Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan.
Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
J Diabetes Investig. 2021 Jun;12(6):1050-1059. doi: 10.1111/jdi.13436. Epub 2020 Nov 20.
AIMS/INTRODUCTION: The present study aimed to clarify the prevalence and clinical characteristics of sarcopenia and dynapenia, which are muscle weakness with and without low muscle mass, respectively, in Japanese patients with type 1 diabetes mellitus and type 2 diabetes mellitus.
This cross-sectional study enrolled 1,328 participants with type 1 diabetes (n = 177), type 2 diabetes (n = 645) and without diabetes (n = 506). Sarcopenia was defined as a low grip strength and slow gait speed with low skeletal muscle mass index, whereas dynapenia was defined as low strengths of grip and knee extension with a normal skeletal muscle mass index. Participants without sarcopenia and dynapenia were defined as robust.
Among participants aged ≥65 years, sarcopenia and dynapenia were observed in 12.2% and 0.5% of individuals without diabetes, 42.9% and 11.4% of type 1 diabetes patients, and 20.9% and 13.9% of type 2 diabetes patients. In both type 1 diabetes and type 2 diabetes patients, sarcopenic patients were significantly older and thinner, and showed a significantly higher rate of diabetic neuropathy than robust patients. In patients with type 1 diabetes and type 2 diabetes, dynapenic patients were older, and showed a higher rate of diabetic neuropathy and lower estimated glomerular filtration rate than robust patients. Patients complicated with sarcopenia and dynapenia showed a significantly lower physical quality of life and higher rate of incidental falls than robust patients.
Sarcopenia and dynapenia were more frequent in patients with type 1 diabetes and type 2 diabetes than in individuals without diabetes, which might contribute to their impaired quality of life and incidental falls.
目的/引言：本研究旨在阐明肌肉减少症和动力不足症（分别为伴有和不伴有低肌肉量的肌肉无力）在日本 1 型和 2 型糖尿病患者中的患病率和临床特征。
本横断面研究纳入了 1328 名 1 型糖尿病（n=177）、2 型糖尿病（n=645）和无糖尿病患者（n=506）。肌肉减少症定义为低握力和慢步速伴低骨骼肌质量指数，动力不足症定义为低握力和膝关节伸展力伴正常骨骼肌质量指数。无肌肉减少症和动力不足症的患者被定义为强壮。
在≥65 岁的参与者中，无糖尿病者中分别有 12.2%和 0.5%的个体存在肌肉减少症和动力不足症，1 型糖尿病患者中分别有 42.9%和 11.4%的个体存在肌肉减少症和动力不足症，2 型糖尿病患者中分别有 20.9%和 13.9%的个体存在肌肉减少症和动力不足症。在 1 型和 2 型糖尿病患者中，肌肉减少症患者明显更年长、更瘦弱，且糖尿病神经病变的发生率明显高于强壮患者。在 1 型和 2 型糖尿病患者中，动力不足症患者年龄更大，且糖尿病神经病变和估算肾小球滤过率更低的发生率高于强壮患者。同时患有肌肉减少症和动力不足症的患者生活质量明显更低，偶发性跌倒的发生率明显更高。
与无糖尿病者相比，1 型和 2 型糖尿病患者中肌肉减少症和动力不足症更为常见，这可能导致他们生活质量下降和偶发性跌倒。
