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1480 名中老年人群血浆同型半胱氨酸与骨密度、瘦体重、肌肉力量和身体功能的关系:来自 NHANES 的数据。

Relationship Between Plasma Homocysteine and Bone Density, Lean Mass, Muscle Strength and Physical Function in 1480 Middle-Aged and Older Adults: Data from NHANES.

机构信息

Center on Aging, University of Connecticut, Farmington, CT, USA.

Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia.

出版信息

Calcif Tissue Int. 2023 Jan;112(1):45-54. doi: 10.1007/s00223-022-01037-0. Epub 2022 Nov 7.

Abstract

Hyperhomocysteinemia induces oxidative stress and chronic inflammation (both of which are catabolic to bone and muscle); thus, we examined the association between homocysteine and body composition and physical function in middle-aged and older adults. Data from the National Health and Nutrition Examination Survey was used to build regression models. Plasma homocysteine (fluorescence immunoassay) was used as the exposure and bone mineral density (BMD; dual-energy X-ray absorptiometry; DXA), lean mass (DXA), knee extensor strength (isokinetic dynamometer; newtons) and gait speed (m/s) were used as outcomes. Regression models were adjusted for confounders (age, sex, race/Hispanic origin, height, fat mass %, physical activity, smoking status, alcohol intakes, cardiovascular disease, diabetes, cancer and vitamin B12). All models accounted for complex survey design by using sampling weights provided by NHANES. 1480 adults (median age: 64 years [IQR: 56, 73]; 50.3% men) were included. In multivariable models, homocysteine was inversely associated with knee extensor strength (β = 0.98, 95% CI 0.96, 0.99, p = 0.012) and gait speed (β = 0.85, 95% CI 0.78, 0.94, p = 0.003) and borderline inversely associated with femur BMD (β = 0.84, 95% CI 0.69, 1.03, p = 0.086). In the sub-group analysis of older adults (≥ 65 years), homocysteine was inversely associated with gait speed and femur BMD (p < 0.05) and the slope for knee extensor strength and whole-body BMD were in the same direction. No significant associations were observed between homocysteine and total or appendicular lean mass in the full or sub-group analysis. We found inverse associations between plasma homocysteine and muscle strength/physical function, and borderline significant inverse associations for femur BMD.

摘要

高同型半胱氨酸血症可导致氧化应激和慢性炎症(两者都会导致骨骼和肌肉分解代谢);因此,我们研究了同型半胱氨酸与中年和老年人的身体成分和身体功能之间的关系。本研究使用了来自全国健康和营养检查调查的数据来建立回归模型。血浆同型半胱氨酸(荧光免疫测定法)作为暴露因素,骨密度(双能 X 射线吸收法;DXA)、瘦体重(DXA)、膝关节伸肌力量(等速测力计;牛顿)和步态速度(米/秒)作为结果。回归模型根据混杂因素(年龄、性别、种族/西班牙裔、身高、体脂肪百分比、身体活动、吸烟状况、酒精摄入量、心血管疾病、糖尿病、癌症和维生素 B12)进行了调整。所有模型均通过使用 NHANES 提供的抽样权重来考虑复杂的调查设计。共纳入 1480 名成年人(中位数年龄:64 岁[IQR:56,73];50.3%为男性)。在多变量模型中,同型半胱氨酸与膝关节伸肌力量呈负相关(β=0.98,95%CI 0.96,0.99,p=0.012)和步态速度呈负相关(β=0.85,95%CI 0.78,0.94,p=0.003),与股骨骨密度呈临界负相关(β=0.84,95%CI 0.69,1.03,p=0.086)。在年龄较大(≥65 岁)的老年人亚组分析中,同型半胱氨酸与步态速度和股骨骨密度呈负相关(p<0.05),膝关节伸肌力量和全身骨密度的斜率方向相同。在全组或亚组分析中,均未观察到同型半胱氨酸与总瘦体重或四肢瘦体重之间存在显著关联。我们发现血浆同型半胱氨酸与肌肉力量/身体功能呈负相关,与股骨骨密度呈临界负相关。

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