The Occurrence Of Sarcopenia And Related Factors Analysis In Elderly Patients With Type 2 Diabetes Mellitus

Objective(1)The purpose of this paper was to investigate the occurrence of sarcopenia in elderly patients with type 2 diabetes mellitus,and to compare the difference in the aspects of muscle mass, strength, physical performance and prevalence of sarcopenia between T2 DM group and(non-T2DM) group.(2) Further to explore the relative influencing factors of sarcopenia in elderly patients with type 2 diabetes mellitus, promoting the understanding of sarcopenia among elderly people in zhenjiang area and even throughout the country,developing healthy living habits and reducing the prevalence of sarcopenia to achieve the secondary prevention and early intervention of sarcopenia in elderly people especially the patients with T2 DM.MethodsA total of 330 subjects were divided into T2 DM group(n=165) and non-T2 DM group(n=165) based on the criteria of 1999 World Health Organization(WHO) and Chinese diabetes prevention and treatment guidelines. All subjects were more than or equal to 60 years old. We use the Body Composition Analyzer(TANITA-MC180) to detect the appendicular skeletal muscle mass(ASM),use the appendicular skeletal muscle mass(SMI) to assess the skeletal muscle mass,use handgrip strength dynamometer(JAMAR) to assess the muscle strength,and apply 4 meters walking test to assess the physical performance.The aim of the research was to explore the occurrence of sarcopenia of the elderly in zhenjiang area which based on the criteria of the Asian Sarcopenia Working Group(AWGS),then comparing the difference of muscle mass,strength, physical performance and sarcopenia prevalence between T2 DM group and(non- T2DM) group. 165 cases of T2 DM group was also divided into Sarcopenia group(n=24) and non-Sarcopenia(n=141),then 165 subjects were received 75 g oral glucose tolerance test(OGTT), fasting plasma glucose(FPG),2h postprandial blood glucose(2h PBG), glycosylated hemoglobin(Hb A1c),total cholesterol(TC), triglycerides(TG)and other biochemical parame- ters. Human body parameters such as body weight,height, waist circumference(WC) and hip circumference(HC) were measured by professionals, they also calculated body mass index(BMI), waist hip ratio(WHR), as well as recorded the duration of T2 DM.Results(1) SMI levels were lower in T2 DM group[(7.08±1.20) kg/m2 vs.(7.40±1.15) kg/m2,(P<0.05)] than that in non-T2 DM group, difference of age, sex, BMI, handgrip strength and gait speed between two groups had no statistical meaning(P>0.05).SMI levels of elderly male were lower in T2 DM group[(7.92±1.04) kg/m2 vs.(8.23±0.80) kg/m2,(P<0.05)] than that in non-T2 DM group, difference of age, BMI, handgrip strength and gait speed between two groups had no statistical meaning(P>0.05).SMI levels of elderly female were lower in T2 DM group [(6.25±0.64) kg/m2 vs.(6.83±1.01) kg/m2,(P<0.01)]than that in non-T2 DM group and HS levels were lower in T2 DM group[(22.46±4.15) kg vs.(25.97 ±6.72) kg/m2,(P<0.01)] than that in non-T2 DM group,there were no statistically significant of the difference of age,BMI and gait speed between two groups(P>0.05).(2) The percentage of sarcopenia in 330 elderly people was about 10.61%, the prevalence of sarcopenia was higher in T2 DM group[14.55% vs.6.67%,χ2=5.40,(P<0.05)] than in non-T2 DM group, the prevalence of sarcopenia between two groups in elderly male and female had no statistical meaning [17.07% vs.9.33%, 12.05%vs.4.44%,(P>0.05)].(3) The age was higher in Sarcopenia group[(74.71±5.54) 岁 vs.(69.09±5.80) 岁,(P<0.05)] than that in non-Sarcopenia group;The duration of T2 DM was longer in Sarcopenia group[(14.33±4.97) 年 vs.(9.35±5.08) 年,(P<0.05)] than that in non-Sarcopenia group;The BMI was lower in Sarcopenia group [(21.89±2.57)kg/m2 vs.(24.21±3.17)kg/m2,(P<0.05)] than that in non-Sarcopenia group;The Hb A1 C was higher in Sarcopenia group[(9.21±1.34)%vs.(8.33± 1.55)%,(P<0.05)] than that in non-Sarcopenia group;(4) Univariate analysis showed that the prevalence of sarcopenia in elderly patients ofT2 DM among different age,BMI, Hb A1 C and duration of T2 DM group had statistically meaning(P<0.05). The result of multiivariate unconditional Logisitic regression reflected that the age [OR=4.251,95%CI(1.715~10.534),(P< 0.05)],diabetic course[OR=2.603,95%CI(1.180~5.744),(P<0.05)], Hb A1 C [OR= 3.998,95%CI(1.224~ 13.060),(P<0.05)]were the risk factors of sarcopenia in elderly patients with type 2 diabetes mellitus.Conclusion(1) The musle mass were lower and the prevalence of sarcopenia were higher in elderly patients with T2 DM compared to that in the elderly people without T2 DM.The musle mass in elderly male with T2 DM were lower than that in people without T2 DM,the musle mass and strength in elderly female with T2 DM were lower than people without T2 DM. T2 DM might play a certain role in the pathogenesis of sarcopenia.(2) The age, duration of T2 DM, Hb A1 C of elderly patients with type 2 diabetes mellitus were independent risk factors contributing to the occurrence of sarcopenia, the elderly patients who were clinically older and had long duration of diabetes and long-term poor blood glucose should be early screened to realize in-time prevention and intervention.