手握力和/或步行速度与新发慢性肾脏病的关系：英国生物库观察性研究。
Association of handgrip strength and/or walking pace with incident chronic kidney disease: A UK biobank observational study.
机构信息
Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
National Clinical Research Center for Kidney Disease, Guangzhou, China.
出版信息
J Cachexia Sarcopenia Muscle. 2023 Apr;14(2):805-814. doi: 10.1002/jcsm.13180. Epub 2023 Jan 28.
BACKGROUND
The individual and combined relations of handgrip strength and walking pace with the risk of chronic kidney disease (CKD) remain uncertain. We aimed to investigate the relationship of handgrip strength and/or walking pace with incident CKD, using data from the large-scale, observational UK Biobank.
METHODS
A total of 417 504 participants free of prior kidney diseases were included from UK Biobank. Handgrip strength was assessed by dynamometer. The walking pace was self-reported as slow, average, or brisk. Cox proportional hazards models were applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CKD.
RESULTS
The average age of the study population was 56.3 (SD, 8.1) years. 192 012 (46.0%) of the participants were male. The mean handgrip strength was 23.5 (SD, 6.2) and 40.0 (SD, 8.8) kg for females and males, respectively. Over a median follow-up duration of 12.1 years, 11 064 (2.7%) participants developed incident CKD. Handgrip strength was significantly inversely associated with the risk of incident CKD in both males and females (both P for trend <0.001). When handgrip strength was assessed as sex-specific quartiles, compared with those in the first quartile, the adjusted HRs (95% CI) of incident CKD in participants in the second, third and fourth quartiles were 0.84 (0.79, 0.89), 0.76 (0.71, 0.81) and 0.72 (0.67, 0.77), respectively. Compared with those with slow walking pace, participants with average (HR, 0.64; 95% CI: 0.60-0.68) or brisk (HR, 0.53; 95% CI: 0.49-0.57) walking pace had significantly lower risks of incident CKD. Compared with those with both lower handgrip strength (the first quartile) and slow walking pace, the lowest risk of incident CKD was observed in participants with both higher handgrip strength (the 2-4 quartiles) and average or brisk walking pace (HR, 0.51; 95% CI: 0.46-0.55).
CONCLUSIONS
Handgrip strength and walking pace were significantly inversely associated with incident CKD in the general population.
背景
目前，尚不清楚握力和步行速度与慢性肾脏病（CKD）风险的个体和综合关系。我们旨在利用来自大型观察性英国生物银行的数据，研究握力和/或步行速度与新发 CKD 之间的关系。
方法
共纳入来自英国生物银行的 417504 名无既往肾脏疾病的参与者。使用测力计评估握力。步行速度由参与者自我报告为慢、中或快。使用 Cox 比例风险模型计算新发 CKD 的风险比（HR）和 95%置信区间（CI）。
结果
研究人群的平均年龄为 56.3（SD，8.1）岁。参与者中 192012 名（46.0%）为男性。女性和男性的平均握力分别为 23.5（SD，6.2）和 40.0（SD，8.8）kg。中位随访时间为 12.1 年后，11064 名（2.7%）参与者发生新发 CKD。握力与男性和女性新发 CKD 的风险均呈显著负相关（均 P<0.001）。当握力按性别四分位区间评估时，与第一四分位区间相比，第二、第三和第四四分位区间的新发 CKD 的校正 HR（95%CI）分别为 0.84（0.79，0.89）、0.76（0.71，0.81）和 0.72（0.67，0.77）。与步行速度较慢的参与者相比，步行速度中等（HR，0.64；95%CI：0.60-0.68）或较快（HR，0.53；95%CI：0.49-0.57）的参与者发生新发 CKD 的风险显著降低。与握力较低（第一四分位区间）和步行速度较慢的参与者相比，握力较高（第 2-4 四分位区间）且步行速度中等或较快的参与者发生新发 CKD 的风险最低（HR，0.51；95%CI：0.46-0.55）。
结论
握力和步行速度与普通人群新发 CKD 显著负相关。
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