SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One Tower 5 #15-10, Singapore, 150167, Singapore.
Duke NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
BMC Geriatr. 2022 May 21;22(1):446. doi: 10.1186/s12877-022-03098-0.
Muscle health decline with age, but its deterioration in older persons with type-2 diabetes mellitus (T2DM) over time is not well-established. This study aimed to determine the change in muscle mass, handgrip strength and gait speed over time among community-dwelling ambulatory older multi-ethnic Asian patients with T2DM and their associated factors.
Among 387 eligible patients aged 60-89 years who were recruited at baseline, 348 (89.9%) were reviewed at a public primary care clinic in Singapore in the subsequent 9 to 34 months. The change in their clinical and functional status, levels of physical activity and muscle status (mass, grip strength and gait speed based on the Asian Working Group for Sarcopenia criteria) were recorded and compared. Their physical activity levels were assessed using the Physical Activity Scale for the Elderly (PASE) and International Physical Activity Questionnaire (IPAQ). Their quality of life was evaluated based on the World Health Organization Quality of Life (WHOQOL) domains. Linear regression analysis was used to identify the factors associated with muscle health change.
The study population comprised men (52.9%), Chinese (69.3%), mean age of 68.4 ± SD5.6 years and had at least secondary education (76.4%). Their mean muscle mass significantly decreased by 0.03 ± SD0.06 kg/m/month, mean handgrip strength by 0.06 ± SD0.26 kg/month and negligible change in gait speed of 0.002 ± SD0.01 m/sec/month. Their mean weight significantly decreased by 0.5 ± SD3.9 kg, waist and hip circumferences by 2.5 ± SD6cm and 3.2 ± SD5.1 cm respectively, with no change in BMI. Linear regression shows significant associations between muscle mass change and education level (β = 0.36,p = 0.012, 95% CI = 0.08-0.64), BMI (β = 0.11,p = < 0.001, 95% CI = 0.05-0.17), change in medication class (β = 0.39,p = < 0.001, 95% CI = 0.06-0.71) and review interval (β = - 0.003, p < 0.001, 95% CI = -0.004--0.002). Gait speed change was associated with singlehood (β = - 0.13,p = 0.029, 95% CI = -0.25--0.01) and WHOQOL physical health (β = 0.01,p = 0.024, 95% CI = 0.00-0.02) domain. No factor was associated with handgrip strength change.
The study population with T2DM showed significant decline in their mean weight, waist and hip circumferences, mean muscle mass and mean grip strength but gait speed was unaffected. Muscle mass change was associated with education level, BMI and length of review interval. Handgrip strength change was not significantly correlated with any factor. Gait speed change was associated with singlehood and physical health.
肌肉健康随年龄增长而衰退，但 2 型糖尿病（T2DM）老年人的肌肉衰退随时间推移而恶化的情况尚不清楚。本研究旨在确定社区居住的多民族亚洲 T2DM 患者的肌肉质量、握力和步态速度随时间的变化及其相关因素。
在基线时招募的 387 名年龄在 60-89 岁的合格患者中，348 名（89.9%）在新加坡的一家公立初级保健诊所进行了后续 9 至 34 个月的复查。记录并比较了他们临床和功能状况、身体活动水平以及肌肉状况（根据亚洲肌肉减少症工作组标准的肌肉质量、握力和步态速度）的变化。使用体力活动量表（PASE）和国际体力活动问卷（IPAQ）评估他们的身体活动水平。根据世界卫生组织生活质量（WHOQOL）领域评估他们的生活质量。使用线性回归分析确定与肌肉健康变化相关的因素。
研究人群包括男性（52.9%）、中国人（69.3%），平均年龄为 68.4 ± 5.6 岁，至少受过中学教育（76.4%）。他们的平均肌肉质量每月显著减少 0.03 ± 0.06 公斤/米，平均握力每月减少 0.06 ± 0.26 公斤，步态速度每月仅略有变化，为 0.002 ± 0.01 米/秒。他们的平均体重显著下降 0.5 ± 3.9 公斤，腰围和臀围分别减少 2.5 ± 6 厘米和 3.2 ± 5.1 厘米，而 BMI 没有变化。线性回归显示肌肉质量变化与教育水平（β=0.36，p=0.012，95%CI=0.08-0.64）、BMI（β=0.11，p<0.001，95%CI=0.05-0.17）、药物类别变化（β=0.39，p<0.001，95%CI=0.06-0.71）和复查间隔（β=-0.003，p<0.001，95%CI=-0.004--0.002）显著相关。步态速度变化与单身（β=-0.13，p=0.029，95%CI=-0.25--0.01）和 WHOQOL 身体健康（β=0.01，p=0.024，95%CI=0.00-0.02）领域相关。没有任何因素与握力变化相关。
患有 T2DM 的研究人群体重、腰围和臀围、平均肌肉质量和平均握力均显著下降，但步态速度不受影响。肌肉质量变化与教育水平、BMI 和复查间隔长度有关。握力变化与任何因素均无显著相关性。步态速度变化与单身和身体健康有关。
