Division of Diabetes, Metabolism and Endocrinology, Kawasaki Medical School, Okayama, Japan.
Geriatr Gerontol Int. 2024 Apr;24(4):410-414. doi: 10.1111/ggi.14864. Epub 2024 Mar 15.
Grip strength (GS) as a surrogate for muscular strength, waist circumference (WC) as a surrogate marker of visceral fat, and body mass index (BMI) as a surrogate marker of obesity should also be considered markers for the management of risks associated with type 2 diabetes mellitus (T2DM). However, in terms of the management of T2DM in elderly patients, the accentuated heterogeneity of sarcopenic change might modify the associations between those factors and glycemic control. In this cross-sectional study, we aimed to clarify the impact of GS, WC, and BMI on hemoglobin A (HbA) in elderly Japanese patients with T2DM.
GS, WC, and BMI were measured in 327 patients. Odds ratios (ORs) and 95% confidence intervals (CIs) for good glycemic control (HbA < 7.0%) were investigated to analyze the three variables as numerical values by dividing them into tertiles. All results were expressed after adjustment was made for the confounders of age, sex, and number of diabetes medications being used by the study participants.
The ORs of GS, WC, and BMI for well-controlled HbA were 1.056 (95% CI, 1.016-1.098), 0.986 (95% CI, 0.960-1.013), and 1.032 (95% CI, 0.959-1.111), respectively. The OR of 3.726 (95% CI, 1.831-7.581) in the high tertile for GS was significantly higher than the OR in the low tertile, and no differences were observed among the tertiles for WC and BMI.
Based on that result, GS was found to have more potential as an effective marker of glycemic control than WC or BMI among elderly Japanese patients with T2DM. Geriatr Gerontol Int 2024; 24: 410-414.
握力(GS)作为肌肉力量的替代指标,腰围(WC)作为内脏脂肪的替代标志物,以及体重指数(BMI)作为肥胖的替代标志物,也应被视为 2 型糖尿病(T2DM)相关风险管理的标志物。然而,在老年患者 T2DM 的管理方面,肌少症变化的明显异质性可能会改变这些因素与血糖控制之间的关联。在这项横断面研究中,我们旨在阐明 GS、WC 和 BMI 对老年日本 T2DM 患者糖化血红蛋白(HbA)的影响。
对 327 例患者进行 GS、WC 和 BMI 测量。通过将三个变量分为三分位数,分析数值值来探讨 ORs 和 95%置信区间(CI)对良好血糖控制(HbA<7.0%)的影响。所有结果均在调整参与者的年龄、性别和使用的糖尿病药物数量等混杂因素后表示。
GS、WC 和 BMI 对 HbA 控制良好的 OR 分别为 1.056(95%CI,1.016-1.098)、0.986(95%CI,0.960-1.013)和 1.032(95%CI,0.959-1.111)。GS 高三分位的 OR 为 3.726(95%CI,1.831-7.581),明显高于低三分位,而 WC 和 BMI 三分位之间没有差异。
基于该结果,与 WC 或 BMI 相比,GS 被发现是老年日本 T2DM 患者血糖控制的更有效标志物。