Karlsen Trine, Nauman Javaid, Dalen Håvard, Langhammer Arnulf, Wisløff Ulrik
Faculty of Medicine, K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
Faculty of Medicine, K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
Mayo Clin Proc. 2017 May;92(5):710-718. doi: 10.1016/j.mayocp.2017.01.023.
To assess the isolated and combined associations of leg and arm strength with adherence to current physical activity guidelines with all-cause and cause-specific mortality in healthy elderly women.
This was a prospective cohort study of 2529 elderly women (72.6±4.8 years) from the Norwegian Healthy survey of Northern Trøndelag (second wave) (HUNT2) between August 15, 1995, and June 18, 1997, with a median of 15.6 years (interquartile range, 10.4-16.3 years) of follow-up. Chair-rise test and handgrip strength performances were assessed, and divided into tertiles. The hazard ratio (HR) of all-cause and cause-specific mortality by tertiles of handgrip strength and chair-rise test performance, and combined associations with physical activity were estimated by using Cox proportional hazard regression models.
We observed independent associations of physical activity and the chair-rise test performance with all-cause and cardiovascular mortality, and between handgrip strength and all-cause mortality. Despite following physical activity guidelines, women with low muscle strength had increased risk of all-cause mortality (HR chair test, 1.37; 95% CI, 1.07-1.76; HR handgrip strength, 1.39; 95% CI, 1.05-1.85) and cardiovascular disease mortality (HR chair test, 1.57; 95% CI, 1.01-2.42). Slow chair-test performance was associated with all-cause (HR, 1.32; 95% CI, 1.16-1.51) and cardiovascular disease (HR, 1.41; 95% CI, 1.14-1.76) mortality. The association between handgrip strength and all-cause mortality was dose dependent (P value for trend <.01).
Handgrip strength and chair-rise test performance predicted the risk of all-cause and CVD mortality independent of physical activity. Clinically feasible tests of skeletal muscle strength could increase the precision of prognosis, even in elderly women following current physical activity guidelines.
评估腿部和手臂力量与健康老年女性遵循当前身体活动指南情况以及全因死亡率和特定病因死亡率之间的单独关联和联合关联。
这是一项对2529名老年女性（72.6±4.8岁）进行的前瞻性队列研究，她们来自挪威北特伦德拉格健康调查（第二波）（HUNT2），研究时间为1995年8月15日至1997年6月18日，中位随访时间为15.6年（四分位间距为10.4 - 16.3年）。评估了从椅子上起身测试和握力表现，并将其分为三分位数。通过握力和从椅子上起身测试表现的三分位数以及与身体活动的联合关联来估计全因死亡率和特定病因死亡率的风险比（HR），采用Cox比例风险回归模型进行分析。
我们观察到身体活动和从椅子上起身测试表现与全因死亡率和心血管疾病死亡率之间存在独立关联，握力与全因死亡率之间也存在关联。尽管遵循了身体活动指南，但肌肉力量低的女性全因死亡率风险增加（从椅子上起身测试的HR为1.37；95%置信区间为1.07 - 1.76；握力的HR为1.39；95%置信区间为1.05 - 1.85）以及心血管疾病死亡率风险增加（从椅子上起身测试的HR为1.57；95%置信区间为1.01 - 2.42）。从椅子上起身测试表现缓慢与全因死亡率（HR为1.32；95%置信区间为1.16 - 1.51）和心血管疾病死亡率（HR为1.41；95%置信区间为1.14 - 1.76）相关。握力与全因死亡率之间的关联呈剂量依赖性（趋势P值<.01）。
握力和从椅子上起身测试表现可预测全因死亡率和心血管疾病死亡率风险，且独立于身体活动情况。即使对于遵循当前身体活动指南的老年女性，临床上可行的骨骼肌力量测试也可提高预后的准确性。
