Abidin Öztürk Zeynel Abidin, Türkbeyler İbrahim Halil, Demir Zeynep, Bilici Muhammet, Kepekçi Yalçın
Department of Internal Medicine, Division of Geriatrics, Medical Faculty of Gaziantep University, Gaziantep, Turkey.
Department of Radiology, New York University, Center for Biomedical Imaging, New York, USA.
Turk J Phys Med Rehabil. 2017 Nov 14;64(1):72-79. doi: 10.5606/tftrd.2018.1068. eCollection 2018 Mar.
This study aims to evaluate the effect of blood glucose regulation on sarcopenia parameters in sarcopenic, obese, and poorly- regulated diabetic patients.
Between June 2013 and December 2013, a total of 147 patients (64 males, 83 females; mean age 70.3±6.3 years; range, 60 to 90 years) who were diagnosed with sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria were included in the study. All patients were obese with a body mass index (BMI) of >30 kg/m2 and their glycated hemoglobin (HbA1c) levels were above 8%. Sarcopenia parameters including the gait speed, muscle strength, muscle mass, and handgrip strength were assessed. After a six-month treatment period, the patients were divided into two groups according to their HbA1c levels as having <8% or >8%. Sarcopenia parameters were evaluated before and after receiving treatment.
The mean disease duration was 16±6.2 years. Sixty patients were found to have a HbA1c level of <8% and 45 patients with a HbA1c level of ≥8% at sixth months of follow-up. In better regulated group, sarcopenia parameters such as gait speed, muscle mass, and handgrip strength improved; however, only the change in the muscle mass was found to be statistically significant (p=0.041). There was no significant change in the parameters of sarcopenia in the patient group with a HbA1c level ≥8%. A negative correlation was found between the muscle mass and HbA1c levels in good- and poorly-regulated groups (p=0.039 r:-0.327 and p=0.044 r:-0.183, respectively).
Our study demonstrates that lowering HbA1c levels may have positive effects on the muscle mass even in diabetic and sarcopenic obese elderly individuals.
本研究旨在评估血糖调节对肌肉减少症患者、肥胖患者及血糖控制不佳的糖尿病患者肌肉减少症参数的影响。
2013年6月至2013年12月期间，共有147例患者（64例男性，83例女性；平均年龄70.3±6.3岁；年龄范围60至90岁）纳入本研究。这些患者均根据欧洲老年人肌肉减少症工作组（EWGSOP）标准被诊断为肌肉减少症。所有患者均肥胖，体重指数（BMI）>30 kg/m2，糖化血红蛋白（HbA1c）水平高于8%。评估肌肉减少症参数，包括步速、肌肉力量、肌肉质量和握力。经过6个月的治疗期后，根据患者的HbA1c水平将其分为两组，HbA1c水平<8%或>8%。在接受治疗前后评估肌肉减少症参数。
平均病程为16±6.2年。在随访的第6个月时，发现60例患者的HbA1c水平<8%，45例患者的HbA1c水平≥8%。在血糖控制较好的组中，步速、肌肉质量和握力等肌肉减少症参数有所改善；然而，仅发现肌肉质量的变化具有统计学意义（p = 0.041）。HbA1c水平≥8%的患者组中，肌肉减少症参数无显著变化。在血糖控制良好和不佳的组中，肌肉质量与HbA1c水平之间均发现负相关（分别为p = 0.039，r = -0.327和p = 0.044，r = -0.183）。
我们的研究表明，即使在糖尿病合并肌肉减少症的肥胖老年个体中，降低HbA1c水平可能对肌肉质量产生积极影响。
