Balogun Saliu A, Aitken Dawn, Wu Feitong, Scott David, Jones Graeme, Winzenberg Tania
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
J Gerontol A Biol Sci Med Sci. 2021 Oct 13;76(11):2015-2020. doi: 10.1093/gerona/glab086.
This study aims to describe the relationships between physical activity (PA), body composition, and multimorbidity over 10 years.
Participants (N = 373; 49% women; average age 61.3 ± 6.7 years) were followed for 10 years. Multimorbidity was defined by self-report as the presence of 2 or more of 12 listed chronic conditions. PA (steps per day) at baseline was assessed by pedometer, handgrip strength (HGS) by dynamometer, and appendicular lean mass (ALM) and total body fat mass by dual-energy x-ray absorptiometry. Relative HGS and ALM were calculated by dividing each body mass index (BMI). Regression cubic splines were used to assess evidence for a nonlinear relationship.
After 10 years, 45% participants had multimorbidity. There was a nonlinear relationship between PA and multimorbidity-PA was associated with lower multimorbidity risk among individuals who engaged in <10 000 steps/d (relative risk [RR] = 0.91, 95% CI: 0.85, 0.97, per 1 000 steps/d), but not among those who participated in ≥10 000 steps/d (RR = 1.04, 95% CI: 0.93, 1.09, per 1 000 steps/d). Higher BMI (RR = 1.05, 95% CI: 1.02, 1.08, per kg/m2) and fat mass (RR = 1.03, 95% CI: 1.01, 1.04, per kg), and lower relative HGS (RR = 0.85, 95% CI: 0.77, 0.94, per 0.1 psi/kg/m2) and ALM (RR = 0.93, 95% CI: 0.88, 0.98, per 0.1 kg/kg/m2) were linearly associated with a higher risk of multimorbidity. Absolute HGS and ALM were not significantly associated with multimorbidity.
These findings highlight the potential clinical importance of maintaining adequate levels of PA and of reducing adiposity and maintaining muscle function for minimizing the risk of multimorbidity in older adults.
本研究旨在描述10年间身体活动（PA）、身体成分与多种疾病共存之间的关系。
对参与者（N = 373；49%为女性；平均年龄61.3±6.7岁）进行了10年的随访。多种疾病共存通过自我报告定义为存在12种列出的慢性病中的2种或更多种。基线时的PA（每日步数）通过计步器评估，握力（HGS）通过测力计评估，四肢瘦体重（ALM）和全身脂肪量通过双能X线吸收法评估。相对HGS和ALM通过除以各自的体重指数（BMI）来计算。使用回归三次样条来评估非线性关系的证据。
10年后，45%的参与者患有多种疾病。PA与多种疾病共存之间存在非线性关系——在每日步数<10000步的个体中，PA与较低的多种疾病共存风险相关（相对风险[RR]=0.91，95%置信区间：0.85，0.97，每1000步/天），但在每日步数≥10000步的个体中则不然（RR = 1.04，95%置信区间：0.93，1.09，每1000步/天）。较高的BMI（RR = 1.05，95%置信区间：1.02，1.08，每kg/m²）和脂肪量（RR = 1.03，95%置信区间：1.01，1.04，每kg），以及较低的相对HGS（RR = 0.85, 95%置信区间：0.77, 0.94, 每0.1 psi/kg/m²）和ALM（RR = 0.93, 95%置信区间：0.88, 0.98, 每0.1 kg/kg/m²）与较高的多种疾病共存风险呈线性相关。绝对HGS和ALM与多种疾病共存无显著关联。
这些发现凸显了保持适当水平的PA以及减少肥胖和维持肌肉功能对于降低老年人多种疾病共存风险的潜在临床重要性。
