在3153名老年人队列中,脂肪与肌肉比例可预测身体功能障碍的发生——这是一种评估肌肉减少症和肌肉减少性肥胖的替代指标。

Adiposity to muscle ratio predicts incident physical limitation in a cohort of 3,153 older adults--an alternative measurement of sarcopenia and sarcopenic obesity.

作者信息

Auyeung Tung Wai, Lee Jenny Shun Wah, Leung Jason, Kwok Timothy, Woo Jean

机构信息

The S. H. Ho Centre for Gerontology and Geriatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.

出版信息

Age (Dordr). 2013 Aug;35(4):1377-85. doi: 10.1007/s11357-012-9423-9. Epub 2012 May 22.

Abstract

Conventionally, sarcopenia is defined by muscle mass and physical performance. We hypothesized that the disability caused by sarcopenia and sarcopenic obesity was related to the amount of adiposity or body weight bearing on a unit of muscle mass, or the adiposity to muscle ratio. We therefore examined whether this ratio could predict physical limitation by secondary analysis of the data in our previous study. We recruited 3,153 community-dwelling adults aged >65 years and their body composition was measured by dual-energy X-ray absorptiometry. Assessment of physical limitation was undertaken 4 years later. The relationship between baseline adiposity to muscle ratio and incident physical limitation was examined by logistic regression. In men, the adiposity to muscle ratios, namely total body fat to lower-limb muscle mass, total body fat to fat-free mass (FFM), and body weight to FFM, were predictive of physical limitation before and after adjustment for the covariates: age, Mini-mental Status Examination score, Geriatric Depression Scale score >8, and the diagnosis of chronic obstructive pulmonary disease, diabetes mellitus, hypertension, heart disease, and stroke (all p values < 0.001), when the total body fat to lower-limb muscle mass ratio was greater than or equal to 0.75. In women, throughout the entire range of that ratio, all three adiposity to muscle ratios were associated with physical limitation 4 years later both before and after adjustment for the same set of covariates (all p values < 0.05). Sarcopenia and sarcopenic obesity as measured by the body weight or adiposity bearing on a unit of muscle mass (the adiposity to muscle ratio) could predict incident or worsening physical limitation in older women across the entire range of the total body fat to lower-limb muscle mass ratio; and in older men when this ratio was equal to or greater than 0.75.

摘要

传统上,肌肉减少症是由肌肉质量和身体机能来定义的。我们假设,肌肉减少症和肌肉减少性肥胖所导致的残疾与单位肌肉质量上的肥胖量或体重负荷有关,或者与脂肪与肌肉的比例有关。因此,我们通过对之前研究中的数据进行二次分析,来检验这个比例是否能够预测身体功能受限情况。我们招募了3153名年龄大于65岁的社区居住成年人,并通过双能X线吸收法测量了他们的身体成分。4年后进行身体功能受限评估。通过逻辑回归分析来研究基线脂肪与肌肉比例和发生身体功能受限之间的关系。在男性中,脂肪与肌肉比例,即全身脂肪与下肢肌肉质量的比例、全身脂肪与去脂体重(FFM)的比例以及体重与FFM的比例,在对协变量(年龄、简易精神状态检查表得分、老年抑郁量表得分>8,以及慢性阻塞性肺疾病、糖尿病、高血压、心脏病和中风的诊断)进行调整前后,均能预测身体功能受限情况(所有p值<0.001),当全身脂肪与下肢肌肉质量的比例大于或等于0.75时。在女性中,在该比例的整个范围内,在对同一组协变量进行调整前后,这三种脂肪与肌肉比例均与4年后的身体功能受限情况相关(所有p值<0.05)。以单位肌肉质量上的体重或肥胖量(脂肪与肌肉比例)来衡量的肌肉减少症和肌肉减少性肥胖,在全身脂肪与下肢肌肉质量比例的整个范围内,能够预测老年女性身体功能受限的发生或恶化情况;在老年男性中,当该比例等于或大于0.75时也能预测。

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