| Background: Sarcopenia is a new kind of senile syndrome proposed in recent years,and it is a degenerative disease characterized by decreased muscle mass,muscle strength and muscle function with the growth of age.In recent years,with the gradual increase of aging population,its morbidity is gradually increasing.Type 2 diabetes mellitus(T2DM),Osteoporosis(OP)and Sarcopenia are common diseases of elderly patients,and patients with diabetes are often accompanied by abnormal bone metabolism,resulting in an increase in the incidence of Osteoporosis.While bone and muscle constitute the skeletal muscle systemtogether,which is responsible for the motor function of the body.Sarcopeniacan make the old people with Osteoporosis be easy to fall down and even have fracture,and after falling or fracture,it will limit the functional activities of the elderly,thereby increasing the loss of bone mass and skeletal muscle and form a vicious circle.Finally,the living quality of the elderly will be affected,even leading to death.However,there are few domestic studies on whether elderly type 2 diabetes mellitus combined with osteoporosis will increase the incidence of sarcopenia.Objective: To study the correlation of elderly type 2 diabetes mellitus complicated with osteoporosis and sarcopeniaand its influencing factors,so as to provide reference for preventing and reducing the occurrence of sarcopeniain the elderly patients with diabetes and osteoporosis,as well as reducing the fracture,falling and disability of the elderly.Methods: 162 elderly T2 DM and primary OP patients over 60 years old who were treated in the endocrinology department of Sichuan Provincial People’s Hospital from March 2018 to December 2018 were selected as research objects.Among them,60 were patients with type 2 diabetes mellitus complicated with osteoporosis(T2DM+OP group),and 52 were patients without type 2 diabetes mellitus complicated with osteoporosis(T2DM group).50 patients with osteoporosis but not complicated with type 2 diabetes mellitus were selected for the study during the same period.General information and clinical data were collected,and muscle mass,muscle strength and muscle function of all subjects were measured by dual-energy X-ray absorptiometry,handgrip strength measurement and step count calculation.At the same time,blood glucose,glycosylated hemoglobin,blood insulin and C-peptide,blood 25-hydroxyvitamin D level and so on were measured.Finally,SPSS17.0 software was used for statistical analysis.Results:(1)There were no significant differences in age,gender and Diabetes course among T2DM+OP group,T2 DM group and OP group(P > 0.05).(2)The detection rate of sarcopeniain the T2DM+OP group,T2 DM group and OP group were 73.3%,30.8% and 40.0%,respectively,with significant differences among the three groups(P=0.031).(3)6-meter walking speed measurement results showed that the walking speed of male and female in the T2DM+OP group was 0.78±0.15 m /s and 0.71 0.19 m /s,respectively,which were the lowest in each group,and the difference was statistically significant(P < 0.05).The results of handgrip strength test showed that the handgrip strength of male and female in the T2DM+OP group was 23.3±3.5kg and 17.4±3.2kg,respectively,which were significantly lower than that of the other two groups(P < 0.05).(4)Compared with patients without sarcopenia,elderly patients with sarcopenia had higher age,higher BMI(body mass index),longer course of T2 DM,and significantly lower average BMD of L1-L4.Their femoral neck BMD and greater trochanteric BMD significantly lowered,and their serum vitamin D levels were lower,with statistically significant differences(P < 0.001).(5)Conditional logistic regression results showed that basic diseases,age,BMI,serum vitamin D level and DM course were independent risk factors for sarcopeniain this study population.Compared with patients without sarcopenia,OR=1.565(95%CI: 1.160-2.123,P=0.008)for patients with type 2 diabetes mellitus complicated with osteoporosis decreased,and the risk of sarcopenia increased with age,BMI,progression of type 2 diabetes mellitus,and increased with the decrease of serum 25-(OH)D3 level.Conclusion:(1)The incidence of sarcopenia for patients with type 2 diabetes complicated with osteoporosis can increased significantly;(2)Underlying disease,age,BMI,serum vitamin D levels,and DM duration were independent risk factors for myopathy in this study population,so the age,Malnutrition,osteoporosis and longer duration of type 2 diabetes attention and monitoring should be focused on and monitored,Screening and intervention of hypothyroidism should be carried out as soon as possible for high-risk patients to improve the quality of life of elderly patients in China. |
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