Çavdar Sibel, Kocak Fatma Ozge Kayhan, Savas Sumru
Division of Geriatrics, Department of Internal Medicine, Ege University Hospital, Izmir, Turkiye.
PLoS One. 2025 Jan 30;20(1):e0317250. doi: 10.1371/journal.pone.0317250. eCollection 2025.
The association of muscle weakness with poor outcomes is well defined in general older population, but there is insufficient data on the association of muscle weakness with functionality in older patients with diabetes mellitus (DM). We aimed to investigate the predictivity of muscle weakness defined as low grip strength thresholds determined by EWGSOP2, and two regional thresholds in older patients with DM for functional disability. Activities of Daily Living (ADL), Instrumental ADL (IADL), grip strength, comorbidities, anthropometric and biochemical data from outpatient clinic medical records were screened retrospectively. Low grip strength was determined by EWGSOP2, and two regional thresholds. Receiver operating characteristic (ROC) analysis, sensitivity and negative predictive values were conducted to identify the discrimination power of three different grip strength thresholds for functional disability in patients with DM. A total of 197 patients with DM and 215 controls were included. In ROC analyses, regional thresholds were with higher sensitivity and negative predictive values for functional disability in both groups. For patients with DM, regional normative thresholds predicted functional disability both for ADLs and IADLs whereas for patients without DM normative thresholds predicted ADL, and calculated thresholds predicted IADL disability. Regional normative thresholds predicted both ADL and IADL functional disability in older patients with DM.
在一般老年人群中,肌肉无力与不良预后之间的关联已得到明确界定,但关于老年糖尿病患者肌肉无力与功能之间关联的数据不足。我们旨在研究将肌肉无力定义为根据EWGSOP2确定的低握力阈值以及两个区域阈值,对老年糖尿病患者功能残疾的预测性。回顾性筛查门诊病历中的日常生活活动(ADL)、工具性ADL(IADL)、握力、合并症、人体测量和生化数据。根据EWGSOP2以及两个区域阈值确定低握力。进行受试者工作特征(ROC)分析、敏感性和阴性预测值分析,以确定三种不同握力阈值对糖尿病患者功能残疾的辨别能力。共纳入197例糖尿病患者和215例对照。在ROC分析中,区域阈值对两组功能残疾的敏感性和阴性预测值更高。对于糖尿病患者,区域规范阈值可预测ADL和IADL的功能残疾;而对于非糖尿病患者,规范阈值可预测ADL,计算得出的阈值可预测IADL残疾。区域规范阈值可预测老年糖尿病患者的ADL和IADL功能残疾。