中国医学前沿杂志（电子版）2026，Vol.18Issue(4)：17-24,8.DOI:10.12037/YXQY.2026.04-03
老年2型糖尿病患者运动功能障碍的中枢-外周互作机制研究进展
Research progress on central-peripheral interplay mechanisms underlying motor dysfunction in elderly patients with type 2 diabetes mellitus
摘要
Abstract
With the accelerating global population aging,motor dysfunction in elderly patients with type 2 diabetes mellitus(T2DM)has emerged as a critical factor impairing quality of life and elevating fall risk.Traditional research has predominantly attributed motor dysfunction to isolated system damage;however,accumulating evidence demonstrates that impairments in the central nervous system(CNS)and peripheral neuromuscular system are not independent but interact through complex bidirectional pathways that mutually amplify pathological processes.This review systematically summarizes recent advances in understanding motor dysfunction in elderly T2DM patients,with a focus on dysregulated central-peripheral interactions in the context of T2DM and their pathophysiological mechanisms mediating the impariment of motor dysfunction.At the central level,hyperglycemia and insulin resistance trigger brain atrophy,white matter lesions,basal ganglia and cerebellar dysfunction,and brain network dysregulation,leading to impaired motor control precision and balance deficits.At the peripheral level,diabetic peripheral neuropathy(DPN),sarcopenia,neuromuscular junction dysfunction(NMJ),and microvascular disease collectively contribute to muscle weakness and proprioceptive loss.Critically,the CNS and peripheral systems interact through four key pathways:the inflammation-metabolism-neural axis,neurotrophic factor network dysregulation,neurovascular unit(NVU)injury,and oxidative stress-mitochondrial dysfunction,forming an intricate pathological network that constitutes the integrative basis for comprehensive motor decline.This paper underscores the need to shift from a"single-system"to a"cross-system"research and intervention paradigm,thereby providing the rationale and empirical support for multi-target integrated strategies.关键词
2型糖尿病/老年人/运动功能障碍/跌倒风险/中枢-外周互作Key words
Type 2 diabetes mellitus/Aged/Motor dysfunction/Fall risk/Central-peripheral interplay引用本文复制引用
周哲平,李圭钰,王兆喆,陈宗艺,张弘弘,胡吉..老年2型糖尿病患者运动功能障碍的中枢-外周互作机制研究进展[J].中国医学前沿杂志（电子版）,2026,18(4):17-24,8.基金项目
Noncommunicable Chronic Diseases-National Science and Technology Major Project:"Four Major Chronic Diseases Major Project"(2023ZD0507100,2023ZD0507103) （2023ZD0507100,2023ZD0507103）
General Program of the National Natural Science Foundation of China(82170836) 慢性病国家科技重大专项:"四大慢病重大专项"(2023ZD0507100,2023ZD0507103) （82170836）
国家自然科学基金面上项目(82170836) （82170836）
