老年2 型糖尿病患者衰弱现状及影响因素分析

Status and influencing factors of frailty syndrome in elderly patients with type 2 diabetes mellitus

摘要:

目的 了解老年2 型糖尿病患者的衰弱现状，并探讨老年2 型糖尿病患者发生衰弱的影响因素。 方法 对成都中医药大学附属医院内分泌科住院治疗的306 例老年2 型糖尿病患者进行横断面调查，采用一般 资料调查表、临床资料调查表分别收集患者的社会人口学资料、生活方式及疾病相关资料，采用Fried 衰弱量 表评估患者衰弱状况，采用营养状况调查表、Charlson 合并症指数（CCI）分别评估患者营养状况、多病共 存的情况。结果 老年2 型糖尿病患者衰弱发生率为54.58%（167/306），衰弱前期为21.24%（65/306），非衰弱 24.18%（74/306）。其中握力低、躯体活动量低、步行速度慢是发生最多的3 个衰弱指标。单因素分析结果显 示：不同2 型老年糖尿病患者的衰弱状况在年龄、糖尿病并发症数量、口服双胍类降糖药患者的比例、糖化 血红蛋白水平、C 反应蛋白水平、营养评分（微型营养评估简表）、BMI、血红蛋白水平、清蛋白水平、CCI 评分方面差异有统计学意义（P <0.05）。多分类有序Logistic 回归结果显示：年龄、营养状况、糖化血糖水平、 CCI 评分为老年2 型糖尿病患者衰弱的影响因素。结论 老年2 型糖尿病患者的衰弱发生率高，衰弱的发生 受多种因素影响，提示临床医护人员应密切关注老年2 型糖尿病患者衰弱问题，针对性的采取干预措施，以减 少衰弱发生。

Abstract:

Objective To investigate the current status of frailty syndrome and its influencing factors in elderly patients with type 2 diabetes mellitus. Methods Convenience sampling was applied to recruit 306 hospitalized elderly patients with type 2 diabetes mellitus who received treatment in Department of Endocrinology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine. The general information questionnaire was used to collect the patients’ sociodemographic data, lifestyle, and clinical data. The Fried Frailty Phenotype was administered to assess the frailty status of the patients. The Mini Nutritional Assessment Short-Form (MNA-SF) was administered to assess the patients’ nutritional status. The Charlson comorbidity index (CCI) was administered to assess the patients’ comorbid conditions. Results The reported rate of frailty was 54.58% (167/306) among the participants, 21.24% (65/306) reported pre-frailty, and 24.18% (74/306) reported no frailty. Grip weakness, low physical activity, and slow walking speed were the main frailty problems. The diabetic patients with the three different frailty indicators differed significantly in terms of age, the number of diabetic complications, proportion of patients with oral biguanidine hypoglycemic drugs, hemoglobin level, C-reactive protein level, MNA-SF score, BMI, albumin level, CCI, and glycosylated hemoglobin level (P < 0.05). Age, nutritional status, glycosylated hemoglobin level and CCI were the relevant factors for frailty in type 2 diabetes mellitus patients. Conclusions The incidence of frailty is high in elderly patients with type 2 diabetes mellitus. And many factors are associated with frailty. Clinical staff should pay more attention to frailty issue and take targeted interventions so as to reduce the incidence of frailty.