The Influence Factors Of Type 2 Diabetes Mellitus Complicated With Sarcopenia And Its Correlation With 25-Hydroxyvitamin D

Objective: The purpose of this study was to investigate the related factors of sarcopenia in elderly patients with T2 DM and its relationship with 25-hydroxyvitamin D by comparing the indexes such as body mass index(BMI),fall history(within 1year),exercise habits,walking speed,grip strength,25-hydroxyvitamin D[25(OH)D]and glycosylated hemoglobin in elderly patients with type 2 diabetes mellitus(T2DM)with or without sarcopenia.Methods: A total of 265 elderly patients with type 2 diabetes,aged 60-88 years,admitted to the Department of Internal Medicine of Lanzhou University First Hospital from April 2021 to December 2022 were collected and divided into two groups according to the SARC-Cal F scale:Diabetes mellitus combined with sarcopenia group(79 cases,30 males and 49 females)and simple diabetes group(186 cases,118 males and 68 females).The differences of general data,muscle-related indicators,and hematological indicators such as 25(OH)D were compared between the two groups.SPSS 25.0 software was used for statistical analysis to explore the related influencing factors of sarcopenia in elderly patients with T2 DM and the relationship with 25-hydroxyvitamin D.Results:1.General data analysis between the two groups: Patients living alone accounted for 25.3% and 14% of patients in the diabetic group combined with sarcopenia and the simple diabetic group,respectively,and the difference was statistically significant(p <0.05).Patients with exercise habits in the two groups accounted for 48.1% and 62.9%,respectively,and the difference was statistically significant(p < 0.05).According to whether the patients had a fall history within 1 year,the patients with a fall history(within 1 year)accounted for 35.4% in the diabetic group combined with sarcopenia,and 14.5% in the simple diabetic group,and the difference in the fall history between the two groups was also statistically significant(p < 0.05).There were statistically significant differences in gender,age,residence style,exercise habits,fall history(within 1 year)and BMI between the diabetic group combined with sarcopenia and the diabetic group alone(p < 0.05),while there were no statistically significant differences in diabetes course and ADL score(p > 0.05).2.Analysis of muscle measurements between the two groups: the calf circumference,walking speed and grip strength of the diabetic group were significantly lower than those of the simple diabetic group,with statistical significance(p < 0.05).3.Analysis of hematological indexes between the two groups: the level of 25(OH)D in the diabetic group combined with sarcopenia was significantly lower than that in the simple diabetic group,and the difference was statistically significant(p <0.05).There were no significant differences in glycosylated hemoglobin,fasting blood glucose,TG,TC,HDL-C and LDL-C(p> 0.05).4.The level of 25-hydroxyvitamin D in elderly patients with T2 DM and sarcopenia was positively correlated with walking speed、grip strength and duration of diabetes,and the differences were statistically significant(p < 0.05).It was negatively correlated with TC 、 HDL-C 、 LDL-C and Hb A1 c,and the differences were also statistically significant(p < 0.05).5.Multivariate logistic regression analysis: Age(OR = 1.113,p < 0.05)and fall history within 1 year(OR = 4.136,p < 0.05)were risk factors for sarcopenia in elderly patients with T2 DM.And 25(OH)D(OR = 0.876,p < 0.05),calf circumference(OR = 0.839,p < 0.05),grip strength(OR = 0.935,p < 0.05),exercise habit(OR = 0.365,p < 0.05)and BMI(OR = 0.863,p < 0.05)were protective factors for sarcopenia in elderly patients with T2 DM.Conclusion:1.Elderly patients with T2 DM have a higher risk of developing sarcopenia,which is closely related to 25-hydroxyvitamin D,age,fall history(within 1 year),exercise habits,BMI,grip strength,calf circumference and other factors.2.25-hydroxyvitamin D is an important protective factor in elderly patients with T2 DM complicated with sarcopenia,and is positively correlated with muscle evaluation indicators as walking speed and grip strength.To investigate the relationship between 25-hydroxyvitamin D and sarcopenia associated with T2 DM may be of great significance for the prevention and treatment of sarcopenia in elderly patients with T2 DM.