2型糖尿病患下肢肌肉功能與肌少症指標之相關研究

目的:了解二型糖尿病人下肢肌肉功能與肌少症的相關指標之相關性，並且探討坐站檢測做為早期糖尿病肌少症檢測指標之可能性。方法：本研究採橫斷性研究，對象為南部糖尿病專科診所，經醫師診斷為二型糖尿病患者為研究對象。資料採用2019年2月1日至2019年5月31日，以亞洲肌少症工作組織(AWGS)建議的檢測及切點來判斷有無肌少症及肌少症前期，同時收集小腿圍、下肢肌肉功能及相關病史、個人基本資料及生化指標。統計方法為皮爾森相關係數、單因子變異數分析、二元邏輯斯回歸以分析下肢肌肉功能、小腿圍、SARC-F量表及生化指標與肌少症檢測之相關與差異。結果:共收集298名二型糖尿病患者，其中男性153人(51.4%)，平均年齡為63.9±9.8歲，罹病期為12.5±7.8年，依據握力、生物電阻抗分析及身體活動功能檢測，共有23位患者診斷肌少症(7.7%)。年齡、小腿圍及檢測下肢肌肉功能中的F2值為肌少症的預測因子。結論:臨床實務上，以測力板測量下肢肌肉功能中F2值為指標，可作為二型糖尿病肌少症之參考。

關鍵字

爆發力；醣化血色素；身體組成

並列摘要

Objective: Thy objective of the study was to examine the correlation between lower extremity muscle function and the sarcopenia index in patients with type 2 diabetes mellitus and investigate the possibility to use the Sitting Rising Test as the index to detect the early stage of sarcopenia for patients. Method: A cross-sectional study was conducted to examine patients with type 2 diabetes mellitus diagnosed by doctors from three specialized diabetes clinics in the south of Taiwan. The data was collected from February 1st to May 31st, 2019, with the screening criteria and cutoff point recommended by the Asian Working Group for Sarcopenia (AWGS) to identify sarcopenia for patients. The study also gathered information of patients in calf circumference, lower extremity muscle function, related medical history, basic personal information, and biochemical index. Statistical methods were utilized for data analysis: Pearson's correlation coefficient, anova, and multinomial logistic regression analysis to analyze the correlation between lower extremity muscle function, calf circumference, SARC-F Scale, biochemical index and sarcopenia diagnosis. Results: The study enrolled 298 patients with type 2 diabetes mellitus, with 153 males (51.4%) involved, mean age 63.9±9.8, average disease duration 12.5±7.8 years. Twenty-three patients (7.7%) were diagnosed sarcopenia based on the tests conducted on their hand grip strength, bioelectrical impedance analysis and physical performance test. Age, calf circumference, and F2 (the force for lower limb muscle mass) on the lower extremity muscle function test were independent risk factors for sarcopenia. Conclusion: In clinical practice, the measurement of lower extremity muscle function can be utilized as the reference for sarcopenia in patients with type 2 diabetes mellitus to reach the goal for early diagnosis and treatment.