Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK.
Institute of Sport, Exercise and Health, UCL Division of Surgery and Interventional Science, University College London, London, UK.
J Cachexia Sarcopenia Muscle. 2022 Aug;13(4):1995-2004. doi: 10.1002/jcsm.12992. Epub 2022 May 19.
Ongoing rises in obesity prevalence have prompted growing concerns about potential increases in the burden of age-related musculoskeletal conditions including sarcopenia and sarcopenic obesity. This is of particular concern for future generations of older adults who have lived more of their lives in an obesogenic environment than current generations of older adults. We aimed to study longitudinal associations between body mass index (BMI) and grip strength in midlife using data from a large population-based sample, the 1970 British Cohort Study (BCS70).
BCS70 participants with valid measures of maximum grip strength at age 46 years were included in analyses [3671 males (49%) and 3876 females (51%)]. Using sex-specific linear regression models, we examined associations of (i) BMI at ages 10, 16, 30, and 46 years; (ii) body fat percentage (BF%) and waist-hip ratio at age 46 years; (iii) BMI gains between 10-16, 16-30, and 30-46; and (iv) age at onset of obesity, with grip strength.
At age 46 years, mean (standard deviation) grip strength was 48.10 kg (8.98) in males and 29.61 kg (5.81) in females. Higher BMI at all ages was associated with stronger grip, and the scale of associations was greater in males than females from age 16 onwards (P < 0.01). For example, in fully adjusted models, a 1 standard deviation increase in BMI at age 16 was associated with mean differences in grip strength at age 46 years of 1.41 kg (95% confidence interval: 1.07, 1.75) in males and 0.72 kg (0.53, 0.91) in females. Higher BF% at age 46 was also associated with stronger grip in both sexes. Greater gains in BMI between ages 10 and 16 were associated with stronger grip in both sexes, but subsequent gains in BMI were only associated with stronger grip in males. Associations of greater length of exposure to obesity and stronger grip were also more consistent among males than females. For example, in fully adjusted models, mean grip strength at age 46 years of males and females who had been obese since age 10 or 16 years was 4.39 kg (1.85, 6.93) and 1.25 kg (-0.18, 2.69) higher than males and females who had never been obese, respectively.
Higher BMI from childhood onwards is associated with stronger grip at age 46 years. This suggests that, at this age, anabolic effects of fat on muscle are outweighing the catabolic effects thought to lead to the manifestation of sarcopenic obesity later in life, especially among men. Midlife may be an optimal time to intervene to prevent sarcopenic obesity.
肥胖患病率的持续上升，引发了人们对与年龄相关的肌肉骨骼疾病（包括肌肉减少症和肌肉减少症性肥胖）负担增加的担忧。对于生活在肥胖环境中的老年人群体来说，这是一个特别令人担忧的问题，他们一生中的大部分时间都生活在肥胖环境中。本研究旨在使用大型人群基础样本（1970 年英国队列研究，BCS70）的数据，研究中年人 BMI 和握力之间的纵向关联。
纳入了在 46 岁时具有最大握力有效测量值的 BCS70 参与者（男性 3671 人[49%]，女性 3876 人[51%]）。使用性别特异性线性回归模型，我们研究了以下因素与握力之间的关联：（i）10 岁、16 岁、30 岁和 46 岁时的 BMI；（ii）46 岁时的体脂肪百分比（BF%）和腰臀比；（iii）10-16 岁、16-30 岁和 30-46 岁之间 BMI 的增长；（iv）肥胖的发病年龄。
在 46 岁时，男性的平均（标准差）握力为 48.10kg（8.98），女性为 29.61kg（5.81）。从 16 岁开始，所有年龄段的 BMI 越高，握力越强，且与女性相比，男性的关联程度更大（P<0.01）。例如，在完全调整的模型中，16 岁时 BMI 增加 1 个标准差，与 46 岁时的握力平均值差异相关，男性为 1.41kg（95%置信区间：1.07，1.75），女性为 0.72kg（0.53，0.91）。46 岁时的 BF%较高也与两性的握力较强相关。10 岁至 16 岁之间 BMI 的更大增长与两性的握力增强相关，但随后 BMI 的增长仅与男性的握力增强相关。与肥胖更长时间暴露相关的关联以及与握力的关联在男性中也比女性更为一致。例如，在完全调整的模型中，从 10 岁或 16 岁开始肥胖的男性和女性的 46 岁时的平均握力分别比从未肥胖的男性和女性高 4.39kg（1.85，6.93）和 1.25kg（-0.18，2.69）。
从儿童期开始的较高 BMI 与 46 岁时的握力较强相关。这表明，在这个年龄段，脂肪对肌肉的合成作用大于导致肌肉减少症性肥胖在以后的生活中表现出来的分解作用，尤其是在男性中。中年可能是预防肌肉减少症性肥胖的最佳时机。
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