男性心血管疾病患者的周围感觉神经功能、2 型糖尿病与虚弱
Peripheral sensory nerve function, type 2 diabetes and frailty among men with cardiovascular disease.
机构信息
The Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
出版信息
J Diabetes Complications. 2022 Dec;36(12):108337. doi: 10.1016/j.jdiacomp.2022.108337. Epub 2022 Oct 11.
OBJECTIVE
To investigated the cross-sectional association between peripheral sensory nerve function and frailty among community-dwelling men, and examine whether type 2 diabetes (T2D) modifies this association.
METHODS
A sample of 349 men [mean age = 77.1 ± 6.4 years; 37 % with T2D] who previously (1990-1998) participated in the Bezafibrate Infarction Prevention (BIP) trial, underwent assessment of frailty and legs vibratory thresholds (LVT), a measure of peripheral sensory nerve function, as part of the BIP Neurocognitive study during 2011-2013. LVT was assessed using a graduated tuning fork and frailty was assessed using the Fried criteria. An ordered logistic regression model was used to assess the link between LVT and degrees of frailty and to test for effect modification by T2D.
RESULTS
Overall, 117 (33.5 %) of patients were non-frail, 134 (38.4 %) pre-frail, and 98 (28.1 %) frail. A significant interaction between LVT and T2D with regard to frailty was found. Among men with T2D, estimated OR (95%CI) for increasing frailty at the 1st, 2nd, and 3rd as compared to the top LVT quartile were 13.5 (3.4-54.3), 5.9 (1.5-23.5), and 4.4 (1.20-16.0), respectively. Among men without T2D, the estimated ORs for increasing frailty in patients at the 1st, 2nd, and 3rd quartiles compared to the top LVT quartile were 2.8 (1.1-7.4), 1.6 (0.6-4.1), and 2.5 (1.0-6.5), respectively.
CONCLUSION
Frailty is significantly associated with worsening peripheral sensory nerve function, particularly among men with T2D.
目的
调查社区居住男性外周感觉神经功能与虚弱之间的横断面关联，并检验 2 型糖尿病（T2D）是否改变这种关联。
方法
本研究纳入了曾于 1990-1998 年参加贝扎贝特梗死预防（BIP）试验的 349 名男性（平均年龄为 77.1±6.4 岁，37%患有 T2D），他们在 2011-2013 年期间参加了 BIP 神经认知研究，评估了虚弱程度和腿部振动阈值（LVT），LVT 是外周感觉神经功能的一种衡量指标。LVT 使用逐渐变细的音叉进行评估，虚弱程度使用 Fried 标准进行评估。采用有序逻辑回归模型评估 LVT 与虚弱程度之间的联系，并检验 T2D 的效应修饰作用。
结果
共有 117 名（33.5%）患者无虚弱，134 名（38.4%）患者为虚弱前期，98 名（28.1%）患者为虚弱。发现 LVT 与 T2D 之间存在显著的交互作用，与 LVT 最高四分位数相比，患有 T2D 的男性在第 1、2 和 3 四分位数时，虚弱程度增加的估计比值比（95%CI）分别为 13.5（3.4-54.3）、5.9（1.5-23.5）和 4.4（1.20-16.0）。在没有 T2D 的男性中，与 LVT 最高四分位数相比，在第 1、2 和 3 四分位数的患者中，虚弱程度增加的估计比值比分别为 2.8（1.1-7.4）、1.6（0.6-4.1）和 2.5（1.0-6.5）。
结论
虚弱与外周感觉神经功能恶化显著相关，尤其是在患有 T2D 的男性中。
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