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握力与社区居民全因死亡率、心血管疾病和癌症风险的关系:一项前瞻性队列研究的荟萃分析。

Association of Grip Strength With Risk of All-Cause Mortality, Cardiovascular Diseases, and Cancer in Community-Dwelling Populations: A Meta-analysis of Prospective Cohort Studies.

机构信息

Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Shandong, Qingdao, P. R. China.

Institute of Cerebrovascular Diseases, Affiliated Hospital of Qingdao University, Shandong, Qingdao, P. R. China.

出版信息

J Am Med Dir Assoc. 2017 Jun 1;18(6):551.e17-551.e35. doi: 10.1016/j.jamda.2017.03.011.

Abstract

OBJECTIVES

Grip strength has been linked to risk of adverse health outcomes. This study aimed to quantitatively assess the associations between grip strength and risk of all-cause mortality, cardiovascular diseases, and cancer in community-dwelling populations.

DESIGN

A meta-analysis of prospective cohort studies was conducted.

SETTING

Embase, Medline, and PubMed were searched from inception to September 14, 2016. Study-specific most adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were combined with a random effects model. Dose-response relation was assessed by restricted cubic splines.

RESULTS

Data were obtained from 42 studies including 3,002,203 participants. For lowest versus highest category of grip strength, the HRs (95% CIs) were 1.41 (1.30-1.52) for all-cause mortality, 1.63 (1.36-1.96) for cardiovascular diseases and 0.89 (0.66-1.20) for cancer. The HRs (95% CIs) with per-5-kg decrease in grip strength was 1.16 (1.12-1.20) for all-cause mortality, 1.21 (1.14-1.29) for cardiovascular diseases, 1.09 (1.05-1.14) for stroke, 1.07 (1.03-1.11) for coronary heart disease, and 1.01 (0.98-1.05) for cancer. The observed associations did not differ by sex, and remained after excluding participants with cardiovascular diseases or cancer at baseline. Adjustment for other covariates cannot fully explain the observed associations. Linear relationships were found between grip strength and risk of all-cause mortality and cardiovascular diseases within grip strength of 56 kg.

CONCLUSION

Grip strength was an independent predictor of all-cause mortality and cardiovascular diseases in community-dwelling populations.

摘要

目的

握力与不良健康结局的风险相关。本研究旨在定量评估社区居民握力与全因死亡率、心血管疾病和癌症风险之间的关系。

设计

对前瞻性队列研究进行荟萃分析。

设置

从 2016 年 9 月 14 日起,在 Embase、Medline 和 PubMed 上进行检索。使用随机效应模型合并研究特异性的调整后风险比(HRs)和 95%置信区间(CIs)。采用限制立方样条评估剂量-反应关系。

结果

数据来自 42 项研究,共纳入 3002203 名参与者。对于握力最低和最高组,全因死亡率的 HR(95%CI)分别为 1.41(1.30-1.52)、心血管疾病为 1.63(1.36-1.96)、癌症为 0.89(0.66-1.20)。握力每下降 5kg,全因死亡率的 HR(95%CI)为 1.16(1.12-1.20)、心血管疾病为 1.21(1.14-1.29)、中风为 1.09(1.05-1.14)、冠心病为 1.07(1.03-1.11)、癌症为 1.01(0.98-1.05)。这些关联在性别之间没有差异,且在排除基线时患有心血管疾病或癌症的参与者后仍然存在。调整其他协变量并不能完全解释观察到的关联。在 56kg 的握力范围内,发现握力与全因死亡率和心血管疾病的风险之间存在线性关系。

结论

在社区居民中,握力是全因死亡率和心血管疾病的独立预测因子。

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