Associação entre Sarcopenia e risco de fraturas em pacientes idosos diabéticos.

Abstract

Introduction: The demographic transition that has been happening in the last decades resulted on a notable growth of the elder population. Functional limitations appear as a determining factor of health and quality of life, of which one that highlights is sarcopenia, which mensuration is possible by using different methods, as image exames and anthropometric measures. Structural and methabolic changes on the skeletal musculature of elders contribute on the development of insulin resistance and diabetes mellitus (DM), that is also common on this stage of life. Therefore, studies that seek to associate sarcopenia and ocurrence of fractures on diabetic elder patients are of great value. Objectives: To evaluate the prevalence of sarcopenia on diabetic elder patients, verifying the association between this muscular condition and the historic of fractures, as well as the correlation between those conditions and anthropometric parameters, history of falls, gliycemic control, lifestyle habits, and other conditions. Methods: Observational, cross-sectional and analytic study, that was performed at the Unit of Endocrinology and Metabology of University Hospital Alcides Carneiro, involving elderly patients (≥ 60 years) with DM. There were excluded patients with a diagnosis of osteoporosis. The predictor criterion of sarcopenia that was adopted was a calf circunference (CC) of < 33 cm for women and < 34 cm for men. Results: The valid sample was 44 patients, with a mean age of 69.6 years (± 5,23). The prevalence of sarcopenia was 20.4%. There was statistically significance on the correlation between sarcopenia and history of fractures, whether they happened on any kind of event (p = 0.033) or on low energy traumas (p = 0.022). There was no disparity between the groups with and without sarcopenia regarding the history of falls on the last 12 months (p = 0.589). There was association between the use of psycotropics and the ocurrence of falls (p = 0.001). Conclusion: Althought CC is not, by itself, a well stabilished method for the diagnosis of sarcopenia, the muscle loss indicated by this measure, is associated to the history of fractures on diabetic elders. So this measurement, accessile and easily applicable, can promote interventions aiming at the improvement elders’ quality of life.