【摘要】 目的 系统评价老年糖尿病共病患者衰弱患病率及其影响因素。方法 检索中国知网、维普、万方、中国生物医学文献数据库与Embase、The Cochrane Library、Web of Science、PubMed数据库中关于老年糖尿病共病患者衰弱患病率及其影响因素的随机对照试验、横断面研究、队列研究，时限为建库至2025年4月9日。由2名研究者对文献进行单独筛选、质量评价和摘取相关资料，使用RevMan5.4软件进行Meta分析。结果 最终纳入20篇文献，18篇横断面研究，2篇队列研究。老年糖尿病共病患者中，衰弱患者3 115例，衰弱前期患者158例。Meta分析显示，老年糖尿病共病患者衰弱总体患病率为50%(95%CI:32%～78%,P=0.002)。年龄（OR=1.42,95%CI:1.22～1.65,P<0.001）、吸烟史（OR=2.44,95%CI:1.80～3.31,P<0.001）、抑郁（OR=2.02,95%CI:1.27～3.22,P=0.003）、糖化血红蛋白（OR=1.68,95%CI:1.07～2.62,P=0.02）、社会支持（OR=2.41,95%CI:2.27～2.55,P<0.001）、日常生活能力中度依赖（OR=3.52,95%CI:1.97～6.32,P<0.001）、日常生活能力重度依赖（OR=6.47,95%CI:3.38～12.40,P<0.001）、心血管疾病（OR=1.59,95%CI:1.07～2.35,P=0.02）、骨质疏松（OR=1.18,95%CI:1.01～1.37,P=0.03）、白细胞计数（OR=1.05,95%CI:1.01～1.10,P=0.02）、红细胞沉降率（OR=1.01,95%CI:1.00～1.03,P=0.02）、健康素养（OR=0.93,95%CI:0.90～0.96,P<0.001）是老年糖尿病共病患者衰弱的影响因素。敏感性分析结果显示，年龄（OR=2.58,95%CI:1.83～3.63）、营养不良（OR=4.26,95%CI:2.83～6.43）、抑郁（OR=2.27,95%CI:1.78～2.88）、机体功能（OR=3.16,95%CI:2.08～4.80）、心血管疾病（OR=2.64,95%CI:1.72～4.04）、脑力活动（OR=0.12,95%CI:0.06～0.24）是老年糖尿病共病患者衰弱的影响因素（P均<0.01）。结论 老年糖尿病共病患者衰弱受生理、心理、社会多方面因素的影响，年龄、吸烟史、抑郁、糖化血红蛋白、社会支持、日常生活能力、心血管疾病、骨质疏松、白细胞、红细胞沉降率、营养不良、机体功能是老年糖尿病共病患者衰弱的危险因素，健康素养、脑力活动是其衰弱的保护因素。医护人员应该全方面评估患者，个体化筛选患者相关因素，及早进行干预，预防患者衰弱发生。更多还原

【Abstract】 Objective To systematically review the prevalence and influencing factors of frailty in elderly patients with diabetes and comorbidities. Methods CNKI, VIP, Wanfang, CBM, Embase, The Cochrane Library, Web of Science, and PubMed were searched for randomized controlled trials, cross-sectional studies, and cohort studies on the prevalence and influencing factors of frailty in elderly patients with diabetes and comorbidities. The search period was from the inception of each database to April 9, 2025. Two researchers independently screened the literature, assessed the quality, and extracted relevant data. Meta-analysis was conducted using RevMan 5. 4 software. Results A total of 20 studies were included, comprising 18 cross-sectional studies and 2 cohort studies. Among older adults with diabetes comorbidities, there were 3 115 cases of frailty and 158 cases of pre-frailty. Meta-analysis showed that the overall incidence of frailty in older adults with diabetes comorbidities was 50%(95% CI: 32%-78%, P=0. 002). The following factors were the influencing factors for frailty in older adults with diabetes comorbidities: age(OR=1. 42, 95% CI: 1. 22-1. 65, P<0. 001), smoking history(OR=2. 44, 95% CI: 1. 80-3. 31, P<0. 001), depression(OR=2. 02, 95% CI: 1. 27-3. 22, P=0. 003), glycated hemoglobin(OR=1. 68, 95% CI: 1. 07-2. 62, P=0. 02), social support(OR=2. 41, 95% CI: 2. 27-2. 55, P<0. 001), moderate dependence in activities of daily living(OR=3. 52, 95% CI: 1. 97-6. 32, P<0. 001), severe dependence in activities of daily living(OR=6. 47, 95% CI: 3. 38-12. 40, P<0. 001), cardiovascular disease(OR=1. 59, 95% CI: 1. 07-2. 35, P=0. 02), osteoporosis(OR=1. 18, 95% CI: 1. 01-1. 37, P=0. 03), white blood cell count(OR=1. 05, 95% CI: 1. 01-1. 10, P=0. 02), erythrocyte sedimentation rate(OR=1. 01, 95% CI: 1. 00-1. 03, P=0. 02), and health literacy(OR=0. 93, 95% CI: 0. 90-0. 96, P<0. 001). The results of the sensitivity analysis showed that,age(OR=2. 58,95% CI:1. 83-3. 63), malnutrition(OR=4. 26, 95% CI: 2. 83-6. 43),depression(OR=2. 27,95% CI:1. 78-2. 88), physical function(OR=3. 16, 95% CI: 2. 08-4. 80),cardiovas cular disease(OR=2. 64,95% CI:1. 72-4. 04) and mental activity(OR=0. 12, 95% CI: 0. 06-0. 24) were the influencing factors for frailty in older adults with diabetes comorbidities(all P<0. 01). Conclusions Frailty in elderly patients with diabetes and comorbidities is influenced by multiple aspects, including physiological, psychological, and social factors. Age, smoking history, depression, glycated hemoglobin, social support, activities of daily living, cardiovascular diseases, osteoporosis, white blood cells, erythrocyte sedimentation rate, malnutrition and body function are risk factors for frailty in elderly patients with diabetes comorbidities, while health literacy and mental activity are protective factors for frailty. Healthcare professionals should conduct a comprehensive assessment of patients, individually screen for relevant factors, and intervene early to prevent the occurrence of frailty.更多还原