老年2型糖尿病患者体脂率对肌力和躯体功能的影响

doi:10.3969/j.issn.1006-7795.2022.04.020

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (4): 641-646.doi: 10.3969/j.issn.1006-7795.2022.04.020

老年2型糖尿病患者体脂率对肌力和躯体功能的影响

修双玲^1,2*, 付俊玲¹, 穆志静¹, 孙丽娜¹, 赵蕾¹

1.首都医科大学宣武医院内分泌科,北京 100053;
2.首都医科大学老年医学系,北京 100053

收稿日期:2022-03-07 出版日期:2022-08-21 发布日期:2022-10-28
基金资助:
北京市属医院科研培育计划项目(PX2020034),北京市属医学科研院所公益发展改革试点项目(京医研2021-8),糖尿病防治研究北京市重点实验室开放基金资助项目(10025220102)。

Effect of body fat percentage on muscle strength and physical performance in the elders with type 2 diabetes mellitus

Xiu Shuangling^1,2*, Fu Junling¹, Mu Zhijing¹, Sun Lina¹, Zhao Lei¹

1. Department of Endocrinology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Geriatrics, Capital Medical University, Beijing 100053, China

Received:2022-03-07 Online:2022-08-21 Published:2022-10-28
Contact: *E-mail: xiushuangling@126.com
Supported by:
This study was supported by Beijing Municipal Administration of Hospitals Incubating Program (PX2020034), Pilot Project for Public Welfare Development and Reform of Beijing-affiliated Medical Research Institutes (Beijing Medical Research 2021-8), Open Fund of Beijing Key Laboratory of Diabetes Prevention and Control Research (10025220102).

摘要/Abstract

摘要： 目的探讨老年2型糖尿病(type 2 diabetes mellitus, T2DM)体脂率与肌力及躯体功能的相关性。方法纳入127例于首都医科大学宣武医院内分泌科住院的≥60岁的T2DM患者,测定糖化血红蛋白(glycosylated hemoglobin A1c, HbA1c)、25羟维生素D₃ [25-hydroxyvitamin D₃, 25(OH)D₃],空腹胰岛素(fasting insulin, FINS),C反应蛋白(C-reactive protein, CRP)、白细胞介素-6(interleukin-6, IL-6)浓度。双能X线吸收仪测定受试者体脂率及四肢骨骼肌肌肉质量(appendicular skeletal muscle mass, ASM)。用握力和椅子起坐试验来评价肌肉力量。步速和简易体能状况量表(Short Physical Performance Battery,SPPB)来评价躯体功能。多元线性回归分析体脂率对肌力和躯体功能的影响。结果女性患者体脂率显著高于男性(35.18%±6.32% vs 28.75%±4.48%, P＜0.001)。体脂率与ASM、骨骼肌肌肉质量指数(appendicular skeletal muscle massindex, ASMI)、握力、步速、SPPB评分显著负相关,与CRP、胰岛素抵抗指数(homeostasis model assessment of insulin resistance, HOMA-IR)、椅子起坐时间正相关(P＜0.01)。调整年龄、性别、ASM、HbA1c和高腰围后,体脂率与握力、步速降低相关(分别为β=-33.68,P=0.003; β=-1.316,P=0.002),亦与5次起坐时间增加相关(β=31.60,P=0.011)。结论体脂率与老年2型糖尿病患者的肌力下降及不良的躯体功能显著相关。

关键词: 2型糖尿病, 体脂率, 握力, 躯体功能, 肥胖

Abstract: Objective To explore the association between body fat percentage and muscle strength and physical performance in old people with type 2 diabetes mellitus (T2DM). Methods A total of 127 old people aged more than 60 years who were admitted in the Department of Endocrinology, Xuanwu Hospital, Capital Medical University were included in the study. Levels of glycosylated hemoglobin A1c (HbA1c), 25-hydroxyvitamin D₃, [25(OH)D₃],fasting insulin (FINS), serum C-reactive protein (CRP) and interleukin-6 (IL-6) were measured. Body fat percentage and appendicular skeletal muscle mass (ASM) were assessed by dual energy X-ray absorptiometry (DEXA). Muscle strength was assessed using hand-grip strength (HS) and chair stands test. Gait speed (GS) and the Short Physical Performance Battery (SPPB) were used to evaluate physical performance. Multiple linear regression analysis was used to evaluate the association between fat percentage and muscle strength, physical performance. Results Female participants had higher body fat percentage than male subjects (35.18%±6.32% vs 28.75%±4.48%, P＜0.001). Body fat percentage were negatively correlated with ASM, appendicular skeletal muscle mass index (ASMI),hand-grip strength,gait speed,SPPB score, while it was positively correlated with serum levels of CRP, HOMA-IR and chair stands time (P＜0.01). After adjusting age, sex, ASM, HbA1c and high waist circumference, body fat percentage was inversely associated with hand-grip strength and gait speed (β=-33.68,P=0.003; β=-1.316,P=0.002, respectively),while it was positively associated with increased chair stands time (β=31.60,P=0.011). Conclusion Body fat percentage were associated with lower muscle strength and poor physical performance in old people with T2DM.

Key words: type 2 diabetes mellitus, body fat percentage, handgrip strength, physical performance, obesity

中图分类号:

R587.l

修双玲, 付俊玲, 穆志静, 孙丽娜, 赵蕾. 老年2型糖尿病患者体脂率对肌力和躯体功能的影响[J]. 首都医科大学学报, 2022, 43(4): 641-646.

Xiu Shuangling, Fu Junling, Mu Zhijing, Sun Lina, Zhao Lei. Effect of body fat percentage on muscle strength and physical performance in the elders with type 2 diabetes mellitus[J]. Journal of Capital Medical University, 2022, 43(4): 641-646.

参考文献

[1] 中国老年2型糖尿病防治临床指南编写组, 中国老年医学学会老年内分泌代谢分会, 中国老年保健医学研究会老年内分泌与代谢分会, 等. 中国老年2型糖尿病防治临床指南(2022年版)[J]. 中华内科杂志, 2022, 61(1):12－50.
[2] Sinclair A J, Abdelhafiz A H, Rodríguez-Maas L. Frailty and sarcopenia-newly emerging and high impact complications of diabetes[J]. J Diabetes Complications, 2017, 31(9):1465－1473.
[3] Anagnostis P, Gkekas N K, Achilla C, et al. Type 2 diabetes mellitus is associated with increased risk of sarcopenia: a systematic review and meta-analysis[J]. Calcif Tissue Int, 2020, 107(5):453－463.
[4] Bianchi L, Volpato S. Muscle dysfunction in type 2 diabetes: a major threat to patient's mobility and independence[J]. Acta Diabetol, 2016, 53(6):879－889.
[5] World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus[R]. Geneva:World Health Organization, 1999.
[6] Baumgartner R N. Body composition in healthy aging[J]. Ann N Y Acad Sci, 2000, 904: 437－448.
[7] 修双玲, 穆志静, 孙丽娜, 等. 老年2型糖尿病代谢综合征患者骨质疏松危险因素研究[J]. 首都医科大学学报, 2020, 41(1):108－112.
[8] 王耀羚, 戚本玲, 刘丽华, 等. 老年综合评估相关项目与踝肱指数的关系研究[J]. 中国全科医学, 2021, 24(17):2163－2168.
[9] Ceresini G, Marina M, Lauretani F, et al. Physical performance across the thyroid function values within the normal range in adult and older persons[J]. Aging Clin Exp Res, 2019, 31(3):385－391.
[10] Garvey W T, Mechanick J I, Brett E M, et al. American association of clinical endocrinologists and american college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity[J]. Endocr Pract, 2016, 22(Suppl 3):S201－S203.
[11] Alberti K G M M, Zimmet P, Shaw J, et al. The metabolic syndrome-a new worldwide definition[J]. Lancet, 2005, 366(9491):1059－1062.
[12] Mori H, Kuroda A, Ishizu M, et al. Association of accumulated advanced glycation end-products with a high prevalence of sarcopenia and dynapenia in patients with type 2 diabetes[J]. J Diabetes Investig, 2019, 10(5):1332－1340.
[13] Batsis J A, Barre L K, Mackenzie T A, et al. Variation in the prevalence of sarcopenia and sarcopenic obesity in older adults associated with different research definitions: dual-energy X-ray absorptiometry data from the National Health and Nutrition Examination Survey 1999－2004[J]. J Am Geriatr Soc, 2013, 61(6):974－980.
[14] Wang H, Hai S, Liu Y X, et al. Associations between sarcopenic obesity and cognitive impairment in elderly Chinese community-dwelling individuals[J]. J Nutr Health Aging, 2019, 23(1):14－20.
[15] Koster A, Ding J Z, Stenholm S, et al. Does the amount of fat mass predict age-related loss of lean mass, muscle strength, and muscle quality in older adults?[J]. J Gerontol A Biol Sci Med Sci, 2011, 66(8):888－895.
[16] Choi K M. Sarcopenia and sarcopenic obesity[J]. Korean J Intern Med, 2016, 31(6):1054－1060.
[17] Mu Z J, Fu J L, Sun L N, et al. Associations between homocysteine, inflammatory cytokines and sarcopenia in Chinese older adults with type 2 diabetes[J]. BMC Geriatr, 2021, 21(1):692.
[18] Delgado C, Chertow G M, Kaysen G A, et al. Associations of body mass index and body fat with markers of inflammation and nutrition among patients receiving hemodialysis[J]. Am J Kidney Dis, 2017, 70(6):817－825.

老年2型糖尿病患者体脂率对肌力和躯体功能的影响

Effect of body fat percentage on muscle strength and physical performance in the elders with type 2 diabetes mellitus

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	苏志燕, 刘薇, 史婷婷. 老年2型糖尿病患者血尿酸浓度与代谢综合征的相关性分析[J]. 首都医科大学学报, 2023, 44(1): 137-142.
[2]	马艺欣, 张仲迎, 佀思聪, 罗鸿宇, 赵欢, 杨伟. 2型糖尿病患者新型脂肪因子血清内脏脂肪素和内脏脂肪特异性丝氨酸蛋白酶抑制因子的表达水平与左心室肥厚的关系[J]. 首都医科大学学报, 2022, 43(5): 767-773.
[3]	张瑾, 池晶晶, 张蕊, 张小燕, 白文佩. 孕前肥胖及超重女性的孕期管理模式探讨及肥胖相关胎盘因子分析[J]. 首都医科大学学报, 2022, 43(5): 774-781.
[4]	苗祖霈, 张迎花, 肖克令, 司瑾, 张浩宇, 李静. 肥胖程度对急性ST段抬高型心肌梗死患者预后的影响[J]. 首都医科大学学报, 2022, 43(2): 192-198.
[5]	宋丽敏, 李思源, 李军, 赵会荣, 李佳佳, 王双. 新疆石河子地区绝经后2型糖尿病女性SOST基因联合LRP5基因多态性及突变与骨代谢关系的研究[J]. 首都医科大学学报, 2022, 43(2): 269-274.
[6]	修双玲, 孙丽娜, 穆志静, 付俊玲, 赵蕾. 不同方法校正的肌肉质量与老年2型糖尿病躯体功能的相关性比较[J]. 首都医科大学学报, 2022, 43(2): 284-288.
[7]	杨柳青, 田红梅, 石汉平. 三种饮食模式与慢性疾病研究进展[J]. 首都医科大学学报, 2022, 43(2): 311-320.
[8]	李健, 白文佩, 江波, 白栎然, 吴凤云. 生酮饮食对超重/肥胖多囊卵巢综合征女性月经及生育力的影响[J]. 首都医科大学学报, 2021, 42(6): 1021-1025.
[9]	张冬雪, 文祯, 孙玉燕, 姜涛. 初诊2型糖尿病患者中肝脏胰岛素清除率与临床特点及胃肠激素相关性的初步分析[J]. 首都医科大学学报, 2021, 42(5): 822-828.
[10]	王虎生, 阮祥燕, 程姣姣, Alfred O. Mueck. 肥胖型多囊卵巢综合征的氧化应激与脂代谢关系的研究[J]. 首都医科大学学报, 2021, 42(4): 540-546.
[11]	米颖馨, 王欣, 张开, 李可悦, 孙丽娜, 修双玲. 中老年男性2型糖尿病患者尿酸水平与肌少症的相关性研究[J]. 首都医科大学学报, 2021, 42(3): 453-458.
[12]	李健, 吴凤云, 张能维, 廉东波, 樊庆, 许光中, 杜德晓, 孙志鹏, 杜燕敏, 白文佩. 微创减重手术对重度肥胖女性月经周期及生育功能的影响[J]. 首都医科大学学报, 2021, 42(2): 200-203.
[13]	郑爽爽, 高志远, 宋双双, 何悦明, 卢洁. BOLD MRI评价糖尿病患者尿微量白蛋白及氧合水平的研究[J]. 首都医科大学学报, 2021, 42(1): 125-130.
[14]	李响, 蒲连美, 阮杨, 李红, 金泽宁. 汉族人群ADIPOR1 rs7539542与冠状动脉粥样硬化性心脏病和2型糖尿病的关联分析[J]. 首都医科大学学报, 2020, 41(6): 935-942.
[15]	尹星琪, 于彩果, 柯静, 赵冬, 于可. 2型糖尿病患者新型冠状病毒肺炎流行期间心理状态及行为调查[J]. 首都医科大学学报, 2020, 41(6): 970-977.