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衰老和血糖控制对老年2型糖尿病患者可能存在的肌肉减少症关联的性别特异性影响:一项横断面研究。

Sex‑specific effects of aging and glycemic control on the association of possible sarcopenia in older adults with type 2 diabetes: a cross-sectional study.

作者信息

Huang Yi-Fang, Liu Shih-Ping, Muo Chih-Hsin, Lai Chen-Yi, Chang Chung-Ta

机构信息

Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan.

Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan.

出版信息

Aging Clin Exp Res. 2025 Aug 20;37(1):251. doi: 10.1007/s40520-025-03159-5.

Abstract

AIM

This study aimed to investigate sex-specific associations and the synergistic effects of aging and glycemic control on the correlation of possible sarcopenia in older adults with type 2 diabetes mellitus (T2DM).

METHODS

In the cross-sectional study of community-dwelling adults aged ≥ 60 years in New Taipei City, Taiwan, Sarcopenia status was classified using the Asian Working Group for Sarcopenia 2019 criteria into possible sarcopenia, sarcopenia, and severe sarcopenia. Categorical and continuous variables were compared using chi-square/Fisher's exact tests and ANOVA. Sex-specific associations between glycemic control and sarcopenia were examined using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

5,728 participants (mean age 72.1 ± 6.1 years; 47.9% men) were enrolled. After adjustment, older women with T2DM had a higher odds of possible sarcopenia (OR = 2.07, 95% CI = 1.57-2.72). In women aged ≥ 70 years, both good and poor glycemic control were significantly correlated with possible sarcopenia (OR = 1.87 and 2.10; 95% CI = 1.16-3.04 and 1.43-3.07; p for trend < 0.0001). T2DM patients with hypertension, ischemic heart disease (IHD), or depression showed increased sarcopenia association (OR = 1.71, 1.81, and 2.45, respectively). Poor glycemic control revealed increased odds of sarcopenia in those with hypertension (OR = 1.80) or IHD (OR = 2.42).

CONCLUSIONS

Glycemic control could be crucial in preventing possible sarcopenia, especially among older women with T2DM. Comorbid hypertension, IHD, or depression are significantly associated with sarcopenia in T2DM patients, particularly in the presence of poor glycemic control.

摘要

目的

本研究旨在调查2型糖尿病(T2DM)老年患者中,衰老和血糖控制对可能的肌肉减少症相关性的性别特异性关联及协同效应。

方法

在台湾新北市对年龄≥60岁的社区居住成年人进行的横断面研究中,根据2019年亚洲肌肉减少症工作组标准将肌肉减少症状态分为可能的肌肉减少症、肌肉减少症和严重肌肉减少症。使用卡方检验/费舍尔精确检验和方差分析比较分类变量和连续变量。使用逻辑回归估计比值比(OR)和95%置信区间(CI),以检验血糖控制与肌肉减少症之间的性别特异性关联。

结果

共纳入5728名参与者(平均年龄72.1±6.1岁;47.9%为男性)。调整后,患有T2DM的老年女性发生可能的肌肉减少症的几率更高(OR = 2.07,95% CI = 1.57 - 2.72)。在年龄≥70岁的女性中,血糖控制良好和不佳均与可能的肌肉减少症显著相关(OR = 1.87和2.10;95% CI = 1.16 - 3.04和1.43 - 3.07;趋势p<0.0001)。患有高血压、缺血性心脏病(IHD)或抑郁症的T2DM患者肌肉减少症关联增加(OR分别为1.71、1.81和2.45)。血糖控制不佳显示高血压患者(OR = 1.80)或IHD患者(OR = 2.42)发生肌肉减少症的几率增加。

结论

血糖控制对于预防可能的肌肉减少症可能至关重要,尤其是在患有T2DM的老年女性中。合并高血压、IHD或抑郁症与T2DM患者的肌肉减少症显著相关,尤其是在血糖控制不佳的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9783/12367817/53304fac4745/40520_2025_3159_Fig1_HTML.jpg

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