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内部的隐秘之战:古吉拉特邦一家三级护理医院中2型糖尿病患者肌肉减少症与肌肉减少性肥胖并存情况的揭示

The Hidden Battle Within: Shedding Light on the Co-existence of Sarcopenia and Sarcopenic Obesity among Participants with Type 2 Diabetes in a Tertiary Care Hospital, Gujarat.

作者信息

Yogesh M, Mody Mansi, Makwana Naresh, Rabadiya Samarth, Patel Jenish, Shah Samyak

机构信息

Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India.

Department of Internal Medicine, Final Year Medical Student, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India.

出版信息

Indian J Endocrinol Metab. 2024 Jan-Feb;28(1):80-85. doi: 10.4103/ijem.ijem_321_23. Epub 2024 Feb 26.

Abstract

INTRODUCTION

Type 2 diabetes (T2DM) is characterised by chronic hyperglycaemia due to abnormal insulin secretion and/or utilisation. Currently, sarcopenia has emerged as a new complication of T2DM, which increases the risk of physical disability, and even death. The study aims to estimate the prevalence of sarcopenia and sarcopenic obesity (SO) as well as their association with various other factors related to T2DM.

METHODS

The study was an observational hospital-based cross-sectional study conducted among diabetic patients who came to the non-communicable diseases (NCD) clinic of a tertiary care hospital in Gujarat, India, from April 2023 to June 2023. Adult patients with T2DM attending follow-ups were included, with a diagnosis of T2DM for at least 1 year from the date of their electronic medical records, regardless of their mode of therapeutic treatment. They were on regular medical reviews with two or more visits to the study site in the past 1 year. Then a self-structured standard questionnaire was used to collect the data, containing socio-demographic characteristics, clinical profiles, anthropometric assessment (comprising weight, height and body mass index [BMI]), bio-impedance indices like body fat%, skeletal muscle% and handgrip by hand dynamometer.

RESULTS

In the study, a total of 404 participants participated. Their mean age was 55 ± 13.5 years and their mean body fat (BF) % was 30 ± 7.4%. BF%-defined obesity was found in 260 (64.4%) participants. A total of 362 (89.6%) had possible sarcopenia, 183 (45.3%) had sarcopenia and 124 (30.7%) had SO. Age (OR: 2.6, CI: 1.7-3.9), duration of diabetes for more than 7 years (OR: 7.5, CI: 3.65-15.4) and BF%-defined obesity (OR: 2.2, CI: 3.6-15) were statistically associated with Sarcopenia, in similar pattern age (OR: 2.4, CI: 1.5-3.7), and duration of diabetes more than 7 years (OR: 18.9, CI: 5.7-62) were associated with SO (P < 0.05).

CONCLUSION

Older age, longer diabetes duration and BF%-defined obesity are associated with an increased likelihood of developing sarcopenia and sarcopenic obesity. Healthcare providers should prioritise regular screening for sarcopenia and SO in elderly individuals with diabetes to facilitate early detection and intervention.

摘要

引言

2型糖尿病(T2DM)的特征是由于胰岛素分泌异常和/或利用异常导致的慢性高血糖。目前,肌肉减少症已成为T2DM的一种新并发症,它会增加身体残疾甚至死亡的风险。本研究旨在估计肌肉减少症和肌肉减少性肥胖(SO)的患病率及其与T2DM相关的各种其他因素的关联。

方法

本研究是一项基于医院的观察性横断面研究,于2023年4月至2023年6月在印度古吉拉特邦一家三级护理医院的非传染性疾病(NCD)诊所就诊的糖尿病患者中进行。纳入了接受随访的成年T2DM患者,自其电子病历日期起诊断为T2DM至少1年,无论其治疗方式如何。他们在过去1年中定期接受医学检查,且到研究地点就诊两次或更多次。然后使用自行构建的标准问卷收集数据,包括社会人口统计学特征、临床概况、人体测量评估(包括体重、身高和体重指数[BMI])、生物电阻抗指标如体脂百分比、骨骼肌百分比以及用握力计测量的握力。

结果

在该研究中,共有404名参与者。他们的平均年龄为55±13.5岁,平均体脂(BF)百分比为30±7.4%。260名(64.4%)参与者被发现存在BF%定义的肥胖。共有362名(89.6%)可能存在肌肉减少症,183名(45.3%)存在肌肉减少症,124名(30.7%)存在SO。年龄(OR:2.6,CI:1.7 - 3.9)、糖尿病病程超过7年(OR:7.5,CI:3.65 - 15.4)和BF%定义的肥胖(OR:2.2,CI:3.6 - 15)与肌肉减少症在统计学上相关,年龄(OR:2.4,CI:1.5 - 3.7)和糖尿病病程超过7年(OR:18.9,CI:5.7 - 62)以类似模式与SO相关(P < 0.05)。

结论

年龄较大、糖尿病病程较长以及BF%定义的肥胖与发生肌肉减少症和肌肉减少性肥胖的可能性增加相关。医疗保健提供者应优先对老年糖尿病患者进行肌肉减少症和SO的定期筛查,以便于早期发现和干预。

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Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis.肌肉减少症的健康结局:一项系统评价与荟萃分析
PLoS One. 2017 Jan 17;12(1):e0169548. doi: 10.1371/journal.pone.0169548. eCollection 2017.

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