社区老年2型糖尿病患者发生肌少症的危险因素研究

The influence factors of sarcopenia in the elderly patients with type 2 diabetes mellitus in the communities

目的探讨社区老年2型糖尿病(T2DM)患者发生肌少症的危险因素。方法选取2018年7月至2019年12月黄浦区及宝山区部分社区卫生服务中心门诊的老年T2DM患者217例,选取健康体检老人225例作为对照组,收集相关资料,进行运动营养评估,采用2014年AWGS(亚洲肌少症工作组)共识诊断流程及标准对研究对象进行分组,并对社区老年2型糖尿病患者发生肌少症的发生率及相关影响因素进行分析。结果老年糖尿病患者组中肌少症的发生率明显高于健康对照组(24.4%与10.7%,P<0.01)。两组间在年龄、体质指数(BMI)指数、营养状况、运动活动等级差异有统计学意义(P<0.05)。进行logistic回归分析后结果显示年龄是糖尿病患者肌少症发生的危险因素(OR>1),高BMI、高运动量是糖尿病患者发生肌少症的保护因素(OR<1)。结论对于社区内老年2型糖尿病患者,尤其是高龄、BMI低下及缺乏体育运动者应该早期予以肌少症筛查并及早进行干预,具有相当重要的现实意义。

Objective To explore the related factors of sarcopenia in elderly type 2 diabetic patients in community.Methods 217 elderly T2DM patients from Community Health Service Centers in Huangpu District and Baoshan District were enrolled in diabetes group,while 225 healthy elderly people were selected as the control group from July 2018 to December 2019.Relevant data were collected for sports and nutrition evaluation.The subjects were divided into groups according to the consensus diagnosis process and standards of AWGs(Asian sarcopenia Working Group)in 2014,and the elderly in the communities were divided into 2 groups.The incidence of sarcopenia and related factors in type 2 diabetes were analyzed.Results The incidence of sarcopenia was significantly higher in the elderly diabetes group than that in control group(24.4%vs 10.7%,P<0.01).There were significant differences between the two groups in age,BMI,nutritional status and exercise activity level(P<0.05).The results of logistic regression analysis showed that age was the risk factor(OR>1),and high BMI and high exercise level were the protective factors(OR<1).Conclusion It is of great practical significance for the elderly patients with type 2 diabetes in the community,especially for the elderly with low BMI and lack of sports,to screen for sarcopenia and intervene early.