老年糖尿病患者肌肉量减少与膳食摄入的相关研究  

Analysis of muscle mass reducing and energy intake in elderly type 2 diabetes

作　　者：任姗姗[1] 汪明芳[1] 王丽娟[1] 程博[1] 杨子艳[1] 李长平[1] 王璐[1] 丁丽丽[1] 陈燕波[1] 孙明晓[1] 

机构地区：[1]卫生部北京医院营养科,100730

出　　处：《中华糖尿病杂志》2015年第2期95-99,共5页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：十二五科技支撑计划课题（2012BAK21802-04）;国家863生物和医药技术领域课题（2014AA022306）

摘　　要：目的了解老年糖尿病患者肌肉量减少与膳食能量及营养素摄入比例的关系。方法回顾性比较225例糖尿病患者中老年与非老年，老年患者中不同性别、是否超重患者间身体成分与膳食摄入能量及三大营养素量和比例的差别。采用多元线性回归的方法探讨与老年患者身体结构特点相关的膳食因素。结果与非老年糖尿病患者比较，老年糖尿病患者体质指数（BMI）、左右手握力、肌肉量均显著较低（t=-3．108、-2．207、-2．825，均P〈0．05），两组腰臀比、体脂百分比、内脏脂肪面积差异无统计学意义（t=-0．531、-0．454、01316，均P〉0．05）；血红蛋白、白蛋白、空腹血糖亦均较低（t=-3．309、-2．047、-1．983，均P〈0．05）。老年糖尿病患者中，女性体脂百分比高于男性（t=-3．911，P〈0．05），左右手握力、肌肉量低于男性（t=-2．207、-2．825、13．921，P〈0．05）。老年患者的总能量及三大营养素摄入的量及比例与非老年患者相比差异均无统计学意义（t=-1．435～0．015，均P〉0．05）；老年患者中，非超重者的校正体重能量摄入明显低于超重者（t=3．239，P〈0．05）。老年糖尿病患者少肌症检出率为6．3％，肌肉量减少者达34．0％。多元线性回归显示，肌肉量减少与能量摄入不足（B=-1．4000，95％CI：-2．770--0．029，P=0．045）、校正体重的蛋白摄入量不足（B=-0．0095，95％CI：-0．168～-0．021，P=0．013）、内脏脂肪面积偏多（B=0.019，95％CI：0．006～0．033，P=0．007）有关。结论老年糖尿病患者的少肌现象与能量及蛋白摄入不足、内脏脂肪超标有关，对老年糖尿病患者应进行个体化的营养评价及支持。Objective To investigate the relationship between dietary intake and body composition in elderly type 2 diabetes （T2DM）. Methods Retrospectively analyzing the differences of body composition between age （older group： ≥60 years and younger group： 〈60 years）, and further analyzing the differences between genders and overweight or not in older group. The related dietary factors of physical makeup in the elderly patients were investigated with multiple linear regression analysis, included the intake of energy and macronutrients. Results Compared with younger group, older group had lower body mass index, grip strength, and muscle mass, and hemoglobin, albumin, fasting blood glucose levels （t= - 3.309 to - 1.983, all P〈0.05）. There was no significant differences in waist-hip ratio, percentage of body fat, visceral fat area and the intake of total energy, quantity and proportion of macronutrients between the age groups （t= - 1.435 to 0.316, all P〉0.05）. In elderly group, female had higher percentage of body fat, and lower grip strength, muscle mass （t= - 3.911, - 2.207, - 2.825,13.921, all P〈0.05）. However, the adjusted energy intake by body weight was lower in non-overweight patients in older group （t=3.239, P〈0.05）. The detection rates of sarcopenia and muscle mass reducing were 6.3% and 34.0% in older group, respectively. Multiple linear regression analysis showed that insufficient intake of energy （B= - 1.4000, P=0.045,95%CI： - 2.770 to - 0.029）, protein （B= - 0.0095, P=0.013,95%CI： - 0.168 to - 0.021）, and excessive visceral fat accumulation （B=0.019, P=0.007,95%CI：0.006 to 0.033）were the independent risk factors of muscle mass reducing in elderly T2DM patients. Conclusions The decrease of muscle mass in elderly diabetic patients relates to insufficient intake of energy and protein, and excessive visceral fat accumulation. Individual nutrition evaluation and support is necessary especially in elderly diabetic patients.

关 键 词：糖尿病 老年人 膳食 肌肉量 

分 类 号：R587.1[医药卫生—内分泌]