Pérez-Sousa Miguel Ángel, Del Pozo-Cruz Jesús, Cano-Gutiérrez Carlos A, Ferrebuz Atilio J, Sandoval-Cuellar Carolina, Izquierdo Mikel, Hernández-Quiñonez Paula A, Ramírez-Vélez Robinson
Faculty of Sport Sciences, University of Huelva, Avenida de las Fuerzas Armadas s/n 21007, 21004 Huelva, Spain.
Department of Physical Education and Sport, University of Seville, 41092 Seville, Spain.
J Clin Med. 2020 Jul 22;9(8):2323. doi: 10.3390/jcm9082323.
Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 ± 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative effect on fasting glucose (β = 9.04, 95%CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related (β = -0.003, 95%CI = -0.005 to -0.001), < 0.001. The direct effect of abdominal obesity on relative HGS was statistically significant (β = -0.069, 95%CI = -0.082 to -0.057), < 0.001. Lastly, fasting glucose levels mediates the detrimental effect of abdominal obesity on relative HGS (indirect effect β = -0.002, 95%CI = -0.004 to -0.001), < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass.
中心性肥胖过多会加速老年人肌肉力量的衰退。此外，高血糖与肌肉量和力量的丧失有关，且独立于相关合并症，还会导致老年人功能受损。我们研究了血糖水平在腹部肥胖与相对握力（HGS）之间关系中的中介作用。采用多阶段区域概率抽样设计，从86个城市中选取了1571名参与者（60.0%为女性，平均年龄69.1±7.0岁）。测量指标包括人口统计学和人体测量学/肥胖指标（体重、身高、体重指数和腰围）。使用数字测力计测量HGS，共测量三组，记录平均值。将这些值按体重进行标准化（相对HGS）。采用酶比色法分析空腹血糖。进行中介分析以确定自变量（腹部肥胖）与结果（相对HGS）之间的关联，并确定空腹血糖水平是否介导了肥胖过多与相对HGS之间的关系。共有1239人（78.8%）存在腹部肥胖。腹部肥胖对空腹血糖有负面影响（β = 9.04，95%CI = 5.87至12.21）；而空腹血糖与相对HGS呈负相关（β = -0.003，95%CI = -0.005至-0.001），<0.001。腹部肥胖对相对HGS的直接影响具有统计学意义（β = -0.069，95%CI = -0.082至-0.057），<0.001。最后，空腹血糖水平介导了腹部肥胖对相对HGS的有害影响（间接效应β = -0.002，95%CI = -0.004至-0.001），<0.001。我们的结果表明，血糖水平可能会使腹部肥胖状态与较低HGS之间的关联恶化。因此，在评估肥胖过多和/或疑似肌肉量丧失的老年人时，考虑空腹血糖水平是合理的。
