抗阻训练联合高乳蛋白营养在老年2型糖尿病伴肌少症病人中的应用研究

doi:10.3969/j.issn.1003-9198.2023.10.005

摘要/Abstract

摘要： 目的探究抗阻训练联合高乳蛋白营养对老年T2DM伴肌少症病人的应用效果。方法选择2021年1月至2022年1月期间我院收治的老年T2DM伴肌少症病人78例作为研究对象,随机分成2组,每组39例,对照组予以常规治疗,研究组在对照组的基础上进行抗阻训练联合高乳蛋白营养干预。比较2组病人静息状态下骨骼肌质量指数、握力、FPG和HbA1c水平、生活质量及跌倒发生率。结果干预后研究组骨骼肌质量指数与握力均高于干预前,且与对照组比较,差异均有统计学意义(P＜0.05); 2组干预后FPG和HbA1c水平均明显降低,且研究组改善更明显,差异有统计学意义(P＜0.05);研究组干预后生活质量各维度得分均高于干预前(P＜0.05),且研究组生理功能、生理职能、总体健康、精神健康各维度得分均高于对照组(P＜0.05);研究组跌倒发生率明显低于对照组(5.13% 比23.08%,P＜0.05)。结论抗阻训练联合高乳蛋白营养能显著提高老年T2DM伴肌少症病人骨骼肌质量指数与握力,降低病人血糖,提高病人生活质量且降低跌倒发生率。

关键词: 抗阻训练, 高乳蛋白营养, 2型糖尿病, 肌少症

Abstract: Objective To explore the effect of resistance training combined with high milk protein nutrition in the elderly patients with type 2 diabetes mellitus (T2DM) and sarcopenia. Methods A total of 78 elderly patients with T2DM and sarcopenia admitted to our hospital from January 2021 to January 2022 were selected as the study subjects, and were randomly divided into two groups, with 39 cases in each group. The control group received routine treatment, while the study group received resistance training combined with high milk protein nutrition intervention on the basic treatment of the control group. The skeletal muscle mass index, grip strength, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), quality of life (QOL) and the incidence of falls in two groups were observed and compared. Results After intervention, the levels of skeletal muscle mass index and grip strength in the study group were significantly higher than those before intervention and those in the control group (P<0.05). The levels of FPG and HbA1c were significantly decreased in two groups after intervention, especially in the study group (P<0.05). After intervention, the scores of QOL of all dimensions were significantly higher than those before intervention in the study group (P<0.05), and the scores of physiological function, role physical, overall health, and mental health in the study group were higher than those in the control group (P<0.05). The incidence rate of falls in the study group was lower than that in the the control group (5.13% vs 23.08%,P<0.05). Conclusions Resistance training combined with high milk protein nutrition can significantly improve the skeletal muscle mass index and grip strength of the elderly T2DM patients with sarcopenia, reduce blood glucose, improve the QOL of the patients and reduce the incidence of falls.

Key words: resistance training, high milk protein nutrition, type 2 diabetes mellitus, sarcopenia

中图分类号:

R 587.1

张林英, 梅群超, 张炜琦, 胡一兰. 抗阻训练联合高乳蛋白营养在老年2型糖尿病伴肌少症病人中的应用研究[J]. 实用老年医学, 2023, 37(10): 995-999.

ZHANG Lin-ying, MEI Qun-chao, ZHANG Wei-qi, HU Yi-lan. Application of resistance training combined with high milk protein nutrition in elderly patients with type 2 diabetes mellitus and sarcopenia[J]. Practical Geriatrics, 2023, 37(10): 995-999.

参考文献

[1] SENOO S, IWASAKI M, KIMURA Y, et al. Combined effect of poor appetite and low masticatory function on sarcopenia in community-dwelling Japanese adults aged ≥ 75 years: a 3-year cohort study[J]. J Oral Rehabil, 2020,47(5):643-650.
[2] CHEN L K, WOO J, ASSANTACHAI P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment[J]. J Am Med Dir Assoc,2020,21(3):300-307.
[3] 牛红娟, 左祥宇, 庞宗然. 2型糖尿病肌少症中西医结合研究进展[J]. 天津中医药,2021,38(1):131-136.
[4] SAEEDI P, PETERSOHN I, SALPEA P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition [J]. Diab Res Clinl Pract, 2019, 157: 107843.
[5] 吴丽娟, 郭太林, 李小明, 等. 亚洲地区老年2型糖尿病患者肌少症患病率和影响因素的Meta分析[J]. 中国糖尿病杂志,2020,28(9): 651-656.
[6] KDILER A, VARLÍ M, YAVUZ Ö, et al. Evaluation of oxidative stress parameters and antioxidant status in plasma and erythrocytes of elderly diabetic patients with sarcopenia[J]. Nutr Health Aging, 2019, 23(3):239-245.
[7] NOMURA T, KAWAE T, KATAOKA H, et al. Aging,physical activity and diabetic complications related to loss of muscle strength in patients with type 2 diabetes[J]. Phys Ther Res, 2018, 21(2):33-38.
[8] 侍磊. 糖尿病肌少症的中医药研究进展[J]. 中医药临床杂志, 2020, 32(8): 1588-1591.
[9] 国家老年医学中心, 中华医学会老年医学分会, 中国老年保健协会糖尿病专业委员会. 中国老年糖尿病诊疗指南(2021年版) [J]. 中华糖尿病杂志,2021,13(1):14-46.
[10] 刘娟, 丁清清, 周白瑜, 等. 中国老年人肌少症诊疗专家共识(2021)[J]. 中华老年医学杂志,2021,40(8):943-952.
[11] LI L, CUI Y, CHEN S, et al. The impact of systemic sclerosis on health-related quality of life assessed by SF-36: a systematic review and meta-analysis[J]. Int J Rheum Dis, 2018, 21(11):1884-1893.
[12] GIHA HAYDER A, ALAMIN OSMAN A O, SATER MAI S, et al. Diabetic sarcopenia: metabolic and molecular appraisal[J]. Acta Diabetol,2022,59(8): 989-1000.
[13] LENDERS M, VERDIJK L B, VAN DER HOEVEN L, et al. Patients with type 2 diabetes show a greater decline in muscle mass, muscle strength, and functional capacity with aging [J]. J Am Med Dir Assec, 2013, 14(8): 585-592.
[14] HWANG H, BOWEN B P, LEFORT N, et al. Proteomics analysis of human skeletal muscle reveals novel abnormalities in obesity and type 2 diabetes[J]. Diabetes, 2010, 59(1):33-42.
[15] 张海峰, 朱静芬, 冯易, 等. 上海市社区2型糖尿病患者饮食控制现状研究[J]. 中国全科医学, 2015,18(34): 4251-4256.
[16] KANALEY J A, COLBERG S R, CORCORAN M H, et al. Exercise/physical activity in individuals with type 2 diabetes:a consensus statement from the American College of Sports Medicine[J]. Med Sci Sports Exerc,2022,54(2):353-368.