MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, Cambridgeshire, CB2 0QQ, UK.
Department of Health, Kinesiology, and Recreation, College of Health, University of Utah, 250 South 1850 East Room 204, Salt Lake City, UT, 84112, USA.
Eur J Epidemiol. 2018 Oct;33(10):953-964. doi: 10.1007/s10654-018-0384-x. Epub 2018 Mar 28.
Little is known about the combined associations of cardiorespiratory fitness (CRF) and hand grip strength (GS) with mortality in general adult populations. The purpose of this study was to compare the relative risk of mortality for CRF, GS, and their combination. In UK Biobank, a prospective cohort of > 0.5 million adults aged 40-69 years, CRF was measured through submaximal bike tests; GS was measured using a hand-dynamometer. This analysis is based on data from 70,913 men and women (832 all-cause, 177 cardiovascular and 503 cancer deaths over 5.7-year follow-up) who provided valid CRF and GS data, and with no history of heart attack/stroke/cancer at baseline. Compared with the lowest CRF category, the hazard ratio (HR) for all-cause mortality was 0.76 [95% confidence interval (CI) 0.64-0.89] and 0.65 (95% CI 0.55-0.78) for the middle and highest CRF categories, respectively, after adjustment for confounders and GS. The highest GS category had an HR of 0.79 (95% CI 0.66-0.95) for all-cause mortality compared with the lowest, after adjustment for confounders and CRF. Similar results were found for cardiovascular and cancer mortality. The HRs for the combination of highest CRF and GS were 0.53 (95% CI 0.39-0.72) for all-cause mortality and 0.31 (95% CI 0.14-0.67) for cardiovascular mortality, compared with the reference category of lowest CRF and GS: no significant association for cancer mortality (HR 0.70; 95% CI 0.48-1.02). CRF and GS are both independent predictors of mortality. Improving both CRF and muscle strength, as opposed to either of the two alone, may be the most effective behavioral strategy to reduce all-cause and cardiovascular mortality risk.
对于一般成年人群，心肺适能（CRF）和握力（GS）的综合关联与死亡率的关系知之甚少。本研究的目的是比较 CRF、GS 及其组合的相对死亡率风险。在 UK Biobank 中，对 50 多万 40-69 岁成年人进行了前瞻性队列研究，通过亚最大自行车测试测量 CRF；使用手持测力计测量 GS。本分析基于 70913 名男性和女性的数据（5.7 年随访期间共有 832 例全因死亡、177 例心血管死亡和 503 例癌症死亡），这些人提供了有效的 CRF 和 GS 数据，并且在基线时没有心脏病发作/中风/癌症病史。与最低 CRF 类别相比，全因死亡率的危险比（HR）分别为 0.76（95%置信区间（CI）为 0.64-0.89）和 0.65（95%CI 为 0.55-0.78），经混杂因素和 GS 调整后。最高 GS 类别与最低 GS 类别相比，全因死亡率的 HR 为 0.79（95%CI 为 0.66-0.95），经混杂因素和 CRF 调整后。心血管和癌症死亡率也有类似的结果。最高 CRF 和 GS 组合的 HR 分别为 0.53（95%CI 为 0.39-0.72）和 0.31（95%CI 为 0.14-0.67），与最低 CRF 和 GS 的参考类别相比：癌症死亡率无显著相关性（HR 0.70；95%CI 0.48-1.02）。CRF 和 GS 都是死亡率的独立预测因素。与仅提高其中一项相比，提高 CRF 和肌肉力量可能是降低全因和心血管死亡率风险的最有效行为策略。
