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肌肉减少症作为 II 型糖尿病的一种未被充分认识的合并症:诊断与治疗的综述。

Sarcopenia as a Little-Recognized Comorbidity of Type II Diabetes Mellitus: A Review of the Diagnosis and Treatment.

机构信息

Hospital Universitario Doctor Peset, 46017 Valencia, Spain.

Hospital Universitario de la Ribera, 46600 Alzira, Spain.

出版信息

Nutrients. 2023 Sep 26;15(19):4149. doi: 10.3390/nu15194149.

Abstract

BACKGROUND

Type II diabetes mellitus (T2DM) is one of the most widespread metabolic diseases worldwide, with a significant impact on morbi-mortality. Sarcopenia has a high risk in this population (two times more risk) and a high impact at the functional level, especially in older adults. In addition, it poses enormous challenges in the diagnosis, prevention, and treatment of this disease concomitantly. The objective is to review the current knowledge on the state of muscle mass and the pathogenesis, diagnosis, and treatment of sarcopenia in people with T2DM.

METHODS

A bibliographic search was conducted in the PubMed-Medline databases for articles from 2015 with previously defined terms.

RESULTS

A loss of muscle mass in older diabetic patients who are malnourished or at risk of malnutrition has a proven negative impact on their autonomy and is closely related to the risk of sarcopenia as a high-impact disease, and also with frailty, as an associated multidimensional syndrome. Notably, we found that malnutrition and protein deficiency are often underdiagnosed in obese and overweight T2DM patients. Biochemical markers could help in the future with approaches to managing T2DM and sarcopenia concomitantly. The four essential elements which form the basis of care for patients with diabetes and sarcopenia are pharmacological treatment, nutrition management, regular physical exercise, and correct daily regime.

CONCLUSIONS

The increasing prevalence of sarcopenia among older patients with T2DM has significant negative impacts on quality of life and is a public health concern. Effective diagnosis and management require a multidisciplinary approach involving pharmacological treatment, nutrition, exercise, and correct daily regime, with future research needed to understand the underlying mechanisms and improve diagnostic and treatment strategies.

摘要

背景

2 型糖尿病(T2DM)是全球最普遍的代谢疾病之一,对病死率和发病率有重大影响。在该人群中,肌少症风险很高(风险增加两倍),对功能水平影响很大,尤其是在老年人中。此外,它在诊断、预防和治疗这种疾病方面带来了巨大挑战。目的是综述 T2DM 患者肌肉质量状况以及肌少症的发病机制、诊断和治疗的现有知识。

方法

在 PubMed-Medline 数据库中,使用先前定义的术语对 2015 年以来的文献进行了文献检索。

结果

营养不良或有营养不良风险的老年糖尿病患者的肌肉质量损失对其自主性有负面影响,与肌少症风险密切相关,因为肌少症是一种高影响疾病,还与衰弱有关,因为衰弱是一种相关的多维综合征。值得注意的是,我们发现肥胖和超重的 T2DM 患者中,营养不良和蛋白质缺乏常常被漏诊。生化标志物可能有助于未来同时管理 T2DM 和肌少症。糖尿病和肌少症患者护理的四个基本要素是药物治疗、营养管理、定期体育锻炼和正确的日常作息。

结论

T2DM 老年患者中肌少症的患病率不断增加,对生活质量有重大负面影响,是一个公共卫生关注点。有效的诊断和管理需要多学科方法,包括药物治疗、营养、运动和正确的日常作息,需要进一步研究以了解潜在机制并改善诊断和治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce04/10574035/8dab1f140137/nutrients-15-04149-g001.jpg

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