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老年糖尿病患者中肌肉减少症和肌无力与跌倒恐惧的相关性比较

[A comparison of the associations of dynapenia and sarcopenia with fear of falling in elderly diabetic patients].

作者信息

Ida Satoshi, Murata Kazuya, Ishihara Yuki, Imataka Kanako, Kaneko Ryutaro, Fujiwara Ryoko, Takahashi Hiroka

机构信息

Department of Diabetes and Metabolism, Ise Red Cross Hospital.

出版信息

Nihon Ronen Igakkai Zasshi. 2017;54(4):537-545. doi: 10.3143/geriatrics.54.537.

Abstract

AIM

To comparatively investigate whether dynapenia and sarcopenia, as defined by the Asian Working Group for Sarcopenia (AWGS), are associated with fear of falling in elderly patients with diabetes.

METHODS

The subjects were outpatients with diabetes who were at least 65 years of age when they visited our hospital. Sarcopenia was evaluated based on the AWGS definition. The cutoff values for the appendicular skeletal mass index (multi-frequency bioelectrical impedance method), grip strength, and walking speed were, respectively, 7.0 kg/m for men and 5.7 kg/m for women, 26 kg for men and 18 kg for women, and ≤0.8 m/s for both men and women. Those with grip strength of less than or equal to the cutoff value were considered to have dynapenia. Fear of falling was assessed by a self-administered questionnaire survey with the Fall Efficacy Scale (FES) Japanese version. A multiple regression analysis was conducted using the FES score as a dependent variable and dynapenia or sarcopenia and moderators as explanatory variables.

RESULTS

A total of 202 patients (male, n=127; female, n=75) were analyzed in this study. The FES scores of the patients with and without sarcopenia did not differ to a statistically significant extent in either male or female patients. The multiple regression analysis revealed a statistically significant association between dynapenia and the FES score in men (P=0.028).

CONCLUSIONS

In elderly outpatients with diabetes, no association was found between sarcopenia and the fear of falling in either men or women. In contrast, a statistically significant association was found between dynapenia and fear of falling in men. This suggests the importance paying attention to the fear of falling when examining elderly male diabetes patients with dynapenia.

摘要

目的

比较研究亚洲肌少症工作组(AWGS)所定义的肌无力和肌少症是否与老年糖尿病患者的跌倒恐惧相关。

方法

研究对象为我院门诊的糖尿病患者,就诊时年龄至少65岁。根据AWGS的定义评估肌少症。采用多频生物电阻抗法测量四肢骨骼肌质量指数、握力和步速,男性和女性的截断值分别为7.0kg/m²和5.7kg/m²、26kg和18kg、≤0.8m/s。握力小于或等于截断值的患者被认为存在肌无力。采用日本版跌倒效能量表(FES)通过自填问卷调查评估跌倒恐惧。以FES评分作为因变量,肌无力或肌少症及调节因素作为解释变量进行多元回归分析。

结果

本研究共分析了202例患者(男性127例,女性75例)。无论男性还是女性患者,有肌少症和无肌少症患者的FES评分在统计学上无显著差异。多元回归分析显示男性肌无力与FES评分之间存在统计学显著关联(P=0.028)。

结论

在老年糖尿病门诊患者中,未发现肌少症与男性或女性的跌倒恐惧之间存在关联。相比之下,男性肌无力与跌倒恐惧之间存在统计学显著关联。这表明在检查患有肌无力的老年男性糖尿病患者时,关注跌倒恐惧的重要性。

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