| Objective(1)This study intends to compare the differences in musculoskeletal indicators and prevalence of Sarcopenia between middle-aged and elderly T2DM patients and Non-T2DM.(2)Further to explore the factors affecting the occurrence of Sarcopenia in middle-aged and elderly patients,to improve the understanding of Sarcopenia,especially in patients with T2DM.(3)The relationship between muscle and skeleton is closely related,It’s necessary to explore the correlation between Sarcopenia and bone mineral density in middle-aged and elderly population.MethodsA total of 203 subjects were included in the study.According to the WHO diagnostic criteria for T2DM in 1999,T2DM group of 101 cases,Non-T2DM group of 102 cases.Stratified by age and gender,the differences in musculoskeletal indicators and prevalence of Sarcopenia between T2DM patients and Non-T2DM population were compared.In accordance with Asian Sarcopenia Working Group(AWGS)diagnostic criteria will divide Sarcopenia and the non-Sarcopenia groups(2 subgroups)in diabetes.To compare the relative factors between two subgroups of diabetes mellitus(e.g.,age,course of diseases,HbAlC,etc.),further to explore the independent risk factors of promoting the occurrence of Sarcopenia in T2DM;The Non-T2DM group and the T2DM group were divided into the Sarcopenia group and the Non-Sarcopenia groups(2 subgroups)respectively,to compare the differences in bone mineral density and vitamin D levels between the two subgroups.Results(1)The grip strength of the middle-aged and elderly T2DM group was significantly lower than that of Non-T2DM group(P<0.01),the walking speed was slower than that of Non-T2DM group(P<0.05),the abdominal circumference was larger than that of Non-T2DM group(P<0.01),and the vitamin D level was significantly lower than that of Non-T2DM group(P<0.01).There were no statistically significant differences in age,BMI,triglyceride,cholesterol,AST,ALT,creatinine,skeletal muscle mass index(SMI)and bone density between the two groups(P>0.05).According to gender stratification,grip strength of middle-aged and elderly men in the T2DM group was significantly lower than that in Non-T2DM group(P<0.01);walking speed of middle-aged and elderly women in the T2DM group was significantly slower than Non-T2DM group(P<0.01),the abdominal circumference was significantly greater than Non-T2DM group(P<0.01),the triglyceride level was higher than Non-T2DM group(P<0.05),and the vitamin D level was lower than Non-T2DM group(P<0.05).According to age stratification,grip strength of middle-aged T2DM group was lower than that of Non-T2DM group(P<0.05),walking speed was significantly slower than that of Non-T2DM group(P<0.01),and vitamin D level was significantly lower than that of Non-T2DM group(P<0.01).The abdominal circumference of the elderly T2DM group was significantly larger than that of the Non-T2DM group(P<0.01).(2)Among 203 middle-aged and elderly patients,23 had Sarcopenia,accounting for about 11.3%.The difference in the prevalence of Sarcopenia between the T2DM group and the Non-T2DM group was statistically significant[18.8%vs.7.4%,P<0.05].Stratified by sex and age,there was no statistical significance in the prevalence of Sarcopenia in T2DM group and Non-T2DM group.(3)In the T2DM group,the age of the Sarcopenia group was significantly older than that of the Non-Sarcopenia group(P<0.01).BMI was smaller than that of the Non-Sarcopenia group(P<0.05).The course of disease was significantly longer than that of the non-Sarcopenia group(P<0.01).The content of glycosylated hemoglobin was higher than that of Non-Sarcopenia group(P<0.05).The fasting c-peptide level was lower than that of the Non-Sarcopenia group(P<0.05).There were no statistically significant differences in gender,abdominal circumference,triglycerides,cholesterol,AST,ALT,creatinine,uric microalbumin,fasting plasma glucose,2h postprandial blood glucose and 2h postprandial c-peptide levels between the two groups(P>0.05).(4)Univariate analysis was performed with statistically significant indexes as independent variables and Sarcopenia as dependent variables to carry out logistic regression analysis.The results showed that age,course of disease and glycosylated hemoglobin were independent risk factors for T2DM Sarcopenia in middle-aged and elderly people.BMI is a protective factor.(5)In the Non-T2DM group and T2DM group,BMD in Sarcopenia group was lower than that in the Non-Sarcopenia group,and the proportion of low bone mass and osteoporosis in group was significantly higher than that in Sarcopenia group[42.9%VS 36.6%,42.9%VS 9.6%,P<0.05;68.75%VS 39.29%,18.75%VS 7.14%P<0.05].There was no significant difference in vitamin D level between the Non-T2DM and the T2DM group between the two subgroups(P>0.05).Conclusions(1)Compared with the non-T2DM group,the prevalence rate of sarcopenia in the middle-aged and elderly T2DM group increased,reaching 15.8%.The difference was mainly reflected in the changes in muscle function,with decreased grip strength in males and decreased walking speed in females,but not the changes in muscle mass.(2)Advanced age,long course of disease and high HbA 1C are independent risk factors for the occurrence of T2DM in the middle-aged and elderly,and the increase in BMI is a protective factor for the occurrence of T2DM in the premise of excluding muscle reducing obesity.(3)Regardless of whether T2DM is associated with T2DM or not,low bone mass and osteoporosis account for a high proportion of sarcopenia,which should be paid great attention to.Moreover,the correlation study between sarcopenia and the pathogenesis of osteoporosis should be strengthened. |
