患者更易出现体质量异常、腹型肥胖和骨骼肌丢失。

Objective To investigate the status of body weight, total body fat and skeletal muscle in elderly patients with diabetes. Methods A total of 71 elderly diabetic patients （ study group） who met entry criteria and signed informed consent were consecutively enrolled, and 70 healthy subjects （control group） matched for age and gender were selected into the study. Body weight, body mass index （ BMI）, waist-to-hip ratio （WHR）, total body fat （TBF）, abdominal fat （AF）, visceral fat （VF）, visceral fat area （VFA）, fat- free mass （FFM） , total body muscle （TBM）, skeletal muscle （SM）, skeletal muscle height index （SMHI） and grip strength （GS） were measured by anthropometry and multi-frequency bioelectric impedance analysis. The rate of low weight, overweight and obesity was judged by BMI ; the rate of abdominal obesity by WHR ; and the status of muscle by TBM, SM, MHI and GS. Results The two groups were comparable at baseline. Compared to the control group, the rate of low weight [ 36.6% （ 26/71 ） vs. 20.0% （ 14/70）, χ^2= 4. 791, P= 0. 039 ], weight loss [ （ 1.37±1.57） kg vs. （ 0. 82±1.12） kg, t = 2. 402, P = 0.018 ], ratio of people who experienced weight loss〉5% in 3 months [22.5% （16/71） vs. 8.6% （6/70） , χ^2 =5. 219, P=0. 035] , TBF% [ （32.3±5.0）% vs. （30.3±5.2）%, t=2.294, P=0.023], WHR （0.91±0.55vs. 0.87±0.51, t=2. 661, P=0. 009）, the rate of abdominal obesity [49.3% （35/71） vs. 25.7% （ 18/70）, X2 =8. 355, P=O. O05], AF [（12.1±3.4） kgvs. （10.3±3.6） kg, t=2.981, P=0.003], VF [（2.9±0.8） kgvs. （2.5±0.9） kg, t=2.853, P=0. 005] andVFA [ （99.8±26.3） cm^2 vs. （84.9±31.1） cm^2, t=3.045, P = 0. 003] were increased significantly in study group, while the FFM [ （ 34.9 ± 7.5 ） kg vs. （ 37.9 ± 5.6） kg, t=-2.691, P=0. 008], SM [ （25.8±4.5） kgvs. （27.3±3.5） kg, t=2.140, P=0.034], SMHI [ （9.4±1.8） kg/m^2vs. （10.2±1.5） kg/m^2, t=-3.081, P=0.002] andGS [ （29.3±6.6） kg vs. （31.8±5.7） kg, t=-2. 406, P=0. 017] were decreased significantly in study group. Conclusion Ab- normal weight, abdominal obesity and loss of skeletal muscle were more likely to be observed in elderly patients with diabetes.