Department of Geriatrics, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, China.
Department of Medical Records, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
Sci Total Environ. 2023 Jun 15;877:162814. doi: 10.1016/j.scitotenv.2023.162814. Epub 2023 Mar 16.
Household air pollution from solid fuel combustion is a leading cause of age-related diseases worldwide. However, little is known about the association between indoor solid fuel use and sarcopenia, especially in developing countries.
A total of 10,261 and 5129 participants from the China Health and Retirement Longitudinal Study were enrolled in the cross-sectional and follow-up analysis, respectively. The effects of household solid fuel use (for cooking and heating) on sarcopenia were evaluated using generalized linear models in the cross-sectional analysis and Cox proportional hazards regression models in the longitudinal analysis.
The prevalence of sarcopenia in the total population, clean cooking fuel users, and solid cooking fuel users were 13.6 % (1396/10,261), 9.1 % (374/4114), and 16.6 % (1022/6147), respectively. A similar pattern was observed for heating fuel users, with a higher prevalence of sarcopenia among solid fuel users (15.5 %) than among clean fuel users (10.7 %). In the cross-sectional analysis, solid fuel use for cooking/heating, separately or simultaneously, was positively associated with an elevated risk of sarcopenia after adjusting for potential confounders. During the four-years follow-up period, 330 participants (6.4 %) with sarcopenia were identified. The multivariate-adjusted hazard ratio (HR) (95 % confidence interval [95 % CI]) for solid cooking fuel users and solid heating fuel users was 1.86(95 % CI:1.43-2.41) and 1.32(95 % CI:1.05-1.66), respectively. Moreover, compared with persistent clean fuel users, participants who switched from clean to solid fuel for heating appeared to have an increased risk of sarcopenia (HR:1.58; 95 % CI:1.08-2.31).
Our findings show that household solid fuel use is a risk factor for sarcopenia development among middle-aged and older Chinese adults. The transition from solid to clean fuel use may help reduce the burden of sarcopenia in developing countries.
家庭固体燃料燃烧造成的空气污染是全球与年龄相关疾病的主要原因。然而，对于室内固体燃料的使用与肌肉减少症之间的关系，尤其是在发展中国家，我们知之甚少。
共有 10261 名和 5129 名来自中国健康与退休纵向研究的参与者分别被纳入横断面和随访分析。在横断面分析中，使用广义线性模型评估家庭固体燃料（用于烹饪和取暖）使用与肌肉减少症之间的关系；在纵向分析中，使用 Cox 比例风险回归模型评估家庭固体燃料使用与肌肉减少症之间的关系。
在总人群、使用清洁烹饪燃料的人群和使用固体烹饪燃料的人群中，肌肉减少症的患病率分别为 13.6%（1396/10261）、9.1%（374/4114）和 16.6%（1022/6147）。对于取暖燃料使用者，也观察到了类似的模式，固体燃料使用者（15.5%）比清洁燃料使用者（10.7%）的肌肉减少症患病率更高。在调整了潜在混杂因素后，单独或同时使用固体燃料进行烹饪/取暖与肌肉减少症风险升高呈正相关。在四年的随访期间，共确定了 330 名（6.4%）患有肌肉减少症的参与者。多变量调整后的危险比（HR）（95%置信区间[95%CI]）显示，使用固体烹饪燃料和固体取暖燃料的参与者发生肌肉减少症的风险分别为 1.86（95%CI：1.43-2.41）和 1.32（95%CI：1.05-1.66）。此外，与持续使用清洁燃料的参与者相比，从清洁燃料改为固体燃料取暖的参与者发生肌肉减少症的风险似乎更高（HR：1.58；95%CI：1.08-2.31）。
我们的研究结果表明，家庭固体燃料的使用是中国中年及以上成年人肌肉减少症发生的一个危险因素。从固体燃料向清洁燃料的转变可能有助于减轻发展中国家肌肉减少症的负担。
