Department of Endocrinology, Hefei Second People's Hospital Affiliated to Bengbu Medical University, Anhui, Hefei, China.
Eur Rev Med Pharmacol Sci. 2023 Mar;27(5):1912-1920. doi: 10.26355/eurrev_202303_31557.
Growing evidence shows that sarcopenia is more prevalent in patients with type 2 diabetes mellitus (T2DM) than in the normal population. However, currently, data on the relationship between blood glucose fluctuation and sarcopenia in elderly patients with T2DM are still limited.
In this study, 280 patients ≥ 60 years with T2DM were divided into sarcopenic group and non-sarcopenic group, according to the diagnostic criteria of the 2019 Asian Working Group for Sarcopenia. They wore MeiQi to acquire the indexes including time in range (TIR), time above range (TAR), time below range (TBR), mean amplitude of glycemic excursion (MAGE), coefficient of Variation (CV), blood glucose standard deviation (SD), largest amplitude of glycemic excursions (LAGE) and mean glucose (MG). The prevalence rate of sarcopenia was statistically analyzed and the different indicators of glucose fluctuation between the two groups were compared. We analyzed the indexes of glucose fluctuation and appendicular skeletal muscle mass index (ASMI), handgrip strength, the time of five times sit to stand test (FTSST) with Spearman's correlation analysis. Logistic regression was used to analyze the influence factors for sarcopenia.
The prevalence of sarcopenia was 15.36%. TIR, MG and TAR were correlated with ASMI, handgrip strength, the time of FTSST. MG and TAR were risk factors for sarcopenia, while TIR was the protective factor of sarcopenia. After adjusting mixing factors, logistic regression analysis showed that TIR was an independent protective factor. The result of the Chi-square test showed that the incidence of sarcopenia in different TIR ranges was different: the proportion of patients with sarcopenia was 40.48% (TIR ≤50%), 20.41% (50%<TIR≤70%) and 8.47% (TIR >70%).
TIR is associated with sarcopenia in elderly T2DM patients. Furtherly, the incidence rate of sarcopenia decreases with the increase of TIR.
越来越多的证据表明，与普通人群相比，2 型糖尿病（T2DM）患者的肌少症更为普遍。然而，目前关于老年 T2DM 患者血糖波动与肌少症之间关系的数据仍然有限。
本研究根据 2019 年亚洲肌少症工作组的诊断标准，将 280 例年龄≥60 岁的 T2DM 患者分为肌少症组和非肌少症组。他们佩戴美奇血糖仪，获取时间在目标范围内（TIR）、血糖高于目标范围（TAR）、血糖低于目标范围（TBR）、血糖波动幅度的平均值（MAGE）、变异系数（CV）、血糖标准差（SD）、血糖波动最大幅度（LAGE）和平均血糖（MG）等指标。统计分析肌少症的患病率，并比较两组间血糖波动的不同指标。我们采用 Spearman 相关分析对血糖波动指标与四肢骨骼肌质量指数（ASMI）、握力、五次坐站试验（FTSST）时间进行分析。采用 Logistic 回归分析肌少症的影响因素。
肌少症的患病率为 15.36%。TIR、MG 和 TAR 与 ASMI、握力、FTSST 时间相关。MG 和 TAR 是肌少症的危险因素，而 TIR 是肌少症的保护因素。调整混杂因素后，Logistic 回归分析显示 TIR 是独立的保护因素。卡方检验结果显示，不同 TIR 范围内肌少症的发生率不同：TIR≤50%、50%<TIR≤70%和 TIR>70%的患者中肌少症的比例分别为 40.48%、20.41%和 8.47%。
TIR 与老年 T2DM 患者的肌少症相关。进一步的，随着 TIR 的增加，肌少症的发生率降低。
