Bruce David G, Davis Wendy A, Davis Timothy M E
Medical School, The University of Western Australia, Fremantle Hospital, Alma Street, Fremantle, WA 6160, Australia.
J Clin Med. 2023 Jul 6;12(13):4528. doi: 10.3390/jcm12134528.
To investigate temporal changes in mobility in community-based people with type 2 diabetes, Fremantle Diabetes Study Phase II (FDS2) data were analysed. The baseline assessment included the Timed Up and Go (TUG) test, which was repeated biennially for up to six years. Group-based trajectory modelling (GBTM) identified TUG trajectory groups in participants with ≥2 tests. Independent associates of group membership were assessed using multinomial regression. Of 1551 potential FDS2 participants, 1116 (72.0%; age 64.9 ± 11.0 years, 45.6% female) were included in the modelling. The best-fitting GBTM model identified two groups with linear, minimally changing trajectories (76.2% and 19.4% of participants; baseline TUG times 8 ± 2 and 12 ± 3 s, respectively), and a third (4.5%; baseline TUG 17 ± 5 s) with a TUG that increased over time then fell at Year 6, reflecting participant attrition. Both slower groups were older, more likely to be female, obese, and had greater diabetes-associated complications and comorbidities. Almost one-quarter of the FDS2 cohort had clinically relevant mobility impairment that persisted or worsened over six years, was multifactorial in origin, and was associated with excess late withdrawals and deaths. The TUG may have important clinical utility in assessing mobility and its consequences in adults with type 2 diabetes.
为了研究社区2型糖尿病患者运动能力随时间的变化，我们分析了弗里曼特尔糖尿病研究二期（FDS2）的数据。基线评估包括定时起立行走（TUG）测试，该测试每两年重复一次，最长持续六年。基于组的轨迹建模（GBTM）在进行了≥2次测试的参与者中确定了TUG轨迹组。使用多项回归评估组成员的独立关联因素。在1551名潜在的FDS2参与者中，1116名（72.0%；年龄64.9±11.0岁，45.6%为女性）被纳入建模。拟合度最佳的GBTM模型确定了两组具有线性、变化极小的轨迹（分别占参与者的76.2%和19.4%；基线TUG时间分别为8±2秒和12±3秒），以及第三组（4.5%；基线TUG为17±5秒），其TUG随时间增加，然后在第6年下降，反映了参与者的损耗。较慢的两组年龄更大，更可能为女性、肥胖，并且有更多与糖尿病相关的并发症和合并症。FDS2队列中近四分之一的患者存在临床上相关的运动能力损害，这种损害在六年中持续存在或恶化，其起源是多因素的，并且与过多的晚期退出和死亡相关。TUG在评估2型糖尿病成年人的运动能力及其后果方面可能具有重要的临床应用价值。
