Yuan Yi, Li Sidong, Yin Lu, Su Yongbin, Guo Zhe, Liu Yandong, Blake Glen M, Wang Ling, Liu Yajun, Cheng Xiaoguang, Engelke Klaus, Vlug Annegreet G
Department of Radiology, Beijing Jishuitan Hospital, Capital Medical University, National Center for Orthopaedics, Beijing 100035, China; Sarcopenia Research Center, Beijing Research Institute of Traumatology and Orthopaedics, Beijing 100035, China.
Institute of Public Health Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.
J Nutr Health Aging. 2025 Apr;29(4):100506. doi: 10.1016/j.jnha.2025.100506. Epub 2025 Feb 14.
We aimed to compare muscle strength, physical performance, and muscle parameters in non-diabetic and type 2 diabetes mellitus (T2DM) older adults and to determine the association of the duration of diabetes with these outcomes.
A cross-sectional study.
The China Action on Spine and Hip Status study (CASH).
301 participants enrolled from a subcohort of CASH, of which 114 were diagnosed with well-controlled type 2 diabetes mellitus, MEASUREMENTS: We measured physical performance and muscle strength with the timed up-and-go test (TUG) and handgrip strength (HGS) and measured the area and density of the thigh, gluteus and trunk muscles (core muscles) using quantitative CT scans.
Participants with long-term (≥10 years) diabetes had a longer TUG (β coefficient: 0.64 [95% CI, 0.06, 1.22]; P = 0.030) and a lower HGS (-2.29 [-4.48, -0.10]; P = 0.041) as well as a lower muscle area of the thigh (-7.10 [-13.44, -0.76]; P = 0.028). The lower HGS among patients with long-term (≥10 years) diabetes was largely mediated by muscle area of the thigh (compared with non-diabetic controls: percentage mediated, 38.3%; P = 0.023; compared with <10 years diabetes: percentage mediated, 51.8%; P = 0.039).
Older adults with long-term (≥10 years) diabetes had lower TUG and HGS than either non-diabetic participants, and the difference in HGS was largely mediated by a decrease in muscle area of the thigh muscles. Our finding suggested that long duration of diabetes, even in well-controlled subjects, may be associated with poor physical functions.
我们旨在比较非糖尿病和2型糖尿病（T2DM）老年成年人的肌肉力量、身体机能及肌肉参数，并确定糖尿病病程与这些结果之间的关联。
一项横断面研究。
中国脊柱与髋部状况行动研究（CASH）。
从CASH的一个亚队列中招募了301名参与者，其中114人被诊断为控制良好的2型糖尿病。
我们采用计时起立行走测试（TUG）和握力（HGS）来测量身体机能和肌肉力量，并使用定量CT扫描测量大腿、臀肌和躯干肌肉（核心肌肉）的面积和密度。
患有长期（≥10年）糖尿病的参与者TUG时间更长（β系数：0.64 [95%置信区间，0.06，1.22]；P = 0.030），HGS更低（-2.29 [-4.48，-0.10]；P = 0.041），大腿肌肉面积也更低（-7.10 [-13.44，-0.76]；P = 0.028）。长期（≥10年）糖尿病患者较低的HGS在很大程度上由大腿肌肉面积介导（与非糖尿病对照组相比：介导百分比，38.3%；P = 0.023；与糖尿病病程<10年的患者相比：介导百分比，51.8%；P = 0.039）。
患有长期（≥10年）糖尿病的老年成年人的TUG和HGS低于非糖尿病参与者，且HGS的差异在很大程度上由大腿肌肉面积的减少介导。我们的研究结果表明，即使是血糖控制良好的患者，糖尿病病程较长也可能与身体机能较差有关。
