Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Maturitas. 2020 Aug;138:69-75. doi: 10.1016/j.maturitas.2020.04.017. Epub 2020 May 5.
It is unclear what combinations of physical capability markers used to define sarcopenia have the strongest associations with health outcomes.
To compare the associations between different combinations of physical capability markers of sarcopenia with cardiovascular and respiratory outcomes and all-cause mortality.
469,830 UK Biobank participants were included in this prospective study. Four groups were derived based on combinations of three physical capability markers used to define sarcopenia or severe sarcopenia: gait speed, grip strength and muscle mass. Outcomes studied were all-cause mortality, as well as incidence and mortality from cardiovascular disease (CVD), respiratory disease and chronic obstructive pulmonary disease (COPD).
All combinations of physical capability markers used to define sarcopenia or severe sarcopenia identified individuals at increased risk of respiratory disease and all-cause mortality. However, the definition most strongly associated with a wide range of adverse health outcomes was the combination of slow gait speed plus low muscle mass, followed by severe sarcopenia, and the combination of slow gait speed plus low grip strength. The current definition of sarcopenia (low grip strength plus low muscle mass) had the weakest associations with all-cause (HR: 1.35 [95% CI: 1.07 to 1.71]) and respiratory mortality (HR: 1.88 [95% CI: 1.15 to 3.10]), as well as respiratory disease (HR: 1.38 [95% CI: 1.11 to 1.73]) and COPD incidence (HR: 2.08 [95% CI: 1.14 to 3.79]).
Associations of sarcopenia with adverse outcomes were strongest when sarcopenia was defined as slow gait speed plus low muscle mass, followed by severe sarcopenia, suggesting that this combination of physical capability markers should be still considered in the diagnosis of sarcopenia.
目前尚不清楚用于定义肌少症的身体能力标志物组合与健康结果的关联程度。
比较不同肌少症身体能力标志物组合与心血管和呼吸系统结局以及全因死亡率之间的关联。
本前瞻性研究纳入了 469830 名英国生物库参与者。根据用于定义肌少症或严重肌少症的三种身体能力标志物的组合，将参与者分为四组：步态速度、握力和肌肉质量。研究的结局包括全因死亡率以及心血管疾病（CVD）、呼吸系统疾病和慢性阻塞性肺疾病（COPD）的发生率和死亡率。
用于定义肌少症或严重肌少症的所有身体能力标志物组合都能识别出患有呼吸系统疾病和全因死亡率风险增加的个体。然而，与广泛不良健康结局关联最强的定义是步态速度缓慢加上肌肉质量低的组合，其次是严重肌少症，以及步态速度缓慢加上握力低的组合。目前肌少症的定义（握力低加上肌肉质量低）与全因死亡率（HR：1.35 [95%CI：1.07 至 1.71]）和呼吸死亡（HR：1.88 [95%CI：1.15 至 3.10]）以及呼吸系统疾病（HR：1.38 [95%CI：1.11 至 1.73]）和 COPD 发生率（HR：2.08 [95%CI：1.14 至 3.79]）的关联最弱。
当肌少症被定义为步态速度缓慢加上肌肉质量低时，与不良结局的关联最强，其次是严重肌少症，这表明在肌少症的诊断中仍应考虑这种身体能力标志物的组合。
