Hiltunen L A
Department of Public Health Science and General Practice, University of Oulu, Finland.
Cent Eur J Public Health. 2001 Feb;9(1):22-5.
The aim of this study was to find out if there are associations between the deterioration of glucose tolerance and balance, gait or muscle strength among non-institutionalised northern Finnish subjects aged 70 years or over. 79% of the eligible 483 subjects participated in the study (n = 379; of whom 141 were men). 14 % (n = 19) of the men had previously diagnosed diabetes, 9% had undiagnosed diabetes, and 32% had impaired glucose tolerance (IGT). The corresponding figures for the women were 19% (n = 46), 9% (n = 21) and 35% (n = 84). The proportion of the female subjects with good balance tended to decrease along with the deterioration of the glucose tolerance status and there was a trend that disturbances in gait (walking speed, step length among the women) increased along with the deterioration of glucose tolerance. A greater proportion of the previously diagnosed diabetic subjects had decreased thenar (p = 0.09), interosseus (p = 0.00), tibialis anterior (p = 0.003), tibialis posterior (p = 0.07) and peroneus (p = 0.03) muscle strength and decreased or missing biceps (p = 0.019) and quadriceps (p = 0.010) tendon reflexes. More of the subjects with abnormal glucose tolerance had weakening of the abdominal muscles compared to the persons with normal glucose tolerance (NGT) (p = 0.001). A greater proportion of the previously diagnosed diabetic subjects had abnormal vibration sense in the sternum compared to the subjects with NGT (p = 0.028) and the tendency was similar for undiagnosed diabetes. As a majority of the abnormal findings in this study were made among the previously diagnosed diabetic patients, the long duration of hyperglycemia probably contributes to the development of these disturbances. Therefore, early detection and active treatment of hyperglycemia might prevent or at least delay the development of signs of diabetic neuropathy among elderly subjects.
本研究的目的是探究在70岁及以上的非机构化芬兰北部人群中，糖耐量恶化与平衡能力、步态或肌肉力量之间是否存在关联。符合条件的483名受试者中有79%参与了研究（n = 379；其中141名男性）。14%（n = 19）的男性之前被诊断患有糖尿病，9%患有未确诊的糖尿病，32%有糖耐量受损（IGT）。女性的相应数据分别为19%（n = 46）、9%（n = 21）和35%（n = 84）。平衡能力良好的女性受试者比例往往随着糖耐量状态的恶化而降低，并且存在一种趋势，即步态障碍（女性的步行速度、步长）随着糖耐量的恶化而增加。在之前被诊断为糖尿病的受试者中，有更大比例的人拇指对掌肌（p = 0.09）、骨间肌（p = 0.00）、胫骨前肌（p = 0.003）、胫骨后肌（p = 0.07）和腓骨肌（p = 0.03）力量下降，肱二头肌（p = 0.019）和股四头肌（p = 0.010）肌腱反射减弱或消失。与糖耐量正常（NGT）的人相比，糖耐量异常的受试者中有更多人的腹部肌肉力量减弱（p = 0.001）。与NGT受试者相比，之前被诊断为糖尿病的受试者中有更大比例的人胸骨振动觉异常（p = 0.028），未确诊糖尿病的受试者也有类似趋势。由于本研究中的大多数异常发现是在之前被诊断为糖尿病的患者中出现的，高血糖的长期存在可能促成了这些功能障碍的发生。因此，早期发现并积极治疗高血糖可能预防或至少延缓老年受试者糖尿病神经病变体征的出现。
