老年糖尿病患者维生素D与握力和肌肉质量相关性研究

目的研究老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者维生素D水平与肌肉质量和握力的相关性。方法选取2016年5月至2018年1月入住宣武医院内分泌科年龄≥60岁的2型糖尿病患者201例进行前瞻性研究,根据25羟维生素D[25-hydroxyvitamin D,25(OH)D]水平分为维生素D缺乏组[25(OH)D<20μg/L]140例和非缺乏组[20μg/L≤25)(OH)D<70μg/L]61例,测定患者握力、步速及上下肢肌肉质量。并进行体格检查和实验室检查。结果两组患者实验室各项指标比较差异均无统计学意义(P均>0.05)。维生素D非缺乏组患者的握力、上肢及下肢肌肉含量显著高于缺乏组[(33.49±9.43)kg与(29.59±10.30)kg、(4.99±1.09)kg与(4.57±1.11)kg、(15.69±3.10)kg与(14.54±3.03)kg,P值分别为0.010、0.015、0.017]。多因素Logistic回归分析显示维生素D缺乏与握力减低及下肢肌肉质量下降独立相关(OR=1.286,95%CI:1.197~1.346,P<0.01;OR=1.231,95%CI:1.102~1.283,P<0.05)。结论维生素D缺乏是老年2型糖尿病患者握力减低及下肢肌肉质量下降的危险因素。

Study on the relationship between vitamin D,grip strength and muscle mass in elderly diabetic patients

Objective To study the relationship between vitamin D level and muscle mass and grip strength in elderly patients with type 2 diabetes mellitus(T2DM).Methods From May 2016 to January 2018,201 patients with type 2 diabetes mellitus aged≥60 who were admitted to the Department of endocrinology of Xuanwu Hospital were selected for prospective study.According to 25-hydroxyvitamin D level(25(OH)D),the patients were divided into the vitamin D deficiency group(25(OH)D<20μg/L,140 cases)and the non-deficiency group(20μg/L≤25(OH)D<70μg/L,61 cases).The grip strength,walking speed and muscle mass of upper and lower limbs were measured.Physical examination and laboratory examination were carried out.Results There was no significant difference between the two groups(P>0.05).The grip strength,upper limb and lower limb muscle contents in the non deficiency group were significantly higher than those in the deficiency group((33.49±9.43)kg vs.(29.59±10.30)kg,(4.99±1.09)kg vs.(4.57±1.11)kg,(15.69±3.10)kg vs.(14.54±3.03)kg,P=0.01,0.015,0.017).Multivariate logistic regression analysis showed that vitamin D deficiency was independently related to grip strength and lower limb muscle mass(OR=1.286,95%CI:1.197-1.346,P<0.01;OR=1.231,95%CI:1.102-1.283,P<0.05).Conclusion Vitamin D deficiency is a risk factor for the decrease of grip strength and lower extremity muscle mass in elderly patients with type 2 diabetes.