한국 노인 당뇨병 환자에서 근감소성 비만의 발생과 관련 요인 분석

Abstract

Objective Sarcopenic obesity is a double burden for older people because it carries the cumulative risk of functional abnormality, metabolic, cardiovascular risk, and mortality compared to either sarcopenia or obesity alone. Identifying individuals at risk and precise, early intervention to prevent sarcopenic obesity can greatly improve public health in today’s aging society. Diabetes is related to an increase in visceral adiposity and is associated with the risk of sarcopenia. The objective of this study was to explore a prevalence of sarcopenic obesity and determine associated factors with sacopenic obesity in Korean older people with diabetes. Research Design and Methods This study was based on data from the Korean National Health and Nutrition Examination Survey (KNHANES), conducted by the Korean Ministry of Health and Welfare, from 2009 to 2010. Out of 19,491 participants, the analysis included data for 3,206 older people. Multivariate logistic regression analyses were used to identify independent associated factors with sarcopenic obesity. The complex sample analysis was used for the KNHANES data for weighting all values following the guidance of statistics from the Korea Centers for Disease Control and Prevention. Results The prevalence rates of nonsarcopenic nonobesity, nonsarcopenic obesity, sarcopenic nonobesity, and sarcopenic obesity were 43.2%, 7.7%, 23.5%, and 25.6%, respectively, in all subjects. The prevalence of sarcopenic obesity in older people with diabetes was significantly higher than those without diabetes (33.9% vs. 23.4%, p-value < 0.001). Diabetes was an independent associated factor with sarcopenic obesity in korean older people after fully adjusting for confounding factors, including chronic diseases, sociodemographic influences, and lifestyle differences. Among the older people with diabetes, undiagnosed diabetes, diabetes duration with more than 10 years, elevated diastolic blood pressure, known hypertension, increased intake of protein, and number of comorbidity were independent associated factors with higher risk of sarcopenic obesity. History of stroke and increased vitamin D level were independently associated with a lower risk of sarcopenic obesity. Conclusion Diabetes influenced the sarcopenic obesity risk in Korean older people. Undiagnosed diabetes, diabetes duration with more than 10 years, elevated diastolic blood pressure, known hypertension, increased intake of protein, number of comorbidity, history of stroke, and vitamin D level were independently associated with sarcopenic obesity in Korean older people with diabetes.