Tanaka Sho, Takubo Masahiro, Kohno Genta, Kushimoto Masaru, Ikeda Jin, Ogawa Katsuhiko, Suzuki Yutaka, Abe Masanori, Ishihara Hisamitsu, Fujishiro Midori
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan.
Department of Internal Medicine, Nihon University Hospital, Tokyo 101-8309, Japan.
Geriatrics (Basel). 2020 May 19;5(2):33. doi: 10.3390/geriatrics5020033.
The aim of this study was to investigate factors associated with sarcopenia among elderly patients with poorly controlled diabetes mellitus (DM). We retrospectively analyzed 41 patients with type 2 DM, aged ≥65 years who required diabetes education hospitalization. Patients were classified into two groups according to the presence or absence of a weakened hand grip, and clinical characteristics were compared. Patients with a weakened hand grip ( = 21) scored worse on a mini-mental state examination (24.3 vs. 26.5, = 0.04), showed a higher prevalence of diabetic peripheral neuropathy (76% vs. 40%, = 0.03), and had a higher serum phosphorus concentration (3.8 vs. 3.3 mg/dL, < 0.01) compared to those without a weakened hand grip ( = 20). The serum phosphorus concentration was inversely correlated to hand grip strength ( = -0.501, < 0.001) among the total of 41 patients. This inverse association was also confirmed after adjusting the effects of estimated glomerular filtration rate, age, and glycated hemoglobin. Thus, cognitive impairment, diabetic peripheral neuropathy, and high serum phosphorus concentrations are associated with hand grip weakness in elderly patients with type 2 DM.
本研究旨在调查血糖控制不佳的老年糖尿病患者中与肌肉减少症相关的因素。我们回顾性分析了41例年龄≥65岁、因糖尿病教育而住院的2型糖尿病患者。根据握力是否减弱将患者分为两组,并比较其临床特征。与握力未减弱的患者(n = 20)相比,握力减弱的患者(n = 21)在简易精神状态检查中的得分更低(24.3对26.5,P = 0.04),糖尿病周围神经病变的患病率更高(76%对40%,P = 0.03),血清磷浓度更高(3.8对3.3 mg/dL,P < 0.01)。在41例患者中,血清磷浓度与握力呈负相关(r = -0.501,P < 0.001)。在调整估算肾小球滤过率、年龄和糖化血红蛋白的影响后,这种负相关关系也得到了证实。因此,认知障碍、糖尿病周围神经病变和高血清磷浓度与老年2型糖尿病患者的握力减弱有关。