Department of Endocrinology and Metabolism, Graduated School of Medicine Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Diabetology, Kameoka Municipal Hospital, Kameoka, Japan.
J Diabetes. 2019 Jun;11(6):477-483. doi: 10.1111/1753-0407.12874. Epub 2018 Dec 4.
Energy intake is important for the maintenance of muscle mass. The relationship between energy intake and sarcopenia in elderly patients with type 2 diabetes (T2D) has been unclear.
Using a brief-type self-administered diet history questionnaire we assessed habitual food and nutrient intake of patients with T2D aged ≥65 years, all of whom were Japanese and physically active, taking part in the KAMOGAWA-DM cohort study. Patients' body composition was evaluated by bioimpedance analysis. Sarcopenia was defined as having both a grip strength of <26 kg for men and <18 kg for women and a skeletal muscle mass index of <7.0 kg/m for men and <5.7 kg/m for women. Logistic regression analyses were used to investigate the effect of energy intake on the presence of sarcopenia in this cross-sectional study of 391 patients (205 men, 186 women).
Fifty-five patients (14.1%) were diagnosed as having sarcopenia. Energy intake was significantly lower in patients with sarcopenia than without sarcopenia (mean ± SD [n = 366] 1498.8 ± 389.4 vs 1786.2 ± 706.7 kcal/d, respectively; P = 0.016). After adjusting for age, sex, exercise, smoking status, HbA1c, and body mass index, patients' energy intake (per 100 kcal) was negatively associated with the presence of sarcopenia (odds ratio 0.86; 95% confidence interval 0.78-0.95; P = 0.001).
Energy intake was negatively associated with the presence of sarcopenia in elderly patients with T2D.
能量摄入对于维持肌肉量很重要。对于 2 型糖尿病（T2D）老年患者，能量摄入与肌肉减少症之间的关系尚不清楚。
使用简短的自我管理饮食历史问卷，我们评估了年龄≥65 岁的 T2D 患者习惯性的食物和营养素摄入情况，所有患者均为日本裔且身体活跃，参加了神奈川糖尿病队列研究。通过生物电阻抗分析评估患者的身体成分。肌肉减少症的定义为男性握力<26kg，女性握力<18kg，男性骨骼肌质量指数<7.0kg/m，女性骨骼肌质量指数<5.7kg/m。在这项横断面研究中，对 391 名患者（205 名男性，186 名女性）进行了逻辑回归分析，以研究能量摄入对肌肉减少症发生的影响。
55 名患者（14.1%）被诊断为患有肌肉减少症。患有肌肉减少症的患者的能量摄入明显低于没有肌肉减少症的患者（平均±标准差[n=366]分别为 1498.8±389.4 和 1786.2±706.7kcal/d；P=0.016）。在校正年龄、性别、运动、吸烟状况、HbA1c 和体重指数后，患者的能量摄入（每 100kcal）与肌肉减少症的发生呈负相关（优势比 0.86；95%置信区间 0.78-0.95；P=0.001）。
能量摄入与 T2D 老年患者肌肉减少症的发生呈负相关。
