Chen Yanli, Liao Jinni, Zeng Yanhong, Ma Huixin, Jiang Chahua, Yu Shuzhen, Wang Xiaoxia, Zhong Qi
Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China.
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China.
Eur Geriatr Med. 2024 Dec;15(6):1881-1890. doi: 10.1007/s41999-024-01039-1. Epub 2024 Sep 19.
Diabetes mellitus (DM) and sarcopenia are bidirectionally linked and commonly co-occur among middle-aged and elderly individuals. This study aims to examine the combined effect of DM and sarcopenia on depressive symptoms and cognitive function.
This was a nationwide cohort study using data from the China Health and Retirement Longitudinal Study. The definition of DM was self-reported and based on hemoglobin A1c (HbA1c) ≥ 6.5% or fasting blood glucose (FBG) ≥ 126 mg/dL. The diagnosis of sarcopenia was based on the Asian Working Group for Sarcopenia 2019 algorithm. The outcomes included depressive symptoms assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and cognitive function. Multi-adjusted linear and logistic regression models were conducted to evaluate the combined effect of DM and sarcopenia on depression and cognitive performance.
9148 participants were included in the longitudinal analysis, with 45.5% being men and an average age of 57.4 years. 6987 (76.4%) participants had neither DM nor sarcopenia, 1076 (11.8%) had DM only, 983 (10.8%) had sarcopenia only, and 102 (1.1%) had both DM and sarcopenia. In the cross-sectional analysis, the DM (+)/Sarcopenia (+) group exhibited the highest CES-D-10 score (β: 2.23, 95% confidence interval (CI): 1.26, 3.19) and the lowest cognitive score (β: - 1.02, 95% CI - 1.79, - 0.26) (P for trend < 0.05). In the longitudinal analysis, individuals in the DM (+)/Sarcopenia ( +) group had higher risks of moderate-to-severe depression (odds ratio (OR): 2.09, 95% CI 1.18, 3.71) and cognitive decline (OR: 1.87, 95% CI 1.19, 2.95) compared to the DM (-)/Sarcopenia (-) group. The population attributable fractions of DM and sarcopenia were 42.2% (95% CI 6.3, 90.4) for moderate-to-severe depression and 23.0% (95% CI 8.6, 39.3) for cognitive decline.
DM and sarcopenia additively increase the risk of moderate-to-severe depression and cognitive impairment, highlighting the importance of vigilant monitoring and management of these conditions to preserve mental health in middle-aged and elderly individuals.
糖尿病（DM）与肌肉减少症双向关联，在中老年人群中普遍共存。本研究旨在探讨糖尿病和肌肉减少症对抑郁症状和认知功能的综合影响。
这是一项全国性队列研究，使用了中国健康与养老追踪调查的数据。糖尿病的定义基于自我报告，依据糖化血红蛋白（HbA1c）≥6.5%或空腹血糖（FBG）≥126mg/dL。肌肉减少症的诊断基于2019年亚洲肌肉减少症工作组的算法。研究结果包括使用10项流行病学研究中心抑郁量表（CES-D-10）评估的抑郁症状和认知功能。采用多因素调整线性和逻辑回归模型来评估糖尿病和肌肉减少症对抑郁和认知表现的综合影响。
9148名参与者纳入纵向分析，其中45.5%为男性，平均年龄57.4岁。6987名（76.4%）参与者既无糖尿病也无肌肉减少症，1076名（11.8%）仅患有糖尿病，983名（10.8%）仅患有肌肉减少症，102名（1.1%）同时患有糖尿病和肌肉减少症。在横断面分析中，糖尿病（+）/肌肉减少症（+）组的CES-D-10得分最高（β：2.23，95%置信区间（CI）：1.26，3.19），认知得分最低（β：-1.02，95%CI -1.79，-0.26）（趋势P<0.05）。在纵向分析中，与糖尿病（-）/肌肉减少症（-）组相比，糖尿病（+）/肌肉减少症（+）组的个体发生中重度抑郁（优势比（OR）：2.09，95%CI 1.18，3.71）和认知衰退（OR：1.87，95%CI 1.19，2.95）的风险更高。糖尿病和肌肉减少症导致中重度抑郁的人群归因分数为42.2%（95%CI 6.3，90.4），导致认知衰退的人群归因分数为23.0%（95%CI 8.6，39.3）。
糖尿病和肌肉减少症会增加中重度抑郁和认知障碍的风险，凸显了对这些情况进行密切监测和管理以维护中老年人群心理健康的重要性。
