手部握力低与老年 2 型糖尿病患者的糖尿病足病有关。
Low handgrip strength is associated with diabetic foot disease in geriatric patients with type 2 diabetes.
机构信息
Department of Endocrinology and Metabolism, Dr. Ersin Arslan Education and Research Hospital, Gaziantep, Turkey.
Department of Orthopaedics and Traumatology, Abdulkadir Yüksel State Hospital, Gaziantep, Turkey.
出版信息
Turk J Med Sci. 2022 Dec;52(6):1854-1862. doi: 10.55730/1300-0144.5532. Epub 2022 Dec 21.
BACKGROUND
This study aims to reveal the prevalence of low handgrip strength in older patients with type 2 diabetes who have diabetic foot disease and to assess the association of handgrip strength with diabetic foot disease in older patients with type 2 diabetes.
METHODS
Eighty-nine geriatric patients with diabetic foot ulcers and 69 patients without diabetic foot ulcers who presented to the endocrinology outpatient clinic between August 2020 and November 2021 were included in the study. The exclusion criteria were the usage of steroids, stroke-induced quadriplegia, myopathy, disability, hemodialysis treatment, type 1 diabetes, patients under 65 years of age, and history of malignancy. The information of drugs administered, demographic and clinical data were obtained from the patient files. The Wagner score was used to evaluate the severity of ulcers. A handgrip strength test was performed with a handheld digital dynamometer. For females <16 kg (kilograms), for males <27 kg was accepted as low handgrip strength.
RESULTS
Forty-nine patients (55.1%) with diabetic foot ulcers and 25 (36.2%) patients without diabetic foot ulcers had low handgrip strength. There was a significant difference between two groups (p = 0.019). The patients with diabetic foot ulcers who had lower handgrip strength had higher rates of peripheral artery disease than patients with diabetic foot ulcers who had normal handgrip strength (p = 0.02 and p = 0.009, respectively). The patients with diabetic foot ulcers who had lower handgrip strength, had significantly higher rates of Wagner scores 4 and 5 and lower rates of Wagner scores 1 and 3 (p = 0.039).
DISCUSSION
Older patients with type 2 diabetes and diabetic foot disease had a higher rate of low handgrip strength. Low handgrip strength was significantly associated with the occurrence of diabetic foot ulcers and directly correlated with Wagner score in geriatric patients with type 2 diabetes.
背景
本研究旨在揭示患有 2 型糖尿病合并糖尿病足病的老年患者中低握力的患病率，并评估 2 型糖尿病老年患者的握力与糖尿病足病之间的关系。
方法
本研究纳入了 2020 年 8 月至 2021 年 11 月期间在内分泌科门诊就诊的 89 例伴有糖尿病足溃疡的老年患者和 69 例无糖尿病足溃疡的患者。排除标准为使用类固醇、中风引起的四肢瘫痪、肌病、残疾、血液透析治疗、1 型糖尿病、年龄<65 岁和恶性肿瘤病史。从患者病历中获取药物使用情况、人口统计学和临床数据。采用 Wagner 评分评估溃疡严重程度。使用手持数字测力计进行握力测试。女性<16kg，男性<27kg 被认为是低握力。
结果
49 例（55.1%）糖尿病足溃疡患者和 25 例（36.2%）无糖尿病足溃疡患者存在低握力。两组之间存在显著差异（p=0.019）。握力较低的糖尿病足溃疡患者外周动脉疾病的发生率高于握力正常的糖尿病足溃疡患者（分别为 p=0.02 和 p=0.009）。握力较低的糖尿病足溃疡患者的 Wagner 评分 4 和 5 发生率显著较高，而 Wagner 评分 1 和 3 的发生率显著较低（p=0.039）。
讨论
患有 2 型糖尿病和糖尿病足病的老年患者握力较低的发生率较高。低握力与 2 型糖尿病老年患者糖尿病足溃疡的发生显著相关，且与 Wagner 评分直接相关。
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