肌肉超声在评估 2 型糖尿病老年虚弱患者中的作用。

Role of muscle ultrasound in frailty assessment in older adults with type 2 diabetes mellitus.

机构信息

Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.

出版信息

BMC Geriatr. 2024 May 4;24(1):397. doi: 10.1186/s12877-024-05008-y.

DOI:10.1186/s12877-024-05008-y

PMID:38704521

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11069196/

Abstract

BACKGROUND

Frailty is a geriatric syndrome that is characterized by increased vulnerability to intrinsic and extrinsic stressors due to decreased biologic reserves. Muscle ultrasound (US) is a valid and reliable method for assessing muscle quantity in older adults. The study aims to examine the relationship between frailty definitions and US-derived muscle parameters.

METHODS

We conducted a cross-sectional study with type 2 diabetes mellitus outpatients in a tertiary hospital, and all participants underwent a comprehensive geriatric assessment. For frailty assessment, the Fried Frailty Phenotype (FFP), the Clinical Frailty Scale (CFS), and the Edmonton Frailty Scale (EFS) were performed. Muscle US measurements included Gastrocnemius Medialis (GM) muscle thickness, GM fascicle length, GM pennation angle, Rectus Femoris (RF) muscle thickness, Rectus Femoris cross-sectional area (RFCSA), Rectus Abdominis (RA) muscle thickness, External Oblique (EO) muscle thickness, Internal Oblique (IO) muscle thickness, and Transverse Abdominis (TA) muscle thickness.

RESULTS

In all, 373 participants were included in the study. The median age of participants was 72.7 ± 5.9 years, and 64.6% of them were female. According to the FFP, 18.2% of the participants were living with frailty, 56% of them were pre-frail; 57.4% of them were living with frailty according to the CFS; 25.2% of them were living with frailty, and 20.6% of them were pre-frail according to the EFS. The FFP, CFS, and EFS scores were related to muscle thickness of GM, RF, and RA, fascicle length of GM, and pennation angle of GM and RFCSA. Particularly, GM pennation angle, RF muscle thickness, and RFCSA were associated with an increased risk of frailty. Besides muscle thickness of GM, RF, and RA, fascicle length of GM, pennation angle of GM, and RFCSA were significant for predicting the presence of frailty.

CONCLUSIONS

US-derived regional muscle measurements are associated with frailty definitions (in both physical, cumulative deficit, and multidimensional models) in a diabetic geriatric population.

摘要

背景

衰弱是一种老年综合征，其特征是由于生物储备减少，对内在和外在应激源的易感性增加。肌肉超声（US）是一种评估老年人肌肉量的有效且可靠的方法。本研究旨在探讨衰弱定义与 US 衍生的肌肉参数之间的关系。

方法

我们进行了一项横断面研究，纳入了一家三级医院的 2 型糖尿病门诊患者，所有参与者均接受了全面的老年评估。进行衰弱评估时，采用了 Fried 衰弱表型（FFP）、临床虚弱量表（CFS）和埃德蒙顿虚弱量表（EFS）。肌肉 US 测量包括比目鱼肌（GM）肌肉厚度、GM 肌束长度、GM 羽状角、股四头肌（RF）肌肉厚度、RF 横截面积（RFCSA）、腹直肌（RA）肌肉厚度、腹外斜肌（EO）肌肉厚度、腹内斜肌（IO）肌肉厚度和腹横肌（TA）肌肉厚度。

结果

共有 373 名参与者纳入研究。参与者的中位年龄为 72.7±5.9 岁，其中 64.6%为女性。根据 FFP，18.2%的参与者患有衰弱，56%的参与者为衰弱前期；根据 CFS，57.4%的参与者患有衰弱；根据 EFS，25.2%的参与者患有衰弱，20.6%的参与者为衰弱前期。FFP、CFS 和 EFS 评分与 GM、RF 和 RA 的肌肉厚度、GM 的肌束长度和 GM 及 RFCSA 的羽状角有关。特别是 GM 羽状角、RF 肌肉厚度和 RFCSA 与衰弱风险增加相关。除了 GM、RF 和 RA 的肌肉厚度外，GM 的肌束长度、GM 的羽状角和 RFCSA 对预测衰弱的发生也有意义。