Association between sarcopenia and the foot-ankle function in type 2 diabetic foot ulcer.

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetology & Metabolic Syndrome Pub Date : 2024-11-13 DOI:10.1186/s13098-024-01507-5

Shujing An, Weina Kuang, Yonglu Hu, Xinwei Li, Bingzi Dong, Chengqian Li, Yangang Wang

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Abstract

Background: The diabetic foot (DF) ulcer is the severe complication of type 2 diabetes mellitus (T2DM). Sarcopenia is characterized as the loss of muscle mass and strength, resulting in the increased risk of fracture and physical disability. Sarcopenia may affect the foot-ankle function in DF ulcer patients, compromise the quality of life.

Objective: The aim was to clarify the effect of sarcopenia on foot-ankle function in patients with DF ulcer.

Methods: In total of 108 T2DM patients with DF ulcer were enrolled. Based on the examination of muscle mass by dual energy X-ray absorptiometry (DXA) and grip strength and 5x sit-to-stand test, the DF patients were divided into sarcopenia and non-sarcopenia groups. The severity of DF ulcer was evaluated by Wagner classification. The foot-ankle function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score.

Results: DF patients with sarcopenia showed advanced age, lower BMI, longer duration of T2DM, and more severe Wagner classification, reduced appendicular skeletal muscle mass index (ASMI), grip strength, transcutaneous oxygenpressure (TcPO₂) and prolonged time of 5X sit-to-stand test. The stratified comparison analysis indicated that severity of sarcopenia and DF ulcer, reduced TcPO₂, and grip strength were aggravated with the impaired foot-ankle function (P < 0.05). Multivariate Logistic analysis showed that age, TcPO₂, and severe sarcopenia were risk factors deteriorating the foot-ankle function.

Conclusion: The sarcopenia is a key risk factor of decreasing foot-ankle function in patients with DF ulcer. Thus, the prevention of muscle mass and strength loss could be considered as part of comprehensive therapy for DF ulcer.

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肌肉疏松症与 2 型糖尿病足溃疡患者足踝功能之间的关系。

背景：糖尿病足（DF）溃疡是 2 型糖尿病（T2DM）的严重并发症。肌肉疏松症的特点是肌肉质量和力量的丧失，导致骨折和身体残疾的风险增加。肌肉疏松症可能会影响 DF 溃疡患者的足踝功能，影响其生活质量：目的：阐明肌肉疏松症对 DF 溃疡患者足踝功能的影响：方法：共纳入 108 名患有 DF 溃疡的 T2DM 患者。根据双能 X 光吸收测定法（DXA）、握力和 5 倍坐立测试对肌肉质量的检测结果，将 DF 患者分为肌肉疏松症组和非肌肉疏松症组。用瓦格纳分类法评估 DF 溃疡的严重程度。美国骨科足踝协会（AOFAS）踝-后足评分评估了足踝功能：结果：患有 "肌肉疏松症 "的 DF 患者年龄较大，体重指数较低，T2DM 持续时间较长，瓦格纳分类较严重，骨骼肌质量指数（ASMI）、握力、经皮氧压（TcPO2）降低，5 倍坐立测试时间延长。分层比较分析表明，肌肉疏松症和 DF 溃疡的严重程度、TcPO2 降低和握力会加重足踝功能受损（P 2），严重的肌肉疏松症是足踝功能恶化的危险因素：结论：肌肉疏松症是导致 DF 溃疡患者足踝功能下降的关键风险因素。因此，预防肌肉质量和力量下降可被视为综合治疗 DF 溃疡的一部分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetology & Metabolic Syndrome ENDOCRINOLOGY & METABOLISM-

CiteScore

6.20

自引率

0.00%

发文量

170

审稿时长

7.5 months

期刊介绍： Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome. By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.