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JCEM:糖尿病患者肌少症的患病率和危险因素

2021-12-24 从医路漫漫 MedSci原创

糖尿病患者由于血糖控制不良可能会出现多种并发症。糖尿病肌少症是近年来备受关注的糖尿病并发症。肌少症认为与糖尿病患者的胰岛素抵抗和氧化应激有关。导致肌肉力量和肌肉质量下降,以及肌肉萎缩。

糖尿病患者由于血糖控制不良可能会出现多种并发症。糖尿病肌少症是近年来备受关注的糖尿病并发症。肌少症认为与糖尿病患者的胰岛素抵抗和氧化应激有关导致肌肉力量和肌肉质量下降,以及肌肉萎缩。肌少症在老年人中定义为随着年龄的增长而发生的骨骼肌质量下降、肌肉力量下降或身体能力下降,糖尿病患者是糖尿病相关肌少症的高危对象。此外,行动缓慢是肌少症的一种表现,而肌少症与2型糖尿病患者的跌倒密切相关。据了解,肌肉质量下降会显著增加这些患者的住院率,导致卧床,从而增加肺部感染的风险,降低老年糖尿病患者的生活质量。因此,积极评估和筛选肌少症患者,以提高其生活质量,减轻国家、社会和家庭的经济负担是非常重要的)。然而,基于不同研究人群(如不同性别和不同年龄组)的研究显示,肌少症的患病率差异很大,在7.2%至31.1%之间。糖尿病患者肌少症的患病率是非糖尿病患者的三倍,且与不良预后相关。本研究的目的是探讨糖尿病患者肌少症的全球流行率和危险因素。

方法:

数据从PubMed、Embase、Web of science、万方、知网、维普和CBM等数据库中鉴定了从成立之日起至2020年11月30日发表的相关研究。我们使用以下文本:“糖尿病/糖尿病糖尿病/ 2型糖尿病2型糖尿病/ Diabet * / 1型糖尿病(T1DM,”“Sarcopenia /肌肉萎缩、肌肉萎缩、肌肉/肌肉力量,”“风险因素/影响因素因素/危险因素有关,”“发病率和患病率/流行病学/频率,这些数据库进行搜索。在中文数据库中,使用相应的中文术语进行搜索。我们也检查了参考书目在检索文章可能适当的研究。

纳入与排除标准:纳入标准如下:(1)研究设计:观察性研究,包括横断面研究和前瞻性/回顾性队列研究;(2)研究参与者:年龄≥18岁,临床诊断糖尿病,诊断标准符合世界卫生组织标准(25),不论性别或糖尿病类型;(3)暴露因素:肌减少症。文献中有明确的诊断骨骼肌减少症的参数,如骨骼肌质量指数(SMI),以及亚洲骨骼肌减少症工作组(AWGS)、EWGSOP和美国国立卫生研究院基金会(FNIH)的标准;(4)结局指标:骨骼肌减少症的发生率;(a)一般因素包括年龄、性别、体重指数(BMI)、内脏脂肪面积(VFA)和吸烟。(b)疾病相关因素包括糖化血红蛋白(HbA1c)、糖尿病持续时间、高敏c反应蛋白(HS-CRP)。(c)与治疗相关的因素包括运动和药物。

研究选择年龄≥18岁的临床诊断糖尿病患者。性别和糖尿病类型不受限制。

数据提取数据是由两名审查员使用标准数据收集表格独立提取的。

结果:糖尿病患者肌少症的合并患病率为18% (95% CI,16-20),亚组分析显示,肌肉减少症在男性中比在女性中更普遍,并且在亚洲比在南美洲和大洋洲更普遍。年龄(OR, 1.10)、糖化血红蛋白(OR, 1.16)、内脏脂肪面积(VFA) (OR, 1.03)、糖尿病肾病(OR, 2.54)、糖尿病病程(OR, 1.06)和HS-CRP (OR, 1.33)是糖尿病患者肌少症的危险因素。

图1 横断面研究的质量评价结果

图2 队列研究质量评价结果

图3 糖尿病患者肌少症的总患病率

图4 糖尿病患者骨质疏松症总体患病率的发表偏倚

表1糖尿病患者骨质疏松症患病率的亚组分析

表2 糖尿病患者发生骨质疏松症的危险因素分析

结论。肌少症在糖尿病患者中更为普遍。年龄、糖化血红蛋白(HbA1c)、内脏脂肪面积(VFA)、糖尿病肾病、糖尿病持续时间、HS-CRP是可能的危险因素。今后,医护人员不仅要重视对高危人群的早期筛查,还要提供预防信息。

原文出处:

Feng L,  Gao Q,  Hu K,et al.Prevalence and risk factors of sarcopenia in patients with diabetes: A meta-analysis.J Clin Endocrinol Metab 2021 Dec 14

 

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    2022-09-09 仁者大医
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    2022-11-22 achengzhao
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    2021-12-29 ms1000001222907999

    进一步学习肌少症,非常棒

    0

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    2021-12-26 ms8426593121538491

    热门话题

    0

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    2021-12-24 ms7000002136561391

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