老年2型糖尿病合并冠心病患者发生衰弱的机制及干预措施
The Mechanism and Intervention Measures of Senile Type 2 Diabetes Patients with Coronary Heart Disease
DOI: 10.12677/ACM.2023.1371664, PDF,   
作者: 王芝兰：青海大学研究生院，青海 西宁；杨青岩*：青海大学附属医院老年医学科，青海 西宁
关键词: 老年2型糖尿病；冠心病；衰弱；Elderly Type 2 Diabetes； Coronary Heart Disease； Frailty
摘要: 2型糖尿病(Type 2 diabetes mellitus, T2DM)是一种常见的代谢综合征，其中冠状动脉及外周粥样硬动脉化是其常见的大血管并发症，也是造成糖尿病相关发病率和死亡率的主要原因。衰弱是一种临床综合征，其核心是老年人生理储备能力降低和多系统功能失调，而老年糖尿病患者由于胰岛素抵抗及血糖控制不佳等，造成骨骼肌细胞能量代谢障碍，蛋白合成代谢反应下降，较易引起骨骼肌减少症，促进衰弱的发生，另外共存疾病也是发生衰弱的一个重要危险因素，所以2型糖尿病合并冠心病会加速机体衰弱的发生。本文就2型糖尿病合并冠心病患者发生衰弱的机制以及2型糖尿病合并冠心病患者发生衰弱时的干预措施进行综述。
Abstract: Type 2 diabetes (T2DM) is a common metabolic syndrome, in which coronary artery and peripheral atherosclerotic arterialization are common macrovascular complications, and also the main reason for diabetes related incidence rate and mortality. Weakness is a clinical syndrome, the core of which is the reduction of the physiological reserve capacity of the elderly and the dysfunction of multiple systems. However, the elderly patients with diabetes suffer from insulin resistance and poor blood sugar control, resulting in energy metabolism disorders of skeletal muscle cells, decreased protein anabolism, which is more likely to cause sarcopenia and promote the occurrence of weakness. In addition, coexisting diseases are also an important risk factor for the occurrence of weakness, Therefore, type 2 diabetes combined with coronary heart disease will accelerate the occurrence of body weakness. This article reviews the mechanism of type 2 diabetes with coronary heart disease and the intervention measures for type 2 diabetes with coronary heart disease.
文章引用：王芝兰, 杨青岩. 老年2型糖尿病合并冠心病患者发生衰弱的机制及干预措施[J]. 临床医学进展, 2023, 13(7): 11876-11883. https://doi.org/10.12677/ACM.2023.1371664

参考文献

[1] Kurra, S. and Siris, E. (2011) Diabetes and Bone Health: The Relationship between Diabetes and Osteoporo-sis-Associated Fractures. Diabetes/Metabolism Research and Reviews, 27, 430-435. [Google Scholar] [CrossRef] [PubMed]
[2] Ogurtsova, K., Da, R.F.J., Huang, Y., et al. (2017) IDF Diabetes Atlas: Global Estimates for the Prevalence of Diabetes for 2015 and 2040. Diabetes Research and Clinical Practice, 128, 40-50. [Google Scholar] [CrossRef] [PubMed]
[3] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版) [J]. 中国实用内科杂志, 2018, 38(4): 292-344.
[4] Kozakova, M., Morizzo, C., Fraser, A.G. and Palombo, C. (2017) Impact of Glycemic Control on Aortic Stiffness, Left Ventricular Mass and Diastolic Longitudinal Function in Type 2 Diabetes Mellitus. Cardiovascular Diabetology, 16, Article No. 78. [Google Scholar] [CrossRef] [PubMed]
[5] 刘瑶霞, 陈树, 陈平, 等. 中国老年糖尿病患者血脂异常现况调查及影响因素分析(GDCR研究基线2) [J]. 中国糖尿病杂志, 2018, 26(8): 647-652.
[6] Vergès, B. (2018) La réduction de l’hyperglycémieentraîne-t-elle un bénéficecardiovasculaire? La Presse Médicale, 47, 764-768. [Google Scholar] [CrossRef] [PubMed]
[7] 郭智慧, 李雨涵. 心脏彩超联合颈动脉超声对冠心病的诊断价值[J]. 临床医学研究与实践, 2022, 7(18): 106-109.
[8] 潘志明, 罗立镇, 赵欣, 等. 双源CT冠状动脉成像在老年冠心病临床诊断中的应用分析[J]. 实用医学影像杂志, 2022, 23(1): 11-13.
[9] Clegg, A., Young, J., Iliffe, S., et al. (2020) Frailty in Elderly People. The Lancet, 381, 752-762. [Google Scholar] [CrossRef] 
[10] Abdelhafiz, A.H., Davies, P.C. and Sinclair, A.J. (2020) Triad of Impairment in Older People with Diabetes-Reciprocal Relations and Clinical Implications. Diabetes Research and Clinical Practice, 161, Article ID: 108065. [Google Scholar] [CrossRef] [PubMed]
[11] 修双玲, 穆志静, 孙丽娜, 等. 老年2型糖尿病患者衰弱的危险因素[J]. 中华老年多器官疾病杂志, 2021, 20(9): 646-649.
[12] Yanase, T., Yanagita, I., Muta, K. and Nawata, H. (2018) Frailty in Elderly Diabetes Patients. Endocrine Journal, 65, 1-11. [Google Scholar] [CrossRef] 
[13] Lontchi-Yimagou, E., Sobngwi, E., Matsha, T.E. and Kengne, A.P. (2013) Diabetes Mellitus and Inflammation. Current Diabetes Reports, 13, 435-444. [Google Scholar] [CrossRef] [PubMed]
[14] Soysal, P., Stubbs, B., Lucato, P., et al. (2016) Inflammation and Frailty in the Elderly: A Systematic Review and Meta-Analysis. Ageing Research Reviews, 31, 1-8. [Google Scholar] [CrossRef] [PubMed]
[15] Angulo, J., El Assar, M. and Rodríguez-Mañas, L. (2016) Frailty and Sarcopenia as the Basis for the Phenotypic Manifestation of Chronic Diseases in Older Adults. Molecular Aspects of Medicine, 50, 1-32. [Google Scholar] [CrossRef] [PubMed]
[16] Morley, J.E., Kim, M.J. and Haren, M.T. (2005) Frailty and Hor-mones. Reviews in Endocrine and Metabolic Disorders, 6, 101-108. [Google Scholar] [CrossRef] [PubMed]
[17] Husemoen, L.L.N., Skaaby, T., Thuesen, B.H., et al. (2012) Se-rum 25(OH)D and Incident Type 2 Diabetes: A Cohort Study. European Journal of Clinical Nutrition, 66, 1309-1314. [Google Scholar] [CrossRef] [PubMed]
[18] Pfeifer, M., Begerow, B. and Minne, H.W. (2002) Vitamin D and Mus-cle Function. Osteoporosis International, 13, 187-194. [Google Scholar] [CrossRef] [PubMed]
[19] Holick, M.F., Binkley, N.C., Bischoff-Ferrari, H.A., et al. (2011) Evaluation, Treatment and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 96, 1911-1930. [Google Scholar] [CrossRef] [PubMed]
[20] Mekli, K., Marshall, A., Nazroo, J., et al. (2015) Genetic Variant of In-terleukin-18 Gene Is Associated with the Frailty Index in the English Longitudinal Study of Ageing. Age Ageing, 44, 938-942. [Google Scholar] [CrossRef] [PubMed]
[21] Blasco-Baque, V., Serino, M., Vergnes, J., et al. (2012) High-Fat Diet Induces Periodontitis in Mice through Lipopolysaccharides (LPS) Receptor Signaling: Protective Action of Estrogens. PLOS ONE, 7, e48220. [Google Scholar] [CrossRef] [PubMed]
[22] Alaghehband, F.R., Erkkilä, A.T., Rikkonen, T., et al. (2021) Association of Baltic Sea and Mediterranean Diets with Frailty Phenotype in Older Women, Kuopio OSTPRE-FPS Study. European Journal of Nutrition, 60, 821-831. [Google Scholar] [CrossRef] [PubMed]
[23] Yaribeygi, H., Sathyapalan, T., Atkin, S.L., et al. (2020) Molec-ular Mechanisms Linking Oxidative Stress and Diabetes Mellitus. Oxidative Medicine and Cellular Longevity, 2020, Ar-ticle ID: 8609213. [Google Scholar] [CrossRef] [PubMed]
[24] Soysal, P., Isik, A.T., Carvalho, A.F., et al. (2017) Oxidative Stress and Frailty: A Systematic Review and Synthesis of the Best Evidence. Maturitas, 99, 66-72. [Google Scholar] [CrossRef] [PubMed]
[25] Alie, N., Eldib, M., Fayad, Z.A. and Mani, V. (2014) Inflam-mation, Atherosclerosis, and Coronary Artery Disease: PET/CT for the Evaluation of Atherosclerosis and Inflammation. Clinical Medicine Insights: Cardiology, 8, 13-21. [Google Scholar] [CrossRef] 
[26] Hansson, G.K. (2005) Inflammation, Atherosclerosis and Coronary Ar-tery Disease. The New England Journal of Medicine, 352, 1685-1695. [Google Scholar] [CrossRef] 
[27] Davignon, J. and Ganz, P. (2004) Role of Endothelial Dysfunction in Atherosclerosis. Circulation, 109, I27-I32. [Google Scholar] [CrossRef] 
[28] 马丽娜. 衰弱与老年人心血管病的关系[J]. 中华高血压杂志, 2017, 25(4): 384-387.
[29] Yamada, Y., Kemnitz, J.W., Weindruch, R., et al. (2018) Caloric Restriction and Healthy Life Span: Frail Phenotype of Nonhuman Primates in the Wisconsin National Primate Research Center Caloric Restriction Study. The Journals of Gerontology: Series A, 73, 273-278. [Google Scholar] [CrossRef] [PubMed]
[30] McPhail, S. (2016) Multimorbidity in Chronic Disease: Impact on Health Care Resources and Costs. Risk Management and Healthcare Policy, 9, 143-156. [Google Scholar] [CrossRef] 
[31] 徐洁琼, 李维辛. 老年糖尿病相关性衰弱、肌少症发病机制及干预的研究进展[J]. 山东医药, 2018, 58(37): 109-112.
[32] 李言洵, 刘倩, 胡志灏, 等. 老年人衰弱特征及肾功能对衰弱的影响研究[J]. 中国全科医学, 2018, 21(1): 41-45.
[33] Cesari, M., Leeuwenburgh, C., Lauretani, F., et al. (2006) Frailty Syndrome and Skeletal Muscle: Results from the Invecchiare in Chianti Study. The American Journal of Clinical Nutrition, 83, 1142-1148. [Google Scholar] [CrossRef] [PubMed]
[34] 宁晓暄, 欧阳敏, 冷晓. 老年衰弱综合征的评估和管理[J]. 保健医苑, 2015(12): 14-15.
[35] Leng, S., Chen, X. and Mao, G. (2014) Frailty Syndrome: An Overview. Clinical Interven-tions in Aging, 9, 433-441. [Google Scholar] [CrossRef] 
[36] Sinclair, A.J., Abdelhafiz, A.H., Forbes, A., et al. (2019) Evi-dence-Based Diabetes Care for Older People with Type 2 Diabetes: A Critical Review. Diabetic Medicine, 36, 399-413. [Google Scholar] [CrossRef] [PubMed]
[37] Strain, W.D., Down, S., Brown, P., Puttanna, A. and Sinclair, A. (2021) Diabetes and Frailty: An Expert Consensus Statement on the Management of Older Adults with Type 2 Diabetes. Diabe-tes Therapy, 12, 1227-1247. [Google Scholar] [CrossRef] [PubMed]
[38] Assar, M.E., Laosa, O. and Rodríguez Mañas, L. (2019) Diabe-tes and Frailty. Current Opinion in Clinical Nutrition & Metabolic Care, 22, 52-57. [Google Scholar] [CrossRef] 
[39] 张爽. 社区老年糖尿病合并衰弱患者多组分运动训练方案的构建及应用研究[D]: [硕士学位论文]. 郑州: 郑州大学, 2020.
[40] Lopez-Garcia, E., Hagan, K.A., Fung, T.T., Hu, F.B. and Rodríguez-Artalejo, F. (2018) Mediterranean Diet and Risk of Frailty Syndrome among Women with Type 2 Diabetes. The American Journal of Clinical Nutrition, 107, 763-771. [Google Scholar] [CrossRef] [PubMed]
[41] Rashidi Pour Fard, N., Amirabdollahian, F. and Haghighatdoost, F. (2019) Dietary Patterns and Frailty: A Systematic Review and Meta-Analysis. Nutrition Reviews, 77, 498-513. [Google Scholar] [CrossRef] [PubMed]
[42] Hayakawa, M., Motokawa, K., Mikami, Y., et al. (2021) Low Dietary Variety and Diabetes Mellitus Are Associated with Frailty among Community-Dwelling Older Japanese Adults: A Cross-Sectional Study. Nutrients, 13, Article 641. [Google Scholar] [CrossRef] [PubMed]
[43] 贾文文, 赵慧楠, 戴付敏, 等. 老年糖尿病患者衰弱现状及影响因素研究[J]. 中华护理杂志, 2019, 54(2): 188-193.
[44] Vaccaro, J.A., Gaillard, T., Huffman, F.G. and Vieira, E.R. (2019) Motivational Strategies to Prevent Frailty in Older Adults with Diabetes: A Focused Review. Journal of Aging Research, 2019, Article ID: 3582679. [Google Scholar] [CrossRef] [PubMed]
[45] Izquierdo, M., Laosa, O., Cadore, E.L., et al. (2021) Two-Year Fol-low-Up of a Multimodal Intervention on Functional Capacity and Muscle Power in Frail Patients with Type 2 Diabetes. Journal of the American Medical Directors Association, 22, 1906-1911. [Google Scholar] [CrossRef] [PubMed]

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