多模式运动项目对中年2型糖尿病患者身体表现和肌肉功能的影响
多模式运动项目对2型糖尿病中年患者身体表现和肌肉功能的影响:一项多中心随机对照试验
背景 患有2型糖尿病的中年人群,特别是在亚洲人群中,面临更高的肌肉减少症风险。 这种情况导致肌肉质量和功能下降,从而对他们的生活质量产生负面影响。 因此,迫切需要有效的干预措施来减缓疾病进展并降低这些风险。
方法
- 研究设计:这是一项多中心随机对照试验。
- 参与者:该研究计划招募66名年龄在45至64岁之间、确诊为2型糖尿病的成年人。
分组分配:参与者将被随机分配到对照组或干预组。
- 对照组:参与者仅收到一份“营养与肌肉健康教育单”,并根据现有医疗建议继续常规健康管理。
- 干预组:参与者将收到相同的宣传单以及一本“糖尿病与肌肉健康手册”,并参加为期12周的多模式运动计划。
- 评估:所有参与者将在基线、第6周和第12周接受评估。
结果指标
主要结果:
o 身体功能:短时体能测试(SPPB)、五次坐站测试(5TSTS)、握力以及骨骼肌质量指数(SMI)。
次要结果:
- 代谢控制:糖化血红蛋白(HbA1c)。
- 生活质量:SF-12生活质量问卷。
- 肌肉减少症风险:通过SARC-CalF问卷进行评估。 预期结果 本研究旨在为患有2型糖尿病的中年成年人提供基于证据且可行的多模式运动处方。 研究结果预计将支持健康老龄化的早期干预策略,并为临床实践和公共卫生政策的制定提供有价值的参考。
研究概览
详细说明
主要结局指标
身体功能:
使用简易体能状况量表(SPPB)评估身体表现,该量表通过三个子测试评估下肢功能:平衡能力、步行速度和椅子站立表现。每个组成部分的评分从0到4分,总分范围0-12分,分数越高表示身体表现越好。
还使用五次坐立测试(5TSTS)评估下肢肌肉力量和功能性移动能力。参与者被要求从标准椅子(座位高度43-45厘米)完全站立再返回坐姿,连续五次尽可能快速完成,且不得使用手臂支撑。记录所需总时间(秒),时间越长表示表现越差。
肌肉力量与质量:
使用数字握力计(如Jamar或同等型号)测量握力,作为上肢肌肉力量的指标。参与者站立位进行测试,手臂完全伸展于体侧,被要求用最大力量持续3-5秒。每只手进行两次测试,取最高值(kg)进行分析。根据亚洲肌少症工作组(AWGS 2019)标准,低肌肉力量定义为男性<28 kg、女性<18 kg。
骨骼肌质量指数(SMI)通过生物电阻抗分析(BIA;如InBody 720或同等设备)测定。四肢骨骼肌质量(ASM, kg)计算为双臂和双腿瘦体重的总和。SMI表示为ASM除以身高的平方(kg/m²)。根据AWGS 2019截断值,低肌肉质量定义为男性<7.0 kg/m²、女性<5.7 kg/m²。
次要结局指标
代谢控制:
通过测量糖化血红蛋白(HbA1c)水平评估血糖控制情况。禁食过夜后采集静脉血样本,使用标准化高效液相色谱法(HPLC)进行分析。HbA1c值根据国家糖化血红蛋白标准化计划(NGSP)指南以百分比表示。
生活质量:
使用12项简短健康调查(SF-12)评估健康相关生活质量。该经过验证的问卷包含12个项目,涵盖八个领域,汇总为两个综合评分:生理健康总评(PCS)和心理健康总评(MCS)。根据标准评分手册计算得分,分数越高表示生活质量越好。
肌少症风险评估:
使用SARC-CalF问卷筛查肌少症风险,该问卷结合了五项SARC-F(力量、行走辅助、从椅子站起、爬楼梯和跌倒)与小腿围测量。SARC-F每项评分0-2分,总分范围0-10分。使用无弹性卷尺测量右腿最宽处的小腿围,男性值≤34 cm、女性值≤33 cm时,在SARC-F得分上加10分。SARC-CalF总分≥11分表示肌少症高风险。
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习地点
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Taichung、台湾、402306
- Chung Shan Medical University Hospital
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参与标准
资格标准
适合学习的年龄
- 成人
接受健康志愿者
描述
纳入标准:
- 诊断为2型糖尿病且口服降糖药物稳定。
45至64岁的中年成人。
能够用普通话或闽南语沟通。
愿意提供知情同意或由代理人提供知情同意。
排除标准:
- 肢体或关节功能受限(例如骨折或脱位)。
- 沟通或情绪问题,如抑郁症或精神疾病。
- 严重认知障碍,如痴呆症。
- 终末期肾病。
- 主要合并症或并发症,包括糖尿病足、截肢、心肌梗死、自主神经病变以及过去3年内有中风史。
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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无干预:对照组
本组参与者将作为研究的对照组。
在研究开始时,他们将仅收到一份“营养与肌肉健康教育单”。
他们不会参加多模式运动计划,并将根据现有的医疗建议继续其常规健康管理。
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实验性的:A Multimodal Exercise Intervention
Participants in this group will receive a Diabetes and Muscle Health Handbook and participate in a 12-week multimodal exercise program, including supervised instruction, home-based exercise, and digital support.
From Week 13 to Week 24, app-based maintenance reminders will be provided every two weeks.
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Participants will receive educational materials and participate in a 12-week multimodal exercise program, followed by app-supported maintenance reminders every two weeks through Week 24.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Short Physical Performance Battery (SPPB)
大体时间:All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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Physical performance was assessed using the Short Physical Performance Battery (SPPB), which evaluates lower extremity function through three subtests: balance, gait speed, and chair-stand performance.
Each component was scored from 0 to 4, with a total score ranging from 0 to 12, where higher scores indicate better physical performance.
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All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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Five-Times Sit-to-Stand Test (5TSTS)
大体时间:All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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The Five-Times Sit-to-Stand Test (5TSTS) was also used to assess lower limb muscle strength and functional mobility.
Participants were instructed to rise from a standard chair (seat height 43-45 cm) to a full standing position and return to sitting five consecutive times as quickly as possible without using their arms.
The total time required was recorded in seconds, with longer times indicating poorer performance.
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All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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Handgrip strength
大体时间:All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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Handgrip strength was measured using a digital dynamometer (e.g., Jamar or equivalent model) as an indicator of upper limb muscle strength.
Participants performed the test in a standing position with the arm fully extended at the side and were instructed to exert maximum force for 3-5 seconds.
Two trials were performed for each hand, and the highest value (kg) was used for analysis.
Low muscle strength was defined according to the Asian Working Group for Sarcopenia (AWGS 2019) criteria (<28 kg for men and <18 kg for women).
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All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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Skeletal Muscle Mass Index (SMI)
大体时间:All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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Skeletal Muscle Mass Index (SMI) was determined by bioelectrical impedance analysis (BIA; e.g., InBody 720 or equivalent).
Appendicular skeletal muscle mass (ASM, kg) was calculated as the sum of lean mass from both arms and legs.
SMI was expressed as ASM divided by height squared (kg/m²).
Low muscle mass was defined according to the AWGS 2019 cut-off values (<7.0 kg/m² for men and <5.7 kg/m² for women).
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All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Metabolic Control
大体时间:All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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glycated hemoglobin (HbA1c)
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All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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12-Item Short Form Health Survey (SF-12)
大体时间:All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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Health-related quality of life was assessed using the 12-Item Short Form Health Survey (SF-12).
This validated questionnaire consists of 12 items covering eight domains, which are summarized into two composite scores: the Physical Component Summary (PCS) and Mental Component Summary (MCS).
Scores were calculated according to the standard scoring manual, with higher scores representing a better quality of life.
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All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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Sarcopenia Risk Assessment
大体时间:All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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Risk of sarcopenia was screened using the SARC-CalF questionnaire, which combines the five-item SARC-F (strength, assistance in walking, rising from a chair, climbing stairs, and falls) with calf circumference measurement.
Each item of SARC-F was scored from 0 to 2, yielding a total score ranging from 0 to 10. Calf circumference was measured at the widest point of the right leg using a non-elastic tape, with values ≤34 cm for men and ≤33 cm for women, adding 10 points to the SARC-F score.
A total SARC-CalF score ≥11 indicated a high risk of sarcopenia.
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All participants will be assessed at baseline, Week 6, Week 12, and Week 24.
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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