School of Medicine, Deakin University, Geelong, VIC, Australia.
Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia.
J Cachexia Sarcopenia Muscle. 2020 Jun;11(3):690-697. doi: 10.1002/jcsm.12544. Epub 2020 Feb 15.
Low handgrip strength (HGS) is a measure of poor skeletal muscle performance and a marker of ill health and frailty. Muscle quality (MQ) is a measure of muscle strength relative to muscle mass. We aimed to develop normative data for HGS and MQ, report age-related prevalence of low HGS and MQ, and determine the relationship with age, anthropometry, and body composition for women in Australia.
This cross-sectional analysis included data from 792 women (ages 28-95 years) assessed by the Geelong Osteoporosis Study. Duplicate measures of HGS were performed for each hand with a dynamometer (Jamar) and the mean of maximum values used for analyses. Dual energy X-ray absorptiometry-derived lean mass for the arms was used to calculate MQ as HGS/lean mass (kg/kg). Body mass index (BMI) was categorized as normal (BMI < 25.0 kg/m ), overweight (25.0-29.9 kg/m ), and obese (>30.0 kg/m ). Fat mass index (FMI) was calculated as whole body fat/height (kg/m ) and appendicular lean mass index (ALMI) as lean mass of arms and legs/height (kg/m ).
Mean (±SD) of HGS values for normal BMI, overweight, and obese groups were 25 (±7), 24 (±7), and 24 (±7) kg, P = 0.09, and for MQ, 12 (±3), 11 (±3), and 10 (±3) kg/kg, P < 0.001. Our data indicated a quadratic relationship between age and HGS or MQ. Mean HGS and MQ remained stable until the fifth age decade then declined steadily with increasing age; therefore, we used data for women (n = 283) aged 28-49 years as the young adult reference group, with mean (SD) values for HGS 28 (±6) kg and MQ 12 (±3) kg/kg. The prevalence of low (T-score < -2) HGS and MQ for women 80 years and older was 52.2% and 39.6%, respectively. In multivariable models, age-adjusted HGS was associated with FMI (B = -0.13, P = 0.004) and ALMI (1.03, <0.001) while age-adjusted MQ was associated with BMI (-0.15, <0.001) but not with FMI. In a sensitivity analysis, the same pattern remained after the removal of 129 women who reported hand and/or arm pain.
Mean HGS and MQ declined with advancing age in older women. Our data suggest that while mean HGS increased with appendicular lean mass and decreased with body fat mass, there was no association with BMI. By contrast, MQ decreased with increasing BMI, but not with increasing adiposity.
低握力（HGS）是肌肉骨骼表现不佳的衡量标准，也是健康状况不佳和虚弱的标志。肌肉质量（MQ）是衡量肌肉力量相对于肌肉质量的指标。我们旨在为 HGS 和 MQ 制定规范数据，报告澳大利亚女性与年龄相关的低 HGS 和 MQ 患病率，并确定与年龄、人体测量和身体成分的关系。
这项横断面分析包括了 792 名（年龄 28-95 岁）女性的 Geelong 骨质疏松症研究数据。使用测力计（Jamar）对每只手进行两次 HGS 测量，分析时使用最大数值的平均值。使用双能 X 射线吸收法测量的手臂瘦体重用于计算 HGS/瘦体重（kg/kg）作为 MQ。体重指数（BMI）分为正常（BMI<25.0kg/m）、超重（25.0-29.9kg/m）和肥胖（>30.0kg/m）。体脂指数（FMI）计算为全身脂肪/身高（kg/m），四肢瘦体重指数（ALMI）计算为手臂和腿部瘦体重/身高（kg/m）。
正常 BMI、超重和肥胖组的 HGS 值的平均值（±SD）分别为 25（±7）、24（±7）和 24（±7）kg，P=0.09，而 MQ 分别为 12（±3）、11（±3）和 10（±3）kg/kg，P<0.001。我们的数据表明，年龄与 HGS 或 MQ 之间呈二次关系。HGS 和 MQ 的平均值在第五个年龄十年之前保持稳定，然后随着年龄的增长而稳步下降；因此，我们将 283 名 28-49 岁的女性数据作为年轻成年参考组，HGS 的平均值（SD）为 28（±6）kg，MQ 的平均值（SD）为 12（±3）kg/kg。80 岁及以上女性低（T 评分<-2）HGS 和 MQ 的患病率分别为 52.2%和 39.6%。在多变量模型中，年龄调整后的 HGS 与 FMI（B=-0.13，P=0.004）和 ALMI（1.03，<0.001）相关，而年龄调整后的 MQ 与 BMI（-0.15，<0.001）相关，但与 FMI 无关。在敏感性分析中，在排除了 129 名报告手部和/或手臂疼痛的女性后，同样的模式仍然存在。
年长女性的平均 HGS 和 MQ 随年龄增长而下降。我们的数据表明，虽然平均 HGS 随着四肢瘦体重的增加而增加，随着体脂肪量的增加而减少，但与 BMI 无关。相比之下，MQ 随着 BMI 的增加而减少，但与脂肪量的增加无关。
