摘要
目的探讨中老年住院患者的2型糖尿病(type 2 diabetes mellitus,T2DM)与肌少症常见危险因素。方法选择2014年1月至2019年12月北京医院内分泌科收治的中老年T2DM住院患者1125例,根据年龄分为50~<60岁组、60~<75岁组和≥75岁组;根据纳排标准将269例研究对象分为肌少症组(n=90)和非肌少症组(n=179)。收集整理1125例研究对象的一般资料,将肌少症患病与否作为因变量,采用多因素logistic回归分析中老年T2DM住院患者出现肌少症的相关危险因素;对比肌少症组和非肌少症组间的差异,采用逐步回归分析探索肌少症发生的相关因素。结果1125例患者中,男性的肌肉含量减少检出率18.26%,显著高于女性9.28%(P<0.05);≥75岁组的肌肉含量减少检出率高于50~<60岁组、60~<75岁组(P<0.05);≥75岁组的肌少症患病人数占比高于50~<60岁组、60~<75岁组(P<0.05);50~<60岁组和≥75岁的肌少症患病率男性显著高于女性(P<0.05)。logistic回归分析,≥75岁(OR=4.992,95%CI:2.448~10.179)和糖化血红蛋白(glycated hemoglobin A1c,HbA1C)>10%(OR=3.563,95%CI:1.526~8.322)的T2DM患者肌少症患病风险显著增加(P<0.05)。肌少症组≥75岁、≥20年糖尿病病程、有高血压、有冠心病、有哮喘、接受二肽基肽酶抑制剂(dipeptidyl peptidase-4,DPP-4)治疗、白蛋白低下、HbA1c<7%的患者人数占比高于非肌少症组(P<0.05)。≥75岁(OR=12.140,95%CI:2.740~53.790)、糖尿病病程≥20年(OR=3.270,95%CI:1.100~9.740)、有哮喘(OR=7.570,95%CI:1.270~45.150)、未使用DPP-4(OR=1.950,95%CI:1.070~3.570)、餐后2 h血糖≥11.1 mmol/L(OR=0.160,95%CI:0.060~0.420)的T2DM患者肌少症患病风险显著增加(P<0.05)。结论男性、≥75岁老年住院T2DM患者的肌肉含量减少、肌少症检出率更高,中老年T2DM住院患者患肌少症的主要风险因素包括年龄、HbA1c、糖尿病病程、哮喘、DPP-4使用情况和餐后2 h血糖。
ObjectiveTo explore the common risk factors of sarcopenia in middle-aged and elderly inpatients with type 2 diabetes mellitus(T2DM).MethodsA total of 1125 middle-aged and elderly T2DM inpatients admitted to the Endocrinology Department of Beijing Hospital from January 2014 to December 2019 were selected and divided into three groups according to age:50-<60 years old,60-<75 years old,and≥75 years old;According to the inclusion and exclusion criteria,269 study subjects were divided into sarcopenia group(n=90)and non-sarcopenia group(n=179).General data of 1125 subjects were collected and analyzed.With the presence or absence of sarcopenia as the dependent variable,multivariate logistic regression was used to analyze the relevant risk factors of sarcopenia in middle-aged and elderly inpatients with T2DM.With the comparison of the differences between the sarcopenia group and the non-sarcopenia group,stepwise regression analysis was used to explore the related factors of sarcopenia occurrence.ResultsAmong the 1125 patients,the detection rate of muscle content reduction in male was 18.26%,which was significantly higher than that in female 9.28%(P<0.05).The detection rate of muscle content reduction in the senile group was higher than that in 50-<60 years old group and 60-<75 years old group(P<0.05).The proportion of patients with sarcopenia in≥75 years old group was higher than that in 50-<60 years old group and 60-<75 years old group(P<0.05).The prevalence of sarcopenia in male and≥75 years old groups was significantly higher than that in female in 50-<60 years old group and the senile group(P<0.05).Logistic regression analysis showed that T2DM patients aged≥75(OR=4.992,95%CI:2.448-10.179)and with glycated hemoglobin(HbA1c)>10%(OR=3.563,95%CI:1.526-8.322)had a significantly increased risk of sarcopenia(P<0.05).The proportion of patients with≥75 years,with a diatetes duration of≥20 years,with hypertension,with coronary heart disease,with asthma,treated with dipeptidyl peptidase-4(DPP-4)inhibitors,with low albumin and with HbA1c<7%in the sarcopenia group was higher than that in the non-sarcopenia group(P<0.05).T2DM patients aged≥75 years old(OR=12.140,95%CI:2.740-53.790),with a diabetes duration of≥20 years(OR=3.270,95%CI:1.100-9.740),with asthma(OR=7.570,95%CI:1.270-45.150),no use of DPP-4 inhibitors(OR=1.950,95%CI:1.070-3.570),and with a 2-hour postpranpranal blood glucose≥11.1mmol/L(OR=0.160,95%CI:0.060-0.420)had a significantly increased risk of sarcopenia.(P<0.05).ConclusionsMale and elderly inpatients with T2DM aged≥75 years have a higher detection rate of muscle content reduction and sarcopenia.The main risk factors for sarcopenia in middle-aged and elderly inpatients with T2DM include age HbA 1C,diabetes duration,asthma,use of DPP-4 inhibitors and 2-hour postprandial blood glucose.
作者
张籍鹏
陈丽如
江鸿
Zhang Jipeng;Chen Liru;Jiang Hong(Health Service Department of the Guard Bureau of the General Office of the Central Committee of the Communist Party of China,Beijing 100000,China;Department of Endocrinology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中华老年医学杂志》
北大核心
2025年第8期1070-1077,共8页
Chinese Journal of Geriatrics
基金
中国人民解放军保健专项科研课题(19BJZ42)。
关键词
糖尿病
2型
住院
肌少症
年龄
性别
Type 2 Diabetes mellitus
Hospitalization
Sarcopenia
Age
Sex
