Abstract: Background　China has the largest number of diabetics all of the world.In particular，more than 20% of the people aged 60 years and over have type 2 diabetes.Various acute and chronic complications caused by diabetes seriously affect the health status and quality of life of the elders，among them，frailty has become the third major complication，which should be concerned by medical workers.Objective　To investigate the frailty in elderly diabetics，analyze the influencing factors，and explore the targeted intervention measures.Methods　This survey was carried out from January to June 2018 among elderly diabetic endocrinology outpatients selected by convenience sampling from People's Hospital of Ningxia Hui Autonomous Region.During the survey，general sociodemographic characteristics（gender，age，educational level，marital status，level of independence，medical insurance，household monthly income per person，drinking，smoking，regular exercising），and clinical data（course of diabetes，number of hospitalizations due to aggravation of diabetes in the past year，regular pharmaceutical treatment/insulin treatment，coexisted chronic diseases） were collected by self-administered General Sociodemographic Questionnaire and Clinical Questionnaire developed by our research group，respectively.Frailty was assessed by the Frailty Phenotype （proposed and validated by Fried and colleagues in the Cardiovascular Health Study）．Additionally，glycated hemoglobin （HbA1c） was collected by fasting venous blood testing，and BMI was calculated.Ordinal multivariate Logistic regression analysis was adopted to analyze the influencing factors of frailty.Results　Altogether，280 cases participated in the survey，and 278 of them（99.3%） who responded to the survey effectively were included in the final analysis.Of the respondents，there were 127 males（45.7%） and 151 females（54.3%）；130（46.8%） were robust，107（38.5%） were pre-frail，and 41（14.7%） were frail.Ordinal multivariate Logistic regression analysis found that age〔OR=1.273，95%CI（1.039，1.561），P<0.05〕，household monthly income per person〔<1 000 yuan：OR=14.720，95%CI（1.641，132.033），P<0.05；1 000-2 000 yuan：OR=7.631，95%CI（1.153，50.506），P<0.05〕，regular exercise〔OR=0.119，95%CI（0.019，0.734），P<0.05〕，course of diabetes〔OR=1.477，95%CI（1.138，1.915），P<0.05〕，number of hospitalizations due to aggravation of diabetes in the past year〔OR=14.061，95%CI（3.776，52.359），P<0.05〕，number of chronic diseases〔OR=19.779，95%CI（4.677，83.647），P<0.05〕，and HbA1c〔OR=34.207，95%CI（8.208，142.566），P<0.05〕 were the influencing factors of frailty.Conclusion　The frailty of elderly diabetics are affected by age，economic status，exercise status，course of diabetes，blood sugar and complication.Interventions for reducing the risk of frailty should be delivered based on the patients' conditions.

Key words: Diabetes mellitus, Frailty, Aged, Root cause analysis

摘要： 背景　我国是世界上糖尿病患病人数最多的国家，60岁以上老年人2型糖尿病患病率占20%以上，由糖尿病引发的各种急慢性并发症严重影响老年人健康状况及生活质量，其中衰弱已成为老年糖尿病患者的第3大类并发症，老年糖尿病患者衰弱状况应引起医护人员的关注。目的　调查老年糖尿病患者衰弱现状，分析其影响因素，并探讨具有针对性的干预措施。方法　采用便利抽样法抽取2018年1—6月于宁夏回族自治区人民医院内分泌科门诊就诊的老年糖尿病患者为调查对象。采用一般资料问卷（性别、年龄、文化程度、婚姻状况、居住状况、医保情况、家庭人均月收入以及饮酒状况、吸烟状况、是否经常运动锻炼）、临床资料问卷（糖尿病病程、过去1年因糖尿病加重住院次数、规律药物/胰岛素治疗情况、合并慢性病数）进行问卷调查；并采用FRIED等提出的衰弱表型评估患者的衰弱状况，测量糖化血红蛋白（HbA1c）和计算BMI。采用有序多因素Logistic回归分析分析老年糖尿病患者衰弱的影响因素。结果　共发放问卷280份，回收有效问卷278份，有效回收率为99.3%。278例老年糖尿病患者中，男127例（45.7%），女151例（54.3%）；年龄60~86岁，平均年龄（72.2±5.5）岁；无衰弱130例（46.8%），衰弱前期107例（38.5%），衰弱期41例（14.7%）。有序多因素Logistic回归分析结果显示，年龄〔OR=1.273，95%CI（1.039，1.561），P<0.05〕、家庭人均月收入〔<1 000元：OR=14.720，95%CI（1.641，132.033），P<0.05；1 000~2 000元：OR=7.631，95%CI（1.153，50.506），P<0.05〕、是否经常运动锻炼〔是：OR=0.119，95%CI（0.019，0.734），P<0.05〕、糖尿病病程〔OR=1.477，95%CI（1.138，1.915），P<0.05〕、过去1年因糖尿病加重住院次数〔OR=14.061，95%CI（3.776，52.359），P<0.05〕、合并慢性病数〔OR=19.779，95%CI（4.677，83.647），P<0.05〕、HbA1c〔OR=34.207，95%CI（8.208，142.566），P<0.05〕是老年糖尿病患者衰弱的影响因素。结论　老年糖尿病患者衰弱状况受年龄、经济状况、运动锻炼情况、病程、血糖、并发症等多种因素的影响，应考虑影响因素对老年糖尿病患者采取有针对性的干预措施，减少患者衰弱的发生。

关键词: 糖尿病, 衰弱, 老年人, 影响因素分析