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小腿肌肉密度与超重和肥胖老年人的身体功能独立相关。

Calf muscle density is independently associated with physical function in overweight and obese older adults.

作者信息

Scott David, Shore-Lorenti Catherine, McMillan Lachlan B, Mesinovic Jakub, Clark Ross A, Hayes Alan, Sanders Kerrie M, Duque Gustavo, Ebeling Peter R

机构信息

Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia.

出版信息

J Musculoskelet Neuronal Interact. 2018 Mar 1;18(1):9-17.

Abstract

OBJECTIVES

To determine whether associations of calf muscle density with physical function are independent of other determinants of functional decline in overweight and obese older adults.

METHODS

This was a secondary analysis of a cross-sectional study of 85 community-dwelling overweight and obese adults (mean±SD age 62.8±7.9 years; BMI 32.3±6.1 kg/m2; 58% women). Peripheral quantitative computed tomography assessed mid-calf muscle density (66% tibial length) and dual-energy X-ray absorptiometry determined visceral fat area. Fasting glucose, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and C-reactive protein (CRP) were analysed. Physical function assessments included hand grip and knee extension strength, balance path length (computerised posturography), stair climb test, Short Physical Performance Battery (SPPB) and self-reported falls efficacy (Modified Falls Efficacy Scale; M-FES).

RESULTS

Visceral fat area, not muscle density, was independently associated with CRP and fasting glucose (B=0.025; 95% CI 0.009-0.042 and B=0.009; 0.001-0.017, respectively). Nevertheless, higher muscle density was independently associated with lower path length and stair climb time, and higher SPPB and M-FES scores (all P⟨0.05). Visceral fat area, fasting glucose and CRP did not mediate these associations.

CONCLUSIONS

Higher calf muscle density predicts better physical function in overweight and obese older adults independent of insulin resistance, visceral adiposity or inflammation.

摘要

目的

确定在超重和肥胖的老年人中,小腿肌肉密度与身体功能之间的关联是否独立于功能衰退的其他决定因素。

方法

这是一项对85名社区居住的超重和肥胖成年人进行的横断面研究的二次分析(平均±标准差年龄62.8±7.9岁;体重指数32.3±6.1kg/m²;58%为女性)。外周定量计算机断层扫描评估小腿中部肌肉密度(胫骨长度的66%),双能X线吸收法测定内脏脂肪面积。分析空腹血糖、胰岛素抵抗稳态模型评估(HOMA-IR)和C反应蛋白(CRP)。身体功能评估包括握力和膝关节伸展力量、平衡路径长度(计算机化姿势描记法)、爬楼梯测试、简短身体功能量表(SPPB)和自我报告的跌倒效能(改良跌倒效能量表;M-FES)。

结果

内脏脂肪面积而非肌肉密度与CRP和空腹血糖独立相关(B=0.025;95%可信区间0.009-0.042和B=0.009;0.001-0.017)。然而,较高的肌肉密度与较短的路径长度和爬楼梯时间独立相关,以及较高的SPPB和M-FES评分(均P<0.05)。内脏脂肪面积、空腹血糖和CRP并未介导这些关联。

结论

在超重和肥胖的老年人中,较高的小腿肌肉密度预示着更好的身体功能,且独立于胰岛素抵抗、内脏肥胖或炎症。

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