Sex-related differences in frailty factors in older persons with type 2 diabetes: a cross-sectional study
Sex-related differences in frailty factors in older persons with type 2 diabetes: a cross-sectional study
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DOI：
10.1177/2042018819833304
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发表时间：
2019-03-05
影响因子：
3.8
通讯作者：
Inagaki, Nobuya
中科院分区：
文献类型：
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作者：
Nishimura, Akiko;Harashima, Shin-ichi;Inagaki, Nobuya
背景：这项横断面研究旨在描述导致老年2型糖尿病患者虚弱发展的糖尿病特有因素中与性别相关的差异。方法：对60~80岁的老年人进行序贯研究。分别使用经验证的Kihon Checklist(KCL)和亚洲Sarcopenia算法工作组评估脆性和石棺减少症。身体机能和身体特征由训练有素的护士独立测量。结果：本研究共纳入213名研究对象。平均年龄70.4岁，体重指数(BMI)24.3 kg/m(2)，糖化血红蛋白(HbA1c)7.4%。虚弱的患病率在女性中更高。社会和认知功能在衰弱前阶段较低，而身体功能在脆弱阶段较低，尽管骨骼肌质量没有减少。调整年龄后，KCL评分与周围神经病变、饮食评分和冠状动脉疾病(CAD)显著相关；脆弱与CAD和无业相关；易感与饮食评分相关；以及骨质疏松症与男性独居相关。同时，KCL评分与独居和骨骼肌百分比显著相关，与易感和周围神经病变相关，与糖尿病病程、低密度脂蛋白水平、饮食评分和不规律的生活方式相关。结论：在选择老年2型糖尿病早期预防策略时，应考虑脆弱危险因素的性别差异。尤其重要的是，评估男性的社会参与和饮食治疗以及女性的骨骼肌群和心理社会功能。
Background: This cross-sectional study aimed to describe sex-related differences in diabetes-specific factors underlying the development of frailty in older persons with type 2 diabetes. Methods: Older persons aged 60-80 years were sequentially enrolled. Frailty and sarcopenia were evaluated using the validated Kihon checklist (KCL) and Asian Working Group for Sarcopenia algorithm, respectively. Physical function and characteristics were measured by trained nurses independently. Results: This study included 213 participants. The mean age, body mass index (BMI), and glycated hemoglobin (HbA1c) level were 70.4 years, 24.3 kg/m(2), and 7.4%, respectively. Prevalence of frailty was higher in women. Social and cognitive functions were lower in the prefrailty stage, while physical function was lower in the frailty stage, although there was no decrease in skeletal muscle mass. After adjustment for age, the KCL score was significantly associated with peripheral neuropathy, diet score, and coronary artery disease (CAD); frailty, with CAD and inoccupation; prefrailty, with diet score; and sarcopenia, with living alone in men. Meanwhile, the KCL score was significantly associated with living alone and skeletal muscle percentage; prefrailty, with peripheral neuropathy; and sarcopenia, with diabetes duration, LDL-cholesterol level, diet score, and irregular lifestyle in women. Conclusions: Sex differences in the risk factors of frailty should be considered when selecting preventive strategies for older persons with type 2 diabetes, early in the prefrailty stage. In particular, it is important to evaluate social participation and diet therapy in men and skeletal muscle mass and psychosocial function in women.