衰弱的老年高血压患者的高血糖与身体损伤。

Hyperglycemia and Physical Impairment in Frail Hypertensive Older Adults.

机构信息

ASL Avellino, Avellino, Italy.

ASL Caserta, Caserta, Italy.

出版信息

Front Endocrinol (Lausanne). 2022 Apr 14;13:831556. doi: 10.3389/fendo.2022.831556. eCollection 2022.

DOI:10.3389/fendo.2022.831556

PMID:35498439

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9048203/

Abstract

BACKGROUND

Frailty is a multidimensional condition typical of elders. Frail older adults have a high risk of functional decline, hospitalization, and mortality. Hypertension is one of the most common comorbidities in elders. Hyperglycemia (HG) is frequently observed in frail older adults, and represents an independent predictor of worst outcomes, with or without diabetes mellitus (DM). We aimed at investigating the impact of HG on physical impairment in frailty.

METHODS

We studied consecutive older adults with frailty and hypertension at the ASL (local health unit of the Italian Ministry of Health) of Avellino, Italy, from March 2021 to September 2021. Exclusion criteria were: age <65 years, no frailty, no hypertension, left ventricular ejection fraction <25%, previous myocardial infarction, previous primary percutaneous coronary intervention and/or coronary artery bypass grafting. Blood glucose, Hb1Ac, and creatinine were measured in all patients. Physical frailty was assessed applying the Fried Criteria; we performed a 5-meter gait speed (5mGS) test in all patients.

RESULTS

149 frail hypertensive older adults were enrolled in the study, of which 82 had normoglycemia (NG), and 67 had HG. We observed a significantly slower 5mGS in the HG group compared to the NG group (0.52 ± 0.1 . 0.69 ± 0.06; p<0.001). Moreover, we found a strong and significant correlation between 5mGS and glycemia (r: 0.833; p<0.001). A multivariable linear regression analysis using 5mGS as a dependent variable revealed a significant independent association with glycemia (p<0.001) after adjusting for likely confounders.

CONCLUSIONS

HG drives physical impairment in frail hypertensive older adults independently of DM.

摘要

背景

衰弱是老年人的一种多维状态。衰弱的老年人功能下降、住院和死亡的风险较高。高血压是老年人最常见的合并症之一。高血糖（HG）在衰弱的老年人中经常观察到，并且是无论是否患有糖尿病（DM），预后最差的独立预测因素之一。我们旨在研究 HG 对衰弱患者身体损伤的影响。

方法

我们研究了 2021 年 3 月至 2021 年 9 月在意大利阿韦利诺 ASL（意大利卫生部地方卫生单位）的衰弱合并高血压的连续老年人。排除标准为：年龄<65 岁，无衰弱，无高血压，左心室射血分数<25%，既往心肌梗死，既往经皮冠状动脉介入治疗和/或冠状动脉旁路移植术。所有患者均测量血糖、Hb1Ac 和肌酐。所有患者均进行了 5 米步态速度（5mGS）测试，以评估身体衰弱。

结果

共纳入 149 例衰弱的高血压老年患者，其中 82 例血糖正常（NG），67 例血糖高（HG）。HG 组的 5mGS 明显慢于 NG 组（0.52 ± 0.1 比 0.69 ± 0.06；p<0.001）。此外，我们发现 5mGS 与血糖之间存在强而显著的相关性（r：0.833；p<0.001）。多变量线性回归分析以 5mGS 为因变量，在调整可能的混杂因素后，发现血糖与 5mGS 有显著的独立关联（p<0.001）。