老年人群血糖水平与肌肉量、力量和功能的相关性研究  

The correlation between blood glucose level and muscle mass,strength and function in an elderly population

作　　者：吕珊 凌玲 陈星 陈姝 朱思平 林蔚 丁国宪 吕荣 Lyu Shan;Ling Ling;Chen Xing;Chen Shu;Zhu Siping;Lin Wei;Ding Guoxian;Lyu Rong(Department of Gerontology,the First Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China;Department of Gerontology,Suzhou Ninth People′s Hospital,Suzhou 215200,China)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院老年医学科,南京210029 [2]苏州市第九人民医院老年医学科,苏州215200

出　　处：《中华内科杂志》2022年第4期390-396,共7页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金(81871096);江苏省卫生科研项目(BJ20017)。

摘　　要：目的探讨江苏某地区社区老年人群血糖水平与肌少症三要素(肌肉量、肌肉力量和躯体功能)之间的相关性。方法研究共纳入2018—2019年在江苏华侨路社区卫生服务中心健康体检的老年人群(≥60岁)250例,其中男性101例,女性149例,根据美国糖尿病学会(ADA)糖尿病诊断标准分为血糖正常、糖尿病前期、糖尿病3组,并进行肌少症的评估。结果糖尿病组的肌肉量、上肢肌力与正常组差异无统计学意义,而下肢肌力和躯体功能[步速、平衡、成套简短肌肉功能测试(short physical performance battery,SPPB)]明显下降。相关性分析显示,空腹血糖与步速(r=-0.248,P=0.001)、三姿平衡(r=-0.166,P=0.013)、SSPB呈负相关(r=-0.213,P=0.001);糖化血红白与椅上坐-站时间呈正相关性(r=0.205,P=0.002),与三姿平衡(r=-0.186,P=0.006)、SSPB呈负相关(r=-0.154,P=0.024)。多元回归分析提示,空腹血糖与反映躯体功能的步速仍然存在负相关性(β=-0.125,P=0.005),与SPPB存在负相关性(β=-0.034,P=0.012),糖化血红蛋白与椅上坐-站呈正相关(β=0.218,P=0.006),三姿平衡呈负相关(β=-0.143,P=0.012),与SPPB存在负相关性(β=-0.117,P=0.036)。结论老年人群的血糖水平与肌肉量无明显相关性,空腹血糖与步速密切相关,糖化血红蛋白与老年人下肢肌肉力量和平衡能力密切相关。Objective To explore the correlation between blood glucose levels and the three factors of sarcopenia(muscle mass,strength and function)in older Chinese community dwellers.Methods This is a retrospective study conducted by collecting the data of patients in Jiangsu Huaqiao Road Community Health Service Center from 2018 to 2019.Two hundred and fifty people aged 60 years or elder were selected.Among them,101 were men and 149 were women.According to the American Diabetes Association diagnostic criteria for diabetes mellitus in 2018,they were divided into normal glucose tolerance(NGT)group,pre-diabetes group and diabetes group.The patients were assessed for sarcopenia as well.Results Compared with those in the NGT group,muscle mass and upper limb muscle strength did not change in the diabetic group,but lower limb muscle strength and body function[walking speed,balance,short physical performance battery(SPPB)]decreased significantly in the diabetic group.Pearson correlation analyses showed that fasting plasma glucose(FPG)was negatively correlated with walking speed(r=-0.248,P=0.001),three-pose balance(r=-0.166,P=0.013)and SSPB(r=-0.213,P=0.001).Glycosylated hemoglobin A1c(HbA1c)was positively correlated with sitting and standing time(r=0.205,P=0.002),and negatively correlated with three-pose balance(r=-0.186,P=0.006)and SSPB(r=-0.154,P=0.024).Multiple regression analyses showed that FPG was negatively associated with walking speed(β=-0.125,P=0.005)and SPPB(β=-0.034,P=0.012),and that HbA1c was positively associated with sitting and standing time(β=0.218,P=0.006)and negatively associated with three-pose balance(β=-0.143,P=0.012),and SPPB(β=-0.117,P=0.036).Conclusions There is no significant correlation between blood glucose levels and muscle mass in the elderly;however,FPG is closely correlated with gait speed,and HbA1c is closely correlated with muscle strength of lower limbs and balance ability in the elderly.

关 键 词：血糖 老年人 肌少症 肌肉量 肌肉力量 躯体功能 

分 类 号：R587.1[医药卫生—内分泌]