Nogami Eriko, Miyai Nobuyuki, Zhang Yan, Sakaguchi Masato, Hayakawa Hiroko, Hattori Sonomi, Utsumi Miyoko, Uematsu Yuji, Arita Mikio
Graduate School of Health and Nursing Science, Wakayama Medical University.
Graduate School of Medicine, Wakayama Medical University.
Nihon Eiseigaku Zasshi. 2021;76(0). doi: 10.1265/jjh.21003.
Recently, attention has been paid to the impact of cigarette smoking on skeletal muscles, as its underlying pathophysiological mechanism has been gradually elucidated. In this study, we aimed to examine whether cigarette smoking is associated with muscle mass reduction and low muscle strength in elderly men.
The study participants comprised 417 community-dwelling elderly men (aged 73±6 years) without severe glucose intolerance, chronic kidney disease, or liver disease. Bioelectrical impedance analysis was performed to estimate appendicular skeletal muscle mass (ASM), which was normalized for height (ASM index, kg/m). Handgrip strength (HGS) was measured using a Smedley grip dynamometer. Cumulative smoking exposure level during a lifetime was expressed in pack-years, which is a product of the average number of packs of cigarettes smoked per day and smoking duration in years.
When the participants were stratified on the basis of cumulative smoking exposure (<10 pack-years, 10-39 pack-years, ≥40 pack-years), the ASM index and HGS progressively decreased with increasing exposure level (P for trend <0.01). In multiple regression analysis, heavy smoking (defined as ≥40 pack-years) was found to be a significant determinant of the ASM index and HGS, independent of potential confounding factors. Among former smokers, the subgroup that quit smoking for ≥20 years had a significantly higher ASM index and HGS than the subgroup that quit smoking for <10 years. The duration of smoking cessation was significantly associated with the ASM index and HGS, even after adjusting for cumulative smoking exposure.
These findings suggest that cigarette smoking contributes to the loss of muscle mass and function in elderly men and that smoking cessation could reverse the impact of cigarette smoking on skeletal muscles.
近年来,吸烟对骨骼肌的影响受到关注,其潜在病理生理机制已逐渐阐明。本研究旨在探讨吸烟是否与老年男性肌肉量减少和肌肉力量降低有关。
研究参与者包括417名居住在社区的老年男性(年龄73±6岁),无严重糖耐量异常、慢性肾病或肝病。采用生物电阻抗分析法估算四肢骨骼肌量(ASM),并根据身高进行标准化(ASM指数,kg/m)。使用斯梅德利握力计测量握力(HGS)。终生累积吸烟暴露水平以包年表示,即每日平均吸烟包数与吸烟年限的乘积。
根据累积吸烟暴露水平(<10包年、10 - 39包年、≥40包年)对参与者进行分层时,ASM指数和HGS随暴露水平增加而逐渐降低(趋势P<0.01)。在多元回归分析中,发现重度吸烟(定义为≥40包年)是ASM指数和HGS的重要决定因素,独立于潜在混杂因素。在既往吸烟者中,戒烟≥20年的亚组ASM指数和HGS显著高于戒烟<10年的亚组。即使在调整累积吸烟暴露后,戒烟持续时间仍与ASM指数和HGS显著相关。
这些发现表明,吸烟导致老年男性肌肉量和功能丧失,戒烟可逆转吸烟对骨骼肌的影响。