Fatores associados à força de preensão palmar em idosos com diabetes Mellitus tipo 2

Abstract

Introduction: Diabetes Mellitus type 2 (DM2) is considered a prevalent chronic condition, being identified as a risk factor for disability in the elderly, with increased health-related costs. Loss of muscle mass and strength is inherent in the aging process. However, elderly people with DM2 show a greater reduction in muscle mass and strength, compared to elderly people without this health condition. Since studies indicate that DM2 shares pathophysiological mechanisms and risk factors with musculoskeletal changes due to age, there is a need for a greater understanding of the loss of muscle strength in elderly people with DM2. Objective: The objective of this study was to investigate the factors associated with handgrip muscle strength (PPF) in elderly people with DM2. Methodology: This is a cross-sectional, observational study, with a sample of elderly community members with DM2. A sociodemographic and clinical questionnaire was applied to characterize the sample and to collect factors potentially related to FPP. Plasma measurements of sTNFR1 were performed using the Eliza method (Enzyme-Linked Immunosrbent Assay), using plasma samples. FPP was obtained using the Jamar Manual Dynamometer, from the average of three measurements in the dominant upper limb (Kgf). To investigate the factors associated with muscle strength, a multiple linear regression model was developed, using the stepwise method. Results: 232 elderly people were evaluated, of which 193 (69.43 years ± 6.21) provided samples for analysis of sTNFR1 dosages. By the bivariate analysis, the independent variables included in the model (p <0.20) were: income, number of associated diseases and medications, level of physical activity, smoking, use of alcohol, body mass index, depressive symptoms, sTNFR1 and appendicular muscle mass. The final regression model was able to explain 63% of the FPP variability. It was observed that appendicular muscle mass, plasma levels of sTNFR1 and the number of depressive symptoms were associated with FPP in elderly people with DM2, even after adjusting for age, sex, education and time of diagnosis for DM2. Conclusion: Elderly people with lower appendicular muscle mass, higher plasma levels of sTNFR1 and a greater number of depressive symptoms had lower FPP. These results highlight the importance of assessment, adequate approach and monitoring of muscle strength, with the aim of minimizing its impact on the functionality of elderly diabetics.