Research Article
Geriatri polikliniğine başvuran tip 2 diabetes mellituslu hastalarda kas gücü ve kas kütlesinin vücut kitle indeksi ve insülin tedavisiyle ilişkisi
Abstract
Giriş: Bu çalışmanın amacı, 65 yaş üstü diabetes mellituslu hastaların kas gücü ve kas kütlesinin vücut kitle indeksi ve insülin tedavisi ile ilişkisini araştırmaktır.
Gereç ve Yöntem: Çalışmaya Ekim 2015 – Ekim 2019 tarihleri arasında bir üniversite hastanesi Geriatri polikliniğine başvurmuş 65 yaş ve üzeri 123 diabetes mellituslu hasta dahil edilmiştir. Demografik bilgiler, tıbbi kayıtlar, laboratuvar sonuçları, el sıkma gücü, kas kütlesi ölçümleri hastane kayıtlarından retrospektif olarak kaydedilmiştir.
Bulgular: Hastalar, insülin kullanımına ve vücut kitle indeksine göre gruplandırıldı. Hastaların vücut kitle indeksi ve el sıkma güçleri arasında negatif bir korelasyon (p = 0,002), vücut kitle indeksi ile kas kütle indeksi arasında ise pozitif bir korelasyon saptandı (p = 0,001). İnsülin kullanan ve kullanmayan hastaların el sıkma gücü ve kas kütlesi ölçümleri arasında ise anlamlı fark saptanmadı.
Sonuç: Normal kilolu ve obez diabetes mellituslu hastalar arasında, gerçek sarkopenik hastaları tespit etmek için, antropometrik farklılıklar göz önünde tutulmalıdır. Bu hastalarda kas kütlesinin değerlendirilmesinden çok, kas gücü ve hatta kas kalitesinin değerlendirilmesi daha faydalı olabilir.
References
- Andrade F. Estimating diabetes and diabetes-free life expectancy in Mexico and seven major cities in Latin America and the Caribbean. Rev Panam Salud Publica 2009; 26: 9-16.
- Mordarska K, Godziejewska-Zawada M. Diabetes in the elderly. Prz Menopauzalny 2017; 16 (2): 38.
- Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol 2014; 2 (10): 819-29.
- Park SW, Goodpaster BH, Lee JS, et al. Excessive loss of skeletal muscle mass in older adults with type 2 diabetes. Diabetes care 2009; 32 (11): 1993-7.
- Park SW, Goodpaster BH, Strotmeyer ES, et al. Decreased muscle strength and quality in older adults with type 2 diabetes: the health, aging, and body composition study. Diabetes 2006; 55 (6): 1813-8.
- Bonadonna RC, Saccoman MP, Cobelli C, DeFronz RA. Effect of insulin on system A amino acid transport in human skeletal muscle. The Journal of clinical investigation 1993; 91 (2): 514-21.
- Trommelen J, Groen BBL, Hamer HM, de Groot LCPGM, van Loon LJC. Mechanisms ın endocrinology: Exogenous insulin does not increase muscle protein synthesis rate when administered systemically: a systematic review. Eur J Endocrinol 2015; 173 (1): R25-34.
- Tanaka KI, Kanazawa I, Sugimoto T. Reduction in endogenous insulin secretion is a risk factor of sarcopenia in men with type 2 diabetes mellitus. Calcified tissue international 2015; 97 (4): 385-90.
- Ferrari U, Then C, Rottenkolber M, et al. Longitudinal association of type 2 diabetes and insulin therapy with muscle parameters in the KORA‑Age study. Acta Diabetologica 2020; 57: 1057–63.
- Akazawa N, Harada K, Okawa N, Tamura K, Moriyama H. Low body mass index negatively affects muscle mass and intramuscular fat of chronic stroke survivors. PLoS ONE 2019; 14 (1): e0211145.
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- Savaş S, Akçiçek F. Comprehensive geriatric assessment. Ege Journal of Medicine 2010; 49 (Suppl3): 19-30.
- Guigoz Y, Vellas BJ. Malnutrition in the elderly: the Mini Nutritional Assessment (MNA). Ther Umsch1997; 54 (6): 345–50.
- Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician" J Psychiatr Res 1975; 12 (3):189-98.
- Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983; 17 (1): 37–49.
- Katz S. Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living. J Am Geriatr Soc 1983; 31 (12): 721–7.
- Lawton MP, Brod EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 1969; 9: 179-86.
- Lawton MP, Moss M, Fulcomer M, Kleban MH. A Research and Service Oriented Multilevel Assessment Instrument. J Gerontol 1982; 37 (1): 91-9.
- Fukuoka Y, Narita T, Fujita H, et al. Importance of physical evaluation using skeletal muscle mass index and body fat percentage to prevent sarcopenia in elderly Japanese diabetes patients. J Diabetes Investig 2019; 10: 322–30.
- Nakanishi S, Iwamoto M, Shinohara H, Iwamoto H, Kaneto H. Significance of body mass index for diagnosing sarcopenia is equivalent to slow gait speed in Japanese individuals with type 2 diabetes: Cross-sectional study using outpatient clinical data. J Diabetes Investig 2020; Jul 19. doi: 10.1111/jdi.13366 Online ahead of print.
- Bouchi R, Fukuda T, Takeuchi T, et al. Insulin Treatment Attenuates Decline of Muscle Mass in Japanese Patients with Type 2 Diabetes. Calcif Tissue Int 2017; 101: 1–8.
- Murata Y, Kadoya Y, Yamada S, Sanke T. Sarcopenia in elderly patients with type 2 diabetes mellitus: prevalence and related clinical factors. Diabetol Int 2018; 9: 136–42.
- Villani A, McClure R, Barrett M, Scott D. Diagnostic differences and agreement between the original and revised European Working Group (EWGSOP) consensus definition for sarcopenia in community-dwelling older adults with type 2 diabetes mellitus. Arch Gerontol Geriatr 2020; 89: 104081.
- de Freitasa MM, de Oliveiraa VLP, Grassib T, et al. Difference in sarcopenia prevalence and associated factors according to 2010 and 2018 European consensus (EWGSOP) in elderly patients with type 2 diabetes mellitus. Exp Gerontol 2020; 132: 110835.
- .Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition anddiagnosis. Age Ageing 2019; 48: 16–31.
Association of muscle strength and muscle mass with body mass index and insulin treatment in older patients with type 2 diabetes mellitus admitted to geriatric outpatient clinic
Abstract
Aim: The aim of this study was to investigate the hand grip strength and muscle mass of older patients with type 2 diabetes mellitus in relation to body mass index and insulin treatment.
Materials and Methods: A total of 123 older patients with diabetes mellitus ≥65 years of age were admitted to geriatric outpatient clinic of a university hospital between October 2015 and October 2019. Demographic data, medical records, laboratory results, hand grip strength and muscle mass were derived from the hospital records, retrospectively.
Results: The patients were grouped according to body mass index and usage of insulin treatment. There was a negative correlation between body mass index and hand grip strength (p = 0,002), and a positive correlation between body mass index and muscle mass index (p = 0,001). No significant differences for hand grip strength and muscle mass index were observed between insulin treatment group and non-insulin treatment group.
Conclusion: In type 2 diabetes mellitus patients with normal weight and obesity, anthropometric differences should be considered to identify true sarcopenic patients. Assessment of muscle strength, and also evaluation of muscle quality might be more valuable than assessment of muscle mass for those patients
References
- Andrade F. Estimating diabetes and diabetes-free life expectancy in Mexico and seven major cities in Latin America and the Caribbean. Rev Panam Salud Publica 2009; 26: 9-16.
- Mordarska K, Godziejewska-Zawada M. Diabetes in the elderly. Prz Menopauzalny 2017; 16 (2): 38.
- Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol 2014; 2 (10): 819-29.
- Park SW, Goodpaster BH, Lee JS, et al. Excessive loss of skeletal muscle mass in older adults with type 2 diabetes. Diabetes care 2009; 32 (11): 1993-7.
- Park SW, Goodpaster BH, Strotmeyer ES, et al. Decreased muscle strength and quality in older adults with type 2 diabetes: the health, aging, and body composition study. Diabetes 2006; 55 (6): 1813-8.
- Bonadonna RC, Saccoman MP, Cobelli C, DeFronz RA. Effect of insulin on system A amino acid transport in human skeletal muscle. The Journal of clinical investigation 1993; 91 (2): 514-21.
- Trommelen J, Groen BBL, Hamer HM, de Groot LCPGM, van Loon LJC. Mechanisms ın endocrinology: Exogenous insulin does not increase muscle protein synthesis rate when administered systemically: a systematic review. Eur J Endocrinol 2015; 173 (1): R25-34.
- Tanaka KI, Kanazawa I, Sugimoto T. Reduction in endogenous insulin secretion is a risk factor of sarcopenia in men with type 2 diabetes mellitus. Calcified tissue international 2015; 97 (4): 385-90.
- Ferrari U, Then C, Rottenkolber M, et al. Longitudinal association of type 2 diabetes and insulin therapy with muscle parameters in the KORA‑Age study. Acta Diabetologica 2020; 57: 1057–63.
- Akazawa N, Harada K, Okawa N, Tamura K, Moriyama H. Low body mass index negatively affects muscle mass and intramuscular fat of chronic stroke survivors. PLoS ONE 2019; 14 (1): e0211145.
- Bahat G, Tufan A, Kilic C, et al. Cut-off points for weight and body mass index adjusted bioimpedance analysis measurements of muscle mass. Aging Clin Exp Res 2019; 31: 935–42.
- Bahat G, Tufan A, Tufan F, et al. Cut-off points to identify sarcopenia according to European Working Groupon Sarcopenia in Older People (EWGSOP) definition. Clin Nutr 2016; 35: 1557-63
- Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis--part I: review of principles and methods. Clin Nutr 2004; Oct; 23 (5): 1226-43.
- Iannuzzi-Sucich M, Prestwood KM, Kenny AM. Prevalence of Sarcopenia and Predictors of Skeletal Muscle Mass in Healthy, Older Men and Women. J Gerontol A Biol Sci Med Sci 2002; 57 (12): 772–7.
- Savaş S, Akçiçek F. Comprehensive geriatric assessment. Ege Journal of Medicine 2010; 49 (Suppl3): 19-30.
- Guigoz Y, Vellas BJ. Malnutrition in the elderly: the Mini Nutritional Assessment (MNA). Ther Umsch1997; 54 (6): 345–50.
- Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician" J Psychiatr Res 1975; 12 (3):189-98.
- Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983; 17 (1): 37–49.
- Katz S. Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living. J Am Geriatr Soc 1983; 31 (12): 721–7.
- Lawton MP, Brod EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 1969; 9: 179-86.
- Lawton MP, Moss M, Fulcomer M, Kleban MH. A Research and Service Oriented Multilevel Assessment Instrument. J Gerontol 1982; 37 (1): 91-9.
- Fukuoka Y, Narita T, Fujita H, et al. Importance of physical evaluation using skeletal muscle mass index and body fat percentage to prevent sarcopenia in elderly Japanese diabetes patients. J Diabetes Investig 2019; 10: 322–30.
- Nakanishi S, Iwamoto M, Shinohara H, Iwamoto H, Kaneto H. Significance of body mass index for diagnosing sarcopenia is equivalent to slow gait speed in Japanese individuals with type 2 diabetes: Cross-sectional study using outpatient clinical data. J Diabetes Investig 2020; Jul 19. doi: 10.1111/jdi.13366 Online ahead of print.
- Bouchi R, Fukuda T, Takeuchi T, et al. Insulin Treatment Attenuates Decline of Muscle Mass in Japanese Patients with Type 2 Diabetes. Calcif Tissue Int 2017; 101: 1–8.
- Murata Y, Kadoya Y, Yamada S, Sanke T. Sarcopenia in elderly patients with type 2 diabetes mellitus: prevalence and related clinical factors. Diabetol Int 2018; 9: 136–42.
- Villani A, McClure R, Barrett M, Scott D. Diagnostic differences and agreement between the original and revised European Working Group (EWGSOP) consensus definition for sarcopenia in community-dwelling older adults with type 2 diabetes mellitus. Arch Gerontol Geriatr 2020; 89: 104081.
- de Freitasa MM, de Oliveiraa VLP, Grassib T, et al. Difference in sarcopenia prevalence and associated factors according to 2010 and 2018 European consensus (EWGSOP) in elderly patients with type 2 diabetes mellitus. Exp Gerontol 2020; 132: 110835.
- .Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition anddiagnosis. Age Ageing 2019; 48: 16–31.
There are 28 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | April 19, 2021 |
| Submission Date | January 18, 2021 |
| Published in Issue | Year 2021Volume: 60 Suppl:1 (Geriatrics) |
