老年2型糖尿病患者衰弱的危险因素  

Risk factors of frailty in the elderly with type 2 diabetes mellitus

作　　者：修双玲[1] 穆志静[1] 孙丽娜[1] 韩青[1] 赵蕾[1] 付俊玲 XIU Shuang-Ling;MU Zhi-Jing;SUN Li-Na;HAN Qing;ZHAO Lei;FU Jun-Ling(Department of Endocrinology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院内分泌科,北京100053

出　　处：《中华老年多器官疾病杂志》2021年第9期646-649,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：北京市属医院科研培育计划(PX2020034)。

摘　　要：目的探索老年2型糖尿病(T2DM)患者衰弱的危险因素。方法纳入首都医科大学宣武医院内分泌科住院的老年T2DM患者310例,测定患者的空腹血糖、空腹胰岛素、糖化血红蛋白、血脂及25羟基维生素D 3(25-OHD_(3))水平,记录患者的既往史。采用微型营养量表(MNA)进行营养状态评估。采用FRAIL量表评估患者的衰弱状态,并分成3组。采用SPSS 20.0统计软件进行数据分析。根据数据类型,组间比较分别采用χ^(2)检验、Fisher精确概率法、方差分析、LSD检验和秩和检验。结果衰弱组患者45例、衰弱前期组患者132例及正常组患者133例。衰弱组的年龄、有营养不良风险、合并脑卒中比例显著高于正常组,而肾小球滤过率、25-OHD_(3)水平显著低于正常组(P<0.05)。多元logistic回归分析显示,有营养不良风险、合并脑卒中是老年T2DM患者衰弱的独立危险因素(OR=3.80,2.38;P<0.05),25-OHD_(3)水平为衰弱的保护因素(OR=0.91,P=0.001)。结论营养不良风险及合并脑卒中增加老年T2DM患者衰弱的风险,25-OHD_(3)水平高可降低衰弱风险。Objective To explore the risk factors of frailty in the elderly with type 2 diabetes mellitus(T2DM).Methods A total of 310 elderly T2DM patients who admitted to the Department of Endocrinology,XuanWu Hospital of Capital Medical University,were included in the study.The levels of fasting glucose,fasting insulin,glycosylated hemoglobin(HBA1c),blood lipid and 25-hydroxyvitamin D 3(25-OHD 3)were measured,and the past histories were recorded.The mini-nutritional scale(MNA)for nutritional status assessment was used to assess the nutritional status,and the FRAIL scale to assess frailty.The patients were divided into three groups based on frailty.SPSS statistics 20.0 was used for data analysis.Depending on the data type,χ^(2) test,Fisher exact probability method,analysis of variance,LSD test and rank sum test were used for comparison between groups.Results There were 45 patients in the frail group,132 in the pre-frail group,and 133 in the normal group.Age,risk of malnutrition and stroke in the frail group were significantly higher than those in the normal group,but the glomerular filtration rate and 25-OHD 3 levels were significantly lower(P<0.05).The multivariate logistic regression analysis showed that having risk of malnutrition and stroke were independent risk factors of frailty in the elderly with T2DM(OR=3.80,2.38;P<0.05),and 25-OHD 3 level was a protective factor of frailty(OR=0.91,P=0.001).Conclusions Having risk of malnutrition and stroke increases the risk of frailty in the elderly with T2DM,and high 25-OHD 3 level decreases the risk of frailty.

关 键 词：老年人 衰弱 2型糖尿病 危险因素 

分 类 号：R587.1[医药卫生—内分泌]