CAJ | 학술논문

目的探讨65岁及以上病程＞10年的2型糖尿病(T2DM)患者平衡能力及其相关危险因素.方法 2011年5月至9月选取97例65岁及以上病程＞10年的T2DM患者以及59名65岁及以上非糖尿病健康人群进行Berg平衡量表、足部振动觉、压力觉、温度觉、踝肱比、人体成分分析等测试,测定血清25羟维生素D3 [25 (OH) D3]、1,25二羟维生素D3[1.25(OH)2D3]水平,询问近12个月内跌倒次数并采集相关生化及临床指标.应用Spearman相关分析以及多元线性回归方法筛选平衡能力相关因素.结果糖尿病组未受外力作用且与低血糖无关的跌倒发生率[27.8％(18/97)比10.17％(6/59),x2=6.230]、人年均跌倒次数[(0.41±0.08)比(0.12±0.05)次,t=2.570]均明显高于对照组,Berg量表评分[(48.0±1.8)比(50.4±1.4)分,t=-8.900]、振动觉[(17±5)比(13±3)V,f =4.970]、踝肱比(0.79 ±0.11比0.97 ±0.16,t=-8.430)、压力觉(正常比例68.0％比89.8％,x2=9.627)、温度觉(正常比例52.6％比69.5％,x2=4.338)均低于对照组,差异均有统计学意义(均P＜0.05).Spearman相关分析提示糖尿病组患者Berg量表评分与振动觉呈负相关(r=-0.760,P＜0.05),与压力觉、踝肱比呈正相关(r=0.556、0.472,均P＜0.05),多元线性回归提示振动觉和压力觉为Berg量表评分的独立影响因素(β=-0.702、0.251,均P＜0.05).结论 65岁及以上病程＞10年的T2DM患者平衡能力明显减退,振动觉、压力觉是影响其平衡能力的独立危险因素.
목적 탐토65세급이상병정＞10년적2형당뇨병(T2DM)환자평형능력급기상관위험인소.방법 2011년5월지9월선취97례65세급이상병정＞10년적T2DM환자이급59명65세급이상비당뇨병건강인군진행Berg평형량표、족부진동각、압력각、온도각、과굉비、인체성분분석등측시,측정혈청25간유생소D3 [25 (OH) D3]、1,25이간유생소D3[1.25(OH)2D3]수평,순문근12개월내질도차수병채집상관생화급림상지표.응용Spearman상관분석이급다원선성회귀방법사선평형능력상관인소.결과 당뇨병조미수외력작용차여저혈당무관적질도발생솔[27.8％(18/97)비10.17％(6/59),x2=6.230]、인년균질도차수[(0.41±0.08)비(0.12±0.05)차,t=2.570]균명현고우대조조,Berg량표평분[(48.0±1.8)비(50.4±1.4)분,t=-8.900]、진동각[(17±5)비(13±3)V,f =4.970]、과굉비(0.79 ±0.11비0.97 ±0.16,t=-8.430)、압력각(정상비례68.0％비89.8％,x2=9.627)、온도각(정상비례52.6％비69.5％,x2=4.338)균저우대조조,차이균유통계학의의(균P＜0.05).Spearman상관분석제시당뇨병조환자Berg량표평분여진동각정부상관(r=-0.760,P＜0.05),여압력각、과굉비정정상관(r=0.556、0.472,균P＜0.05),다원선성회귀제시진동각화압력각위Berg량표평분적독립영향인소(β=-0.702、0.251,균P＜0.05).결론 65세급이상병정＞10년적T2DM환자평형능력명현감퇴,진동각、압력각시영향기평형능력적독립위험인소.
Objective To evaluate the degree of balance in type 2 diabetic patients with long duration(＞ 10 years) aged 65 years or above and to analyze its related risk factors.Methods A total of 97 diabetic outpatients with a duration over 10 years aged 65 years or above(DM group) and 59 healthy people aged over 65 years (control group) were enrolled in this study.Perception of vibration,pressure,temperature,ankle brachial index,waist-hip ratio,body fat percentage,serum 25 (OH) vitamin D3 (25 (OH) D3),1.25(OH)2 vitamin D3 (1.25 (OH) 2D3),blood glucose,glycated hemoglobin A1c (HbA1c),blood lipid,blood pressure were tested.The balance degree of all subjects were evaluated by Berg balance scale,the cases and number of falls of all subjects in last 12 months were recorded.Statistical analysis was performed by using Spearman correlation analysis and multiple linear regression analysis.Results In DM group,the incidence of falling (27.8％ (18/97) vs 10.17％ (6/59),x2 =6.230) and number of falls ((0.41 ± 0.08) vs (0.12 ± 0.05),t =2.570) were significant higher,while the Berg balance scale scores (48.0±1.8 vs50.4±1.4,t=-8.900),perception of vibration((17±5) vs (13±3)V,t=4.970),ankle brachial index (0.79 ± 0.11 vs 0.97 ± 0.16,t =-8.430),pressure sense (normal ratio 68.0％ vs 89.8％,x2 =9.627),temperature sense (normal ratio 52.6％ vs 69.5％,x2 =4.338) decreased significantly when compared to those in control group(all P ＜ 0.05).Spearman correlation analysis showed that Berg balance scale scores was negatively correlated with vibration perception(r =-0.760,P ＜ 0.05),positively correlated with pressure sense (r =0.556,P ＜ 0.05) and ankle brachial index (r =0.472,P ＜ 0.05).Multiple linear regression analysis showed that vibration perception and pressure sense were independent risk factors for Berg balance scale scores (β =-0.702,0.251,both P ＜ 0.05).Conclusion The balance degree in patients with long-duration T2DM aged 65 years and above declines obviously,vibration perception and pressure sense are independent risk factors for balance degree in those patients.