| Objective:The aim of this study was,in patients with T2DM among the old more than 60 Years,to analyze the relationship between the distribution of TCM syndrome types and clinical variables,and to screen and diagnose sarcopenia,and analyze the relationship between sarcopenia and related clinical variables.Material and method:We collected elderly T2DM hospitalized patients taken from Nanjing Hospital of TCM from January to December of 2019,and performed TCM syndrome classification according to 2011 edition of the Guidelines for prevention and treatment of diabetes in TCM on the patients.And screened and diagnosised of sarcopenia among this patients,them were divided into group of T2DM with sarcopenia,and group of T2DM without sarcopenia.The relevant clinical datas of patients was collected,including age,gender,height,weight,BMI,duration of T2DM,FPG,2hPPG,HbAlc,fasting blood insulin,serum albumin,Serum creatinine,LDL-C,25(OH)VD and other datas,and ln(IAI)which used to assess insulin sensitivity was calculated,and the Daily Life Activity Assessment Scale(ADL)was used to assess the physical status of this patients.Finally,the relationship between TCM syndrome type,sarcopenia and clinical variables of T2DM was analyzed.Results:A total of 214 elderly patients with T2DM were included in this study,55 patients with sarcopenia were detected and diagnosised,and the overall prevalence rate is 25.58%.Compared with the group of patients without sarcopenia,patients with sarcopenia have a higher average age and a longer duration of T2DM,while the weight,BMI,ADL score,and level of serum 25(OH)VD are lower,and the differences are statistically significant(P<0.05).In elderly patients with T2DM,the detection rate of sarcopenia is highest in the group of the yin-yang deficiency syndrome,followed by the group of qi and yin deficiency syndrome,while the sputum(wet)and heat-interconnection syndrome is lowest.The patients with excessive heat impairing body fluid syndrome is the youngest,and the T2DM duration of them is the shortest.The average age of the yin-yang deficiency syndrome is the oldest,and the mean T2DM duration of them is the longest among all enrolled patients(P<0.05).The patients with phlegm(dampness)and heat intermingling syndrome or phlegm-turbidity syndrome are combined into the group of phlegm-dampness syndrome,the other group includes the remaining patients.Compared with patients in the other group,the group of patients with phlegm-dampness syndrome have higher level of BMI,LDL-C,FPG,HbAlc,and worse insulin sensitivity.The difference between the two groups is statistically significant(P<0.05).After logistics regression analysis,BMI and LDL-C can enter the regression equation of phlegm and dampness syndrome(P<0.05).Binary logistic regression analysis of sarcopenia is performed in all patients with T2DM,It’s found that only BMI and age can enter the regression equation of sarcopenia(P<0.05).It’s also found that insulin sensitivity is negatively correlated with BMI and body weight(P<0.05).Conclusion:1.In elderly patients with T2DM,the difference in the detection of sarcopenia among TCM syndromes is not significant.Compared with the patients with qi-yin deficiency syndrome,the average age of the patients with excessive heat impairing body fluid syndrome is younger,the duration of diabetes is shorter,and the physical function is better.The average age of the patients with yin and yang deficiency syndrome is older,while the level of FPG,2hPPG,and HbAlc is even higher.2.In elderly patients with T2DM,patients with phlegm dampness or phlegm turbidity syndrome have higher level of BMI,LDL-C,FPG,and glycated hemoglobin,and their insulin sensitivity is worse.BMI and LDL-C are important influencing factors of phlegm and dampness syndrome.3.In elderly T2DM patients,age is a risk factor for sarcopenia,and high BMI levels are one of the protective factors for sarcopenia. |
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