Diabetes não controlado como fator associado à dinapenia em pessoas com 50 anos ou mais

Abstract

Introduction: Epidemiological studies that demonstrate the association between diabetes and muscle strength (MS) classify individuals as diabetic or non-diabetic. Thus, is not known how such associations behave in undiagnosed diabetics (UD), controlled diabetics (CD) and uncontrolled diabetics (UCD), nor which glycated hemoglobin levels are associated with low MS. Objectives: 1) to analyze the association between UD, CD and UCD and low MS (dynapenia); 2) to analyze how the different grouping of these individuals can modify these associations and 3) to analyze the association between serum glycated hemoglobin levels (HbA1c) and MS. Method: Cross-sectional study with 5.290 ELSA participants 50 years of age or older. In the first two analyzes, logistic regression models were used, with dynapenia (handgrip strength (HG) <26 kgf in men and <16 kgf in women) as outcome and diabetes [non-diabetic (ND), UD, CD and UCD] as exposure. Finally, linear regression was used with HG as the outcome and the participants were classified according to HbA1c values as exposure. The models were adjusted for sociodemographic, behavioral and clinical variables. Results: Only UCD was associated with dynapenia (OR = 1.78, 95% CI 1.22 - 2.59). Joining UD and ND overestimated the association of UCD with dinapenia by 2.8% (OR = 1.83; 95% CI 1.26 - 2.67). Joining CD and UCD underestimates such association in 18% (OR = 1.46; 95% CI 1.10 - 1.93). Individuals with HbA1c between 7 and 8% and > 8% presented a mean reduction of HG of 1.86 kgf and 1.63 kgf, respectively. Conclusion: UCD are more likely to present dynapenia than UD. The different classification of individuals with diabetes modifies the associations between UCD and dynapenia. Individuals with HbA1c ≥ 7% had lower MS than those with HbA1c <6.5%.