2型糖尿病患者握力与动力性平衡相关性的观察

Study of the relationship between grip strength and dynamic balance in patients with type 2 diabetes mellitus

目的探讨T2DM患者握力与动力性平衡能力的相关性。方法选取2016年8月至2017年3月于我院内分泌科住院的T2DM患者191例(T2DM组),年龄40～69岁;同期在我院体检的健康人群58名作为对照组(NC)。使用握力计测量两组握力及动力性平衡的相关指标:站起测试(CRT)、2.4m行走测试、走直线步态测试(TGT),分析握力与动力性平衡能力的关系。结果 T2DM组40～49岁、50～59岁患者2.4m行走测试较NC组延长[(2.58±0.54)vs (2.04±0.49)s,(3.32±1.16)vs(2.19±0.19)s,P<0.05]。以10岁为一个年龄段,将T2DM组分为正常握力亚组(NG)和握力下降亚组(DG)。各年龄段NG亚组与DG亚组FPG、BMI、WC、股骨颈骨密度(CBMD)比较,差异均无统计学意义(P>0.05)。50～59岁、60～69岁年龄段DG亚组与NG亚组比较,CRT延长[(11.96±7.29)vs(6.43±1.10)s,(12.22±4.76)vs(8.71±3.04)s,P<0.05]。60～69岁年龄段DG亚组2.4m行走时间较NG组明显延长[(5.49±5.10)vs(2.95±0.94)s,P<0.05]。50～59岁、60～69岁年龄段NG亚组TGT正常比例较DG亚组高(83.33%vs 51.16%,76.92%vs 28.57%,P<0.05)。多元线性回归分析结果显示,握力是CRT、2.4m行走测试的独立危险因素;Logistic回归分析结果显示,握力是TGT的独立危险因素。结论 40～69岁的T2DM患者握力与动力性平衡能力显著相关。应加强握力下降患者的预防措施,以避免跌倒。

Objective To analyze the relationship between grip strength and dynamic balance in patients with type 2 diabetes mellitus （T2DM）. Methods 191 T2DM inpatients aged from 40 to 69 years were enrolled from Aug 2016 to Mar 2017.Grip strength was assessed using a handgrip dynamometer.The dynamic balance was assessed with chair-rising test （CRT）,tandem gait test （TGT）and 8-foot （ie,2.4 m）walk test. Results The time of 2.4 m walk test in 40～49 years and 50～59 years patients with T2DM was longer than NC group [（2.58±0.54）vs （2.04±0.49）s, （3.32±1.16）vs （2.19±0.19）s,P〈0.05].Take ten years as an age group,each group was divided into normal grip subgroup （NG）and descending grip subgroup （DG）.There were no significantly difference in fasting blood glucose,BMI and CBMD between the two subgroups in every age group （P〈0.05）.In 50～59 years and60～69 years,the time of CRT in DG subgroup was significantly longer than those in NG subgroup [（11.96±7.29）vs （6.43±1.10）s; （12.22±4.76）vs （8.71±3.04）s,P〈0.05].In age group of 60～69 years,the time of 2.4 mwalk test in DG subgroup was significantly longer than those in NG subgroup [（5.49±5.10）vs （2.95±0.94）s,P〈0.05].In 50～59 years and 60～69 years,the ability to perform TGT in NG subgroup was significantly higher than those in DG group （83.33%vs 51.16%,76.92%vs 28.57%,P〈0.05）.Multiple stepwise regression analysis showed that the level of grip strength was an independent risk factor of CRT and 2.4 mwalk test.Logistic regression analysis showed that the level of grip strength was an independent risk factor of TGT. Conclusion Grip strength is significantly associated with dynamic balance in patients with T2DM aged 40～69 years.Interventions should be taken to prevent falls in patients with reduced grip strength.