Sports Health and Rehabilitation Research Center, China Institute of Sport Science, Beijing, PEOPLE'S REPUBLIC OF CHINA.
Med Sci Sports Exerc. 2018 Mar;50(3):458-467. doi: 10.1249/MSS.0000000000001448.
Recent studies suggested that muscle mass and muscle strength may independently or synergistically affect aging-related health outcomes in older adults; however, prospective data on mortality in the general population are sparse.
We aimed to prospectively examine individual and joint associations of low muscle mass and low muscle strength with all-cause mortality in a nationally representative sample. This study included 4449 participants age 50 yr and older from the National Health and Nutrition Examination Survey 1999 to 2002 with public use 2011 linked mortality files. Weighted multivariable logistic regression models were adjusted for age, sex, race, body mass index (BMI), smoking, alcohol use, education, leisure time physical activity, sedentary time, and comorbid diseases.
Overall, the prevalence of low muscle mass was 23.1% defined by appendicular lean mass (ALM) and 17.0% defined by ALM/BMI, and the prevalence of low muscle strength was 19.4%. In the joint analyses, all-cause mortality was significantly higher among individuals with low muscle strength, whether they had low muscle mass (odds ratio [OR], 2.03; 95% confidence interval [CI], 1.27-3.24 for ALM; OR, 2.53; 95% CI, 1.64-3.88 for ALM/BMI) or not (OR, 2.66; 95% CI, 1.53-4.62 for ALM; OR, 2.17; 95% CI, 1.29-3.64 for ALM/BMI). In addition, the significant associations between low muscle strength and all-cause mortality persisted across different levels of metabolic syndrome, sedentary time, and LTPA.
Low muscle strength was independently associated with elevated risk of all-cause mortality, regardless of muscle mass, metabolic syndrome, sedentary time, or LTPA among US older adults, indicating the importance of muscle strength in predicting aging-related health outcomes in older adults.
最近的研究表明，肌肉质量和肌肉力量可能独立或协同影响老年人的与衰老相关的健康结果；然而，一般人群中关于死亡率的前瞻性数据很少。
我们旨在前瞻性地研究低肌肉质量和低肌肉力量与全因死亡率在全国代表性样本中的个体和联合关联。这项研究包括来自国家健康和营养检查调查 1999 年至 2002 年的 4449 名年龄在 50 岁及以上的参与者，以及公共使用 2011 年链接的死亡率文件。加权多变量逻辑回归模型调整了年龄、性别、种族、体重指数（BMI）、吸烟、饮酒、教育、休闲时间体力活动、久坐时间和合并症。
总体而言，低肌肉质量的患病率为 23.1%，定义为四肢瘦体重（ALM），17.0%定义为 ALM/BMI，低肌肉力量的患病率为 19.4%。在联合分析中，无论是否存在低肌肉质量（比值比[OR]，2.03；95%置信区间[CI]，1.27-3.24 为 ALM；OR，2.53；95%CI，1.64-3.88 为 ALM/BMI），低肌肉力量的个体全因死亡率明显更高（OR，2.66；95%CI，1.53-4.62 为 ALM；OR，2.17；95%CI，1.29-3.64 为 ALM/BMI）。此外，低肌肉力量与全因死亡率之间的显著关联在不同水平的代谢综合征、久坐时间和 LTPA 中仍然存在。
在美国老年人中，无论肌肉质量、代谢综合征、久坐时间或 LTPA 如何，低肌肉力量与全因死亡率升高独立相关，表明肌肉力量在预测老年人与衰老相关的健康结果方面的重要性。
