Qiu Shanhu, Wang Qianqian, Chen Wenji, Xie Bo, Wang Duolao, Cai Xue, Sun Zilin, Wu Tongzhi
Department of General Practice, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China.
Department of Endocrinology, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China.
Arch Med Res. 2023 Apr;54(3):261-269. doi: 10.1016/j.arcmed.2023.01.002. Epub 2023 Jan 31.
The existing literature regarding the association between muscle strength and cardiovascular disease (CVD) and all-cause mortality relies mostly on a single measurement of muscle strength but has seldomly focused on the accumulated exposure.
This study explored the association between cumulative muscle strength and risks of CVD and all-cause mortality in middle-aged and older adults.
A total of 6,972 patients from the China Health and Retirement Longitudinal Study, who underwent 3 repeated measurements of muscle strength over 4 years and were followed-up for another 3 years for CVD and all-cause mortality outcomes participated in this study. Muscle strength was evaluated by grip strength and chair-rising time. Cumulative muscle strength was calculated as the area under the curve. Odds ratio (OR) and 95% confidence intervals (CIs) were analyzed.
The odds of CVD and all-cause mortality decreased as cumulative grip strength increased or cumulative chair-rising time decreased. For each 1 standard deviation (SD) increment in cumulative grip strength, the multivariable-adjusted OR for CVD and all-cause mortality were 0.81 (95% CI 0.73-0.91) and 0.85 (95% CI 0.73-0.99), respectively. For each 1 SD decrease in cumulative chair-rising time, the corresponding OR were 0.81 (95% CI 0.75-0.88) and 0.87 (95% CI 0.77-0.98), respectively. However, neither the change-slope of grip strength nor that of chair-rising time was related to decreased OR of CVD or of all-cause mortality.
Cumulative muscle strength was associated with a reduced risk of CVD and all-cause mortality in middle-aged and older Chinese adults.
现有关于肌肉力量与心血管疾病（CVD）及全因死亡率之间关联的文献大多依赖于对肌肉力量的单次测量，而很少关注累积暴露情况。
本研究探讨中年及老年人群累积肌肉力量与CVD风险及全因死亡率之间的关联。
共有6972名来自中国健康与养老追踪调查的患者参与了本研究，他们在4年中接受了3次肌肉力量重复测量，并针对CVD和全因死亡率结局又随访了3年。通过握力和从椅子上起身的时间来评估肌肉力量。累积肌肉力量计算为曲线下面积。分析比值比（OR）和95%置信区间（CI）。
随着累积握力增加或累积从椅子上起身时间减少，CVD和全因死亡率的几率降低。累积握力每增加1个标准差（SD），CVD和全因死亡率的多变量调整OR分别为0.81（95%CI 0.73 - 0.91）和0.85（95%CI 0.73 - 0.99）。累积从椅子上起身时间每减少1个SD，相应的OR分别为0.81（95%CI 0.75 - 0.88）和0.87（95%CI 0.77 - 0.98）。然而，握力的变化斜率和从椅子上起身时间的变化斜率均与CVD或全因死亡率的OR降低无关。
累积肌肉力量与中国中年及老年成年人CVD风险和全因死亡率降低相关。
