Lindgren Martin, Åberg Maria, Schaufelberger Maria, Åberg David, Schiöler Linus, Torén Kjell, Rosengren Annika
1 Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Sweden.
2 Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
Eur J Prev Cardiol. 2017 May;24(8):876-884. doi: 10.1177/2047487317689974. Epub 2017 Feb 5.
Aims To investigate the association between cardiorespiratory fitness (CRF) and muscle strength in late adolescence and the long-term risk of heart failure (HF). Methods A cohort was created of Swedish men enrolled in compulsory military service between 1968 and 2005 with measurements for CRF and muscle strength ( n = 1,226,623; mean age 18.3 years). They were followed until 31 December 2014 for HF hospitalization as recorded in the Swedish national inpatient registry. Results During the follow-up period (median (interquartile range) 28.4 (22.0-37.0) years), 7656 cases of first HF hospitalization were observed (mean ± SD age at diagnosis 50.1 ± 7.9 years). CRF and muscle strength were estimated by maximum capacity cycle ergometer testing and strength exercises (knee extension, elbow flexion and hand grip). Inverse dose-response relationships were found between CRF and muscle strength with HF as a primary or contributory diagnosis with an adjusted hazards ratio (95% confidence interval) of 1.60 (1.44-1.77) for low CRF and 1.45 (1.32-1.58) for low muscle strength categories. The associations of incident HF with CRF and muscle strength persisted, regardless of adjustments for the other potential confounders. The highest risk was observed for HF associated with coronary heart disease, diabetes or hypertension. Conclusions In this longitudinal study of young men, we found inverse and mutually independent associations between CRF and muscle strength with risk of hospitalization for HF. If causal, these results may emphasize the importance of the promotion of CRF and muscle strength in younger populations.
目的 研究青春期晚期心肺适能（CRF）与肌肉力量之间的关联以及心力衰竭（HF）的长期风险。方法 对1968年至2005年间参加义务兵役的瑞典男性进行队列研究，测量其CRF和肌肉力量（n = 1,226,623；平均年龄18.3岁）。根据瑞典国家住院登记处记录，对他们进行随访直至2014年12月31日，观察HF住院情况。结果 在随访期间（中位数（四分位间距）28.4（22.0 - 37.0）年），观察到7656例首次HF住院病例（诊断时平均±标准差年龄50.1±7.9岁）。CRF和肌肉力量通过最大容量自行车测力计测试和力量练习（膝关节伸展、肘关节屈曲和握力）进行评估。发现CRF和肌肉力量与以HF作为主要或辅助诊断之间存在反向剂量反应关系，低CRF组的调整后风险比（95%置信区间）为1.60（1.44 - 1.77），低肌肉力量组为1.45（1.32 - 1.58）。无论对其他潜在混杂因素进行何种调整，新发HF与CRF和肌肉力量之间的关联均持续存在。与冠心病、糖尿病或高血压相关的HF风险最高。结论 在这项针对年轻男性的纵向研究中，我们发现CRF和肌肉力量与HF住院风险之间存在反向且相互独立的关联。如果存在因果关系，这些结果可能强调在年轻人群中促进CRF和肌肉力量的重要性。
