1 型糖尿病中老年患者的身体机能：糖尿病控制和并发症试验/糖尿病干预和并发症流行病学研究的长期随访。
Physical Function in Middle-aged and Older Adults With Type 1 Diabetes: Long-term Follow-up of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study.
机构信息
Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
Biostatistics Center, The George Washington University, Rockville, MD.
出版信息
Diabetes Care. 2022 Sep 1;45(9):2037-2045. doi: 10.2337/dc21-2119.
OBJECTIVE
To describe the prevalence and clinical correlates of functional limitations in middle-aged and older adults with long-standing type 1 diabetes.
RESEARCH DESIGN AND METHODS
Functional limitations were assessed for 1,094 participants in the Epidemiology of Diabetes Interventions and Complications (EDIC) study, a multicenter, longitudinal, observational follow-up of participants with type 1 diabetes randomly assigned to intensive or conventional diabetes therapy during the Diabetes Control and Complications Trial (DCCT). The primary outcome measure was a score <10 on the Short Physical Performance Battery (SPPB). The secondary outcome, self-reported functional limitation, was assessed by written questionnaire. Logistic regression models were used to assess associations of both outcomes with demographic and clinical factors (glycemic and nonglycemic factors, micro- and macrovascular complications, DCCT cohort, and treatment assignment).
RESULTS
Participants were 53% male, with mean ± SD age 59.5 ± 6.8 years and diabetes duration 37.9 ± 4.9 years. The prevalence of SPPB score <10 was 21%. The prevalence of self-reported functional limitations was 48%. While DCCT treatment assignment was not associated with physical function outcomes measured ∼25 years after the end of the DCCT, the time-weighted mean DCCT/EDIC HbA1c was associated with both outcomes. Other clinical factors associated with both outcomes in multivariable analyses were BMI, general psychological distress, and cardiac autonomic neuropathy.
CONCLUSIONS
Almost half of the middle-aged and older adults with long-standing type 1 diabetes reported functional limitations, which were associated with higher HbA1c and BMI, general psychological distress, and cardiac autonomic neuropathy. Future research is needed to determine whether these findings are generalizable.
目的
描述中年和老年长期 1 型糖尿病患者的功能障碍的流行率和临床相关性。
研究设计和方法
在糖尿病控制和并发症试验（DCCT）期间随机分配接受强化或常规糖尿病治疗的参与者的多中心、纵向、观察性随访研究——糖尿病并发症流行病学（EDIC）研究中，评估了 1094 名参与者的功能障碍。主要结局测量是短体物理表现电池（SPPB）得分<10。次要结局，即自我报告的功能障碍，通过书面问卷进行评估。使用逻辑回归模型评估两种结果与人口统计学和临床因素（血糖和非血糖因素、微血管和大血管并发症、DCCT 队列和治疗分配）的关联。
结果
参与者中男性占 53%，平均年龄±标准差为 59.5±6.8 岁，糖尿病病程 37.9±4.9 年。SPPB 评分<10 的患病率为 21%。自我报告的功能障碍患病率为 48%。虽然 DCCT 治疗分配与 DCCT 结束后约 25 年测量的身体功能结果无关，但加权平均 DCCT/EDIC HbA1c 与两种结果均相关。多变量分析中与两种结果相关的其他临床因素包括 BMI、一般心理困扰和心脏自主神经病变。
结论
近一半的中年和老年长期 1 型糖尿病患者报告存在功能障碍，这与较高的 HbA1c 和 BMI、一般心理困扰和心脏自主神经病变相关。需要进一步研究以确定这些发现是否具有普遍性。
Zotero 插件