衰弱对糖尿病患者日常活动能力影响的meta分析

Effect of frailty on activities of daily living among patients with diabetes:a meta-analysis

目的探索衰弱与糖尿病患者日常活动能力的相关性。方法检索PubMed、CINAHL、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库中有关衰弱对糖尿病患者日常活动能力影响的队列研究。采用NOS量表评价所纳入文献的质量,应用RevMan 5.3软件对符合纳入标准的文献资料进行meta分析,合并OR值、RR值、HR值以及95%CI值。结果共纳入6篇文献,1 596例糖尿病患者。Meta分析结果显示,衰弱糖尿病患者日常生活活动能力受损的风险是非衰弱糖尿病患者的2.43倍(OR=2.43,95%CI:1.79~3.32,P<0.01),亚组分析结果显示,较高年龄(OR=2.85,95%CI:1.44~5.63,P<0.01)、较短随访时长(OR=2.76,95%CI:1.20~6.33,P<0.05)、亚洲地区(OR=4.03,95%CI:2.36~6.89,P<0.01)均与日常生活活动能力有关,衰弱前期对糖尿病患者的日常生活活动能力无影响(OR=1.38,95%CI:0.82~2.33,P>0.05),衰弱糖尿病患者工具性日常生活活动能力受损的风险是非衰弱糖尿病患者的2.71倍(OR=2.71,95%CI:2.37~3.11,P<0.01)。结论衰弱是导致糖尿病患者日常活动能力受损的危险因素,发生衰弱的糖尿病患者有更高的失能风险,有必要开展护理干预,以改善糖尿病患者的衰弱现状。

Objective To explore the association between frailty and activities of daily living among patients with diabetes.Methods Cohort studies about the effect of frailty on activities of daily living among patients with diabetes were searched in PubMed,CINAHL,Embase,Web of Science,CNKI,Wanfang,VIP and CBM. The Newcastle-Ottawa Scale(NOS) was used to evaluate qualities of included articles,meta-analysis was performed on the articles that met the inclusion criteria using RevMan5.3 software,the odds ratio(OR),risk ratio(RR),hazard ratio(HR) and 95% confidence interval(CI) were utilized. Results A total of 6 articles and 1 596 patients with diabetes were included. Meta-analysis showed that the risk of impaired activities of daily living in frail diabetic patients was 2.43 times as big as that of non-frail diabetic patients(OR=2.43,95%CI:1.79-3.32,P<0.01). The subgroup analysis showed that older age(OR=2.85,95%CI:1.44-5.63,P<0.01),shorter follow-up duration(OR=2.76,95%CI:1.20-6.33,P<0.05),Asia(OR=4.03,95%CI:2.36-6.89,P<0.01) were associated with activities of daily living. Prophase of frailty had no effect on activities of daily living in diabetic patients(OR=1.38,95%CI:0.82-2.33,P>0.05). The risk of impaired instrumental activities of daily living in frail diabetic patients was 2.71 times as big as that of non-frail diabetic patients(OR=2.71, 95%CI:2.37-3.11,P<0.01). Conclusion Frailty is a risk factor leading to impaired activities of daily living among patients with diabetes,diabetic patients with frailty have a higher risk of disability,and nursing interventions are necessary to improve the current situation of frailty to prevent disability in patients with diabetes.