| 1 BackgroundThe aging of population is a very serious social problem in China.There are 240.9 million people aged 60 or over in mainland China,accounting for 17.3%of the total population.More than 20%of the elderly are diabetic,and more than 45%of the elderly are in pre diabetic state.Diabetes and aging will cause various health problems and physiological function changes,cause physical discomfort and pain,and cause a huge burden on individuals and families.The medical and nursing needs of elderly patients with diabetes are particularly prominent.Hypomyosis is a common phenomenon in elderly patients with diabetes mellitus.When the hypomyosis reaches a certain degree,it will develop into sarcopenia.Studies have shown that the incidence of sarcopenia is 5-10%in the elderly over 65 years old,and 15.7%in the elderly with type 2 diabetes.Diabetes may be related to the occurrence and development of sarcopenia.When the elderly patients with type 2 diabetes mellitus complicated with myopenia,they not only suffer from the pathological harm of diabetes itself,but also suffer from the adverse effects of myopenia,so that their own quality of life is seriously reduced,which may lead to a variety of adverse consequences.At present,there are many differences in basic factors,and the lipid factors related to diabetes are not systematically included and the results are inconsistent in the study of diabetic myosis in the elderly.Myosis and muscle dysfunction may increase the risk of falls.Sarcopenia and muscle dysfunction may increase the risk of falls.Therefore,it is very important to study and analyze the related factors and fall risk of myopenia and myohypofunction in elderly diabetic patients.2 PurposesThe purpose of this study is to investigate the condition of myopenia and hypomyosis in elderly patients with type 2 diabetes mellitus,analyze its basic factors,and use meta analysis to analyze the lipid influencing factors of myopenia;to investigate and analyze the fall risk of myopenia and hypomyosis in elderly patients with type 2 diabetes mellitus,so as to provide basis for improving muscle function and preventing myopenia in elderly patients with diabetes mellitus,so as to reduce the sugar in elderly patients The risk of falls in patients with diabete3 MethodsTaking convenient sampling method,288 elderly patients with type 2 diabetes who were hospitalized in the endocrine Department of the first people's Hospital of Zhaoqing City from September 2015 to September 2017 were selected as the research objects.The general sociological data and disease data of the patients were collected.BIA(bioelectrical impedance)method was used to measure the muscle composition of the human body,grip strength was measured by grip strength meter,and stopwatch was used The walking speed was measured.According to the 2014 Asian diagnosis standard of myopenia,myopenia and hypomyosis were diagnosed.The occurrence of myopenia and hypomyosis in elderly diabetic patients was investigated.The basic factors were analyzed by binary logistic regression.The PubMed,EMBASE,Cochrane Library,Wanfang database and CNKI database were searched by computer,and the case-control literature about lipid factors in elderly patients with type 2 diabetes mellitus complicated with sarcopenia at home and abroad was collected and retrieved until July 17,2019.Two researchers independently selected literature,extracted content and evaluated the risk of bias in the study,and used Revman 5.3 to meta analyze the data.From September 2017 to September 2018,130 elderly patients with type 2 diabetes who were hospitalized in the Department of endocrinology of the first people's Hospital of Zhaoqing City and met the inclusion criteria were selected as the study objects to investigate their fall risk.Chi square was used to test the fall risk difference between the normal muscle function group and the abnormal muscle function group,and binary logistic regression was used to analyze the fall risk factors.4 ResultsTwenty male patients diagnosed with sarcopenia had a detection rate of 13.51%,and 6 female patients had a detection rate of 4.3%.There was a statistically significant difference between men and women with hypoxemia(P=0.01).For example,the detection rate was 53.38%;the female patient's muscle strength was weakened in 82 cases,the detection rate was 58.57%,there was no statistical difference in male and female muscle strength(P=0.38);male physical activity was low in 62 cases,the detection rate was 41.89%.There were 85 cases of female physical activity,the detection rate was 60.71%,and the physical activity of men and women was statistically different(P<0.001).The factors associated with sarcopenia were BMI(body mass index)(OR=0.555),gender(OR=5.861);factors associated with decreased muscle strength were age(OR=1.054),BMI(OR=0.844);physical activity The relevant factor for low ability is gender(OR=0.445).LDL-C(low-density lipoprotein cholesterol)[MD-7.30,95%CI(-11.34,-3.25),P=0.0004]and TG(triglyceride)[MD=-23.77,95%CI(-41.21),-6.34),P=0.0008]is a lipid risk factor for the development of sarcopenia in elderly type 2 diabetic patients.The estimated risk of falls in elderly patients with type 2 diabetes was(24.19±9.00),37 patients with zero risk,accounting for 28.5%,and 93 patients with risk of falls,accounting for 71.5%.There were 52 cases of falling risk in the weakened muscle group,the detection rate was 82.54%,and there were 41 cases of falling risk in the group without muscle weakness,the detection rate was 61.19%,and the risk of fall in the two groups was statistically different(P=0.007);There were 52 cases of fall risk in the low-capacity group,the detection rate was 89.66%,and there were 41 cases of fall risk in the low mobility group,the detection rate was 56.94%,and the risk of fall in the two groups was statistically different(P<0.001).Fall risk related factors were age(OR=4.614)and BMI(OR=0.651).5 Conclusions5.1 Muscle dysfunction is more common.Men and small size are risk factors for the development of sarcopenia;advanced age and small size are risk factors for weakening muscle strength;women are risk factors for low physical activity.To prevent the occurrence of sarcopenia and hypofunction in elderly patients with type 2 diabetes,it is necessary to focus on the elderly and thin population,increase muscle nutrition,enhance exercise,maintain body shape,comprehensive intervention,and improve muscle function.5.2 LDL-C(low density lipoprotein cholesterol)and TG(triglyceride)are the lipid factors related to the occurrence of sarcopenia in elderly patients with type 2 diabetes mellitus.In the care,we need to pay attention to the two lipid indicators of LDL-C and TQ reduce the high-fat diet,use drugs when necessary,reduce blood lipid levels,and reduce the occurrence of sarcopenia.5.3 It is common for elderly patients with type 2 diabetes mellitus to have fall risk.Muscular dysfunction,increased age,and small size can increase the risk of falls in elderly patients with type 2 diabetes.To care for elderly patients with type 2 diabetes,it is necessary to focus on the reduction of muscle function,advanced age and small body size,improve muscle function,take protective measures,increase the time of accompanying care,and reduce the risk of falls. |
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