性别和种族特异性的蛋白质摄入量与老年人肌肉质量和身体功能变化的关系：健康、老龄化和身体成分研究（Health ABC 研究）。
Sex-and race-specific associations of protein intake with change in muscle mass and physical function in older adults: the Health, Aging, and Body Composition (Health ABC) Study.
机构信息
Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands.
Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC - Location VU University Medical Center, Amsterdam, the Netherlands.
出版信息
Am J Clin Nutr. 2020 Jul 1;112(1):84-95. doi: 10.1093/ajcn/nqaa099.
BACKGROUND
Protein intake recommendations advise ≥0.8 g/kg body weight (BW)/d, whereas experts propose a higher intake for older adults (1.0-1.2 g/kg BW/d). It is unknown whether optimal protein intake differs by sex or race.
OBJECTIVES
We examined the shape of sex- and race-specific associations of dietary protein intake with 3- and 6-y changes in appendicular lean mass (aLM) and gait speed and also 6-y incidence of mobility limitation in community-dwelling older men and women.
METHODS
We used data on men (n = 1163) and women (n = 1237) aged 70-81 y of the Health, Aging, and Body Composition Study. Protein intake was assessed using an FFQ (1998-1999). aLM and gait speed were measured at baseline and at 3 and 6 y. Difficulty walking one-quarter mile or climbing stairs was measured every 6 mo over 6 y. Prospective associations were evaluated with linear and Cox regression models, comparing fit of models with and without spline functions. All analyses were stratified by sex and additionally by race.
RESULTS
Mean ± SD protein intake was 0.94 ± 0.36 g/kg adjusted body weight (aBW)/d in men and 0.95 ± 0.36 g/kg aBW/d in women. There were no strong indications of nonlinear associations. In women, higher protein intake was associated with less aLM loss over 3 y (adjusted B per 0.1 g/kg aBW/d: 39.4; 95% CI: 11.6, 67.2), specifically in black women, but not over 6 y or with gait speed decline. In men, protein intake was not associated with changes in aLM and gait speed. Higher protein intake was associated with a lower risk of mobility limitation in men (adjusted HR per 1.0 g/kg aBW/d: 0.55; 95% CI: 0.34, 0.91) and women (adjusted HR: 0.56; 95% CI: 0.33, 0.94), specifically white women.
CONCLUSIONS
Associations between protein intake and physical outcomes may vary by sex and race. Therefore, it is important to consider sex and race in future studies regarding protein needs in older adults.
背景
蛋白质摄入量建议为≥0.8 g/kg 体重（BW）/d，而专家建议老年人的摄入量更高（1.0-1.2 g/kg BW/d）。目前尚不清楚最佳蛋白质摄入量是否因性别或种族而异。
目的
我们研究了饮食蛋白质摄入量与 3 年和 6 年肢体瘦体重（aLM）和步态速度变化以及社区居住的老年男性和女性 6 年移动能力受限发生率之间的性别和种族特异性关联的形状。
方法
我们使用了健康、衰老和身体成分研究中 70-81 岁的男性（n=1163）和女性（n=1237）的数据。使用 FFQ（1998-1999 年）评估蛋白质摄入量。在基线和 3 年和 6 年时测量 aLM 和步态速度。在 6 年期间，每 6 个月测量一次行走四分之一英里或爬楼梯的难度。使用线性和 Cox 回归模型评估前瞻性关联，比较带有和不带有样条函数的模型拟合情况。所有分析均按性别和种族进行分层。
结果
男性和女性调整后的平均±标准差蛋白质摄入量分别为 0.94±0.36 g/kg 调整后体重（aBW）/d 和 0.95±0.36 g/kg aBW/d。没有强烈迹象表明存在非线性关联。在女性中，较高的蛋白质摄入量与 3 年内 aLM 损失减少有关（每 0.1 g/kg aBW/d 调整后的 B：39.4；95%CI：11.6，67.2），特别是在黑人女性中，但与 6 年内的 aLM 或步态速度下降无关。在男性中，蛋白质摄入量与 aLM 和步态速度的变化无关。较高的蛋白质摄入量与男性（每 1.0 g/kg aBW/d 调整后的 HR：0.55；95%CI：0.34，0.91）和女性（调整后的 HR：0.56；95%CI：0.33，0.94）的移动能力受限风险降低相关，特别是白人女性。
结论
蛋白质摄入量与身体结果之间的关联可能因性别和种族而异。因此，在未来关于老年人蛋白质需求的研究中，考虑性别和种族非常重要。
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