Correlation Between Glucose Fluctuation And Sarcopenia In Elderly Patients With Type 2 Diabetes Mellitus

Objective:To study the correlation blood gluose fluctuation and sarcopenia in elderly patients with type 2 diabetes mellitus,so that we can provide clinical basis for the prevention and treatment of diabetic sarcopenia.Methods:In this study,280 patients≥60 years with T2DM were enrolled.Clinical indicators including age,sex,BMI,disease duration,blood glucose,fasting C peptide,fasting insulin,blood lipid were collected for all patients.At the same time,all the enrolled patients wore the Meqi dynamic blood glucose monitoring system to obtain TIR,TAR and other parameters for assessing blood glucose fluctuations.All enrolled patients were classified into sarcopenic group or non-sarcopenic group.SPSS26.0 statistical software was used to analyze the prevalence of sarcopenia and compare the differences between the clinical and glycemic variables in two groups.Spearman Correlation was used to analyze glucose fluctuation indicators with grip strength,the time of five times sit to stand test(FTSST)and ASMI.Logistic Regression was used to analyze the influencing factors of sarcopenia.Results:1.A total of 280 patients were enrolled in this study,including 43 patients in the sarcopenic group and 237 patients in the non-sarcopenic group.The prevalence of sarcopenic was 15.36%(43/280).Age,male prevalence,UACR,the time of FTSST SD,TAR and MG in the sarcopenic group were higher than those in the non-sarcopenic group,while the grip strength,BMI,F-CP,HOMA-IR,25 H-vitamin D,ASMI,and TIR were lower in the non-sarcopenic group(P<0.05).There was no statistical significance in FPG,calcium,phosphorus,PTH,HbAlc,TG,TC,LDL-c,HDL-c,physical activity intensity,DPN,PAD,DR,DKD,CV,MAGE,TBR and LAGE(P>0.05).2.The result of Spearman correlation showed TIR and ASMI were positively correlated with handgrip strength and negatively correlated with the time of FTSST.TAR and MG were negatively correlated with ASMI and handgrip strength,while they were positively correlated with the time of FTSS.Meanwhile,CV,SD and LAGE were negatively correlated with ASMI.LAGE was negatively correlated with handgrip strength.3.Whether sarcopenia was the dependent variable,logistic univariate results showed that age,male,MG,TARD were all risk factors for sarcopenia.BMI,25-(OH)D,TIR were protective factors for sarcopenia.The results of univariate analysis were taken as independent variable and multivariate logistic regression analysis showed that male and age were risk factors for sarcopenia,and TIR was the protective factor for sarcopenia(P<0.05).Conclusions:1.The prevalence of sarcopenia in elderly patients with type 2 diabetes mellitus was 15.36%.The occurrence and development of diabetic sarcopenia was closely related to age,gender,BMI,25-(OH)D,MG,TAR and TIR levels.2.Gender and age of elderly patients with type 2 diabetes are risk factors for the development of sarcopenia,while TIR is its protective factor.