Ren Chenxi, Zhu Yunxia, Tao Jun, Zhang Xiaoyan
Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
Diabetol Metab Syndr. 2025 Jun 23;17(1):241. doi: 10.1186/s13098-025-01830-5.
The aim of this study was to determine whether low calf circumference (CC) could predict nutritional risk and the cut-off value of CC in type 2 diabetes (T2D) older patients. We also aimed to evaluate the risk factors for predicting mortality in T2D.
A total of 296 older patients with T2D were enrolled in this study and followed for 2.5 years at the longest.
The CC level was significantly lower in the nutritional risk group than in the non-nutritional risk with T2D group (26.7 ± 4.1 cm vs. 30.2 ± 3.9 cm, < 0.001). Decreased CC (OR, 6.79; 95% CI, 2.73–16.84; < 0.001) and a new insulin resistance index of triglyceride glucose (TyG) (OR, 2.14; 95% CI, 1.13–4.07; = 0.020) were independent risk factors for nutritional risk. The best CC cut-off value for predicting nutritional risk was 27.8 cm. Decreased CC (HR, 2.98; 95% CI, 1.40–6.33; = 0.005) remained an independent risk factor for mortality.
Decreased CC could predict not only nutritional risk but also mortality in T2D patients aged over 80 years. CC may be a valuable index to screen out this population in T2D. The prevention strategy for diabetes patients should shifts gradually from the prevention of metabolic disorders to the muscle mass loss.
The online version contains supplementary material available at 10.1186/s13098-025-01830-5.
本研究旨在确定小腿围（CC）降低是否可预测2型糖尿病（T2D）老年患者的营养风险及CC的截断值。我们还旨在评估T2D患者死亡的预测危险因素。
本研究共纳入296例老年T2D患者，最长随访2.5年。
营养风险组的CC水平显著低于非营养风险T2D组（26.7±4.1cm对30.2±3.9cm，P<0.001）。CC降低（比值比[OR]，6.79；95%置信区间[CI]，2.73 - 16.84；P<0.001）和新的甘油三酯葡萄糖胰岛素抵抗指数（TyG）（OR，2.14；95%CI，1.13 - 4.07；P = 0.020）是营养风险的独立危险因素。预测营养风险的最佳CC截断值为27.8cm。CC降低（风险比[HR]，2.98；95%CI，1.40 - 6.33；P = 0.005）仍是死亡的独立危险因素。
CC降低不仅可预测80岁以上T2D患者的营养风险，还可预测其死亡率。CC可能是T2D中筛查该人群的有价值指标。糖尿病患者的预防策略应逐渐从预防代谢紊乱转向预防肌肉量减少。
在线版本包含可在10.1186/s13098-025-01830-5获取的补充材料。
