Aguiar Maísa Braga, Kim Solomon, Bortoluzzo Adriana Bruscato, Di Tommaso Ana Beatriz, Cendoroglo Maysa Seabra, Colleoni Gisele W B
Discipline of Geriatrics and Gerontology, Paulista School of Medicine, Federal University of São Paulo, Rua dos Otonis, 863, Vila Clementino, São Paulo, SP, ZIP CODE 04025-002, Brazil.
Insper - Instituto de Ensino e Pesquisa, São Paulo, Brazil.
Acta Diabetol. 2025 Jan 31. doi: 10.1007/s00592-025-02448-9.
Sarcopenia is a common condition in the elderly, especially in diabetics (DM). Metformin (MTF), known to reduce glucose levels, can also be a therapeutic intervention in age-related diseases, although it may contribute to muscle loss.
To compare the prevalence of sarcopenia among elderly people treated for DM, with or without MTF, and non-diabetic patients (NDM) and evaluate whether there is an association between the use of MTF and the development of sarcopenia.
194 independent elderly people over 80 years old were analyzed. Sarcopenia was defined by handgrip (HG), calf circumference (CC), and gait speed (GS). Non-parametric statistical analysis and Kaplan-Meier survival curves were used.
The prevalence of DM was 24.7%, of which 56.25% used MTF. The median fasting blood glucose in the NDM and DM groups was 95 and 104 mg/dL. The median glycated hemoglobin in the NDM and DM groups was 5.7% and 6.4%. There was no statistical difference between the DM and NDM groups when comparing clinical characteristics, functionality, weight, physical tests, and mortality. The prevalence of sarcopenia was similar between NDM and DM (16.55% and 14.63%), with few cases of severe sarcopenia in both groups, without statistical differences. We did not find differences in the same variables when we analyzed NDM and DM using or not MTF. Survival curves showed no significant differences between patients with and without sarcopenia/severe sarcopenia.
Long-lived people with well-controlled DM did not show significant differences concerning those without DM for the outcome of sarcopenia or death.
肌肉减少症在老年人中很常见，尤其是糖尿病患者（DM）。已知二甲双胍（MTF）可降低血糖水平，它也可能是一种针对与年龄相关疾病的治疗干预措施，尽管它可能会导致肌肉流失。
比较接受DM治疗（使用或不使用MTF）的老年人与非糖尿病患者（NDM）中肌肉减少症的患病率，并评估MTF的使用与肌肉减少症的发生之间是否存在关联。
对194名80岁以上的独立老年人进行分析。通过握力（HG）、小腿围（CC）和步速（GS）来定义肌肉减少症。使用非参数统计分析和Kaplan-Meier生存曲线。
DM的患病率为24.7%，其中56.25%使用MTF。NDM组和DM组的空腹血糖中位数分别为95和104mg/dL。NDM组和DM组的糖化血红蛋白中位数分别为5.7%和6.4%。在比较临床特征、功能、体重、身体检查和死亡率时，DM组和NDM组之间没有统计学差异。NDM组和DM组的肌肉减少症患病率相似（分别为16.55%和14.63%），两组中严重肌肉减少症的病例都很少，无统计学差异。当我们分析使用或不使用MTF的NDM和DM时，在相同变量上未发现差异。生存曲线显示，有或没有肌肉减少症/严重肌肉减少症的患者之间没有显著差异。
糖尿病得到良好控制的长寿人群在肌肉减少症或死亡结局方面与非糖尿病患者相比没有显著差异。
