Shortage of energy intake rather than protein intake is associated with sarcopenia in elderly patients with type 2 diabetes: A cross-sectional study of the KAMOGAWA-DM cohort

J Diabetes. 2019 Jun;11(6):477-483. doi: 10.1111/1753-0407.12874. Epub 2018 Dec 4.

Abstract
in English, Chinese

Background: Energy intake is important for the maintenance of muscle mass. The relationship between energy intake and sarcopenia in elderly patients with type 2 diabetes (T2D) has been unclear.

Methods: Using a brief-type self-administered diet history questionnaire we assessed habitual food and nutrient intake of patients with T2D aged ≥65 years, all of whom were Japanese and physically active, taking part in the KAMOGAWA-DM cohort study. Patients' body composition was evaluated by bioimpedance analysis. Sarcopenia was defined as having both a grip strength of <26 kg for men and <18 kg for women and a skeletal muscle mass index of <7.0 kg/m2 for men and <5.7 kg/m2 for women. Logistic regression analyses were used to investigate the effect of energy intake on the presence of sarcopenia in this cross-sectional study of 391 patients (205 men, 186 women).

Results: Fifty-five patients (14.1%) were diagnosed as having sarcopenia. Energy intake was significantly lower in patients with sarcopenia than without sarcopenia (mean ± SD [n = 366] 1498.8 ± 389.4 vs 1786.2 ± 706.7 kcal/d, respectively; P = 0.016). After adjusting for age, sex, exercise, smoking status, HbA1c, and body mass index, patients' energy intake (per 100 kcal) was negatively associated with the presence of sarcopenia (odds ratio 0.86; 95% confidence interval 0.78-0.95; P = 0.001).

Conclusion: Energy intake was negatively associated with the presence of sarcopenia in elderly patients with T2D.

摘要: 背景 能量摄入对于肌肉质量的维持来说很重要。老年2型糖尿病患者的能量摄入与肌萎缩之间的关系目前尚未明确。 方法 使用简要型自我填写的饮食史问卷，我们对年龄≥ 65岁的2型糖尿病患者的日常食物与营养摄入进行了评估，所有的患者都是日本人并且积极锻炼，他们参与了千叶-糖尿病队列研究(KAMOGAWA-DM cohort study)。通过生物阻抗分析来评估患者的身体组成。肌萎缩的定义为男性握力< 26 kg并且骨骼肌质量指数< 7.0 kg/m2 ，女性握力< 18 kg并且骨骼肌质量指数< 5.7 kg/m2 。使用logistic回归分析法在该项纳入了391名患者(男性205名，女性186名)的横断面研究中，调查能量摄入对肌萎缩的影响。 结果 有55名患者(14.1%)被诊断为肌萎缩。肌萎缩患者的能量摄入显著低于无肌萎缩的患者(平均数 ± SD[n = 366]分别为1498.8 ± 389.4与1786.2 ± 706.7千卡/日；P = 0.016)。校正年龄、性别、运动、吸烟状态、HbA1c及体重指数后，发现患者的能量摄入(每100千卡)与肌萎缩之间呈负相关(优势比为0.86；95%置信区间为0.78-0.95；P = 0.001)。 结论 在老年2型糖尿病患者中能量摄入与肌萎缩之间呈负相关。.

Keywords: 2型糖尿病; energy intake; muscle mass; nutrition; sarcopenia; type 2 diabetes; 肌肉质量; 肌萎缩; 能量摄入; 营养.

MeSH terms

  • Aged
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / therapy*
  • Dietary Proteins / adverse effects*
  • Energy Intake*
  • Feeding Behavior
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Muscle Strength*
  • Muscle, Skeletal / physiopathology*
  • Nutrients / adverse effects*
  • Prognosis
  • Sarcopenia / etiology*

Substances

  • Dietary Proteins