Hu Zhigang, Tian Yufeng, Song Xinyu, Zeng Fanjun, Yang Ailan
Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, People's Republic of China.
Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital at Zhijiang, Zhijiang, People's Republic of China.
J Cachexia Sarcopenia Muscle. 2023 Oct;14(5):2029-2043. doi: 10.1002/jcsm.13281. Epub 2023 Jul 13.
Exposure to air pollution brings the advent effect for various diseases, but study about the relationship between air pollution and ageing is scant. We aimed to determine the associations between household air pollution for cooking and heating with muscle and sarcopenia in Chinese older population by a nationally representative study.
This cross-sectional study included individuals aged 60 and above from the China Health and Retirement Longitudinal Study between 2011 and 2015. The diagnosis of sarcopenia was defined by low muscle mass with low muscle strength and/or reduced physical performance. Generalized additive analyses and dose-dependent analyses with three models were used to assess the effects of different pattern of cooking and heating on muscle and sarcopenia.
A total of 8126 Chinese older individuals with predominant male (53.7%) and mean age of 67.3 ± 6.0 years were included in our study. Solid fuel use in cooking showed significant declines in muscle strength (β = -0.424, 95% CI: -0.767, -0.082, P = 0.01 in model 3) and mass (β = -0.034, 95% CI: -0.051, -0.017, P < 0.01 in model 3), when compared with clean fuel use in cooking, respectively. Solid fuel for heating was correlated with lower muscle strength (β = -0.637, 95% CI: -1.033, -0.241, P < 0.01 in model 3) than clean fuel for heating. The joint use of solid fuel for cooking and heating was associated with reduced muscle strength (β = -0.835, 95% CI: -1.306, -0.365, P < 0.01 in model 3) and mass (β = -0.038, 95% CI: -0.061, -0.015, P < 0.01 in model 3) than clean fuel for cooking and heating. Solid fuel for cooking was associated with significantly increased risk of low muscle strength (adjusted OR = 1.29, 95% CI: 1.11, 1.50, P < 0.01 in model 3) and mass (adjusted OR = 1.35, 95% CI: 1.11, 1.61, P < 0.01 in model 3), possible sarcopenia (adjusted OR = 1.33, 95% CI: 1.19, 1.48, P < 0.01 in model 3) and sarcopenia (adjusted OR = 1.44, 95% CI: 1.21, 1.72, P < 0.01 in model 3) compared with clean fuel for cooking. Solid fuel for heating had a significant correlation with low muscle strength (adjusted OR = 1.30, 95% CI: 1.09, 1.56, P < 0.01 in model 3) and possible sarcopenia (adjusted OR = 1.49, 95% CI: 1.31, 1.70, P < 0.01 in model 3). Dose-dependent manner was shown in the associations between the number of solid fuel with low muscle strength and possible sarcopenia. Clean fuel for cooking and solid fuel for heating was positively associated with the prevalence of possible sarcopenia than clean fuel for cooking and heating (adjusted OR = 1.34, 95% CI: 1.14, 1.57, P < 0.01 in model 3).
Our findings suggested that solid fuel for cooking and the number of solid fuel use potentially facilitates the onset and progression of muscle loss and sarcopenia.
接触空气污染会引发多种疾病，但关于空气污染与衰老之间关系的研究却很少。我们旨在通过一项全国代表性研究，确定中国老年人群中烹饪和取暖用家庭空气污染与肌肉及肌肉减少症之间的关联。
这项横断面研究纳入了2011年至2015年间中国健康与养老追踪调查中60岁及以上的个体。肌肉减少症的诊断定义为肌肉量低且肌肉力量低和/或身体机能下降。使用广义相加分析和三种模型的剂量反应分析来评估不同烹饪和取暖方式对肌肉及肌肉减少症的影响。
我们的研究共纳入了8126名中国老年人，其中男性占主要部分（53.7%），平均年龄为67.3±6.0岁。与烹饪时使用清洁燃料相比，烹饪时使用固体燃料会导致肌肉力量显著下降（模型3中β=-0.424，95%CI：-0.767，-0.082，P=0.01）和肌肉量下降（模型3中β=-0.034，95%CI：-0.051，-0.017，P<0.01）。取暖用固体燃料与较低的肌肉力量相关（模型3中β=-0.637，95%CI：-1.033，-0.241，P<0.01），低于取暖用清洁燃料。烹饪和取暖联合使用固体燃料与肌肉力量下降（模型3中β=-0.835，95%CI：-1.306，-0.365，P<0.01）和肌肉量下降（模型3中β=-0.038，95%CI：-0.061，-0.015，P<0.01）相关，低于烹饪和取暖用清洁燃料。与烹饪用清洁燃料相比，烹饪用固体燃料与低肌肉力量（模型3中调整后OR=1.29，95%CI：1.11，1.50，P<0.01）、肌肉量（模型3中调整后OR=1.35，95%CI：1.11，1.61，P<0.01）、可能的肌肉减少症（模型3中调整后OR=1.33，95%CI：1.19，1.48，P<0.01）和肌肉减少症（模型3中调整后OR=1.44，95%CI：1.21，1.72，P<0.01）的风险显著增加相关。取暖用固体燃料与低肌肉力量（模型3中调整后OR=1.30，95%CI：1.09，1.56，P<0.01）和可能的肌肉减少症（模型3中调整后OR=1.49，95%CI：1.31，1.70，P<0.01）有显著相关性。固体燃料数量与低肌肉力量和可能的肌肉减少症之间的关联呈剂量反应关系。烹饪用清洁燃料和取暖用固体燃料与烹饪和取暖用清洁燃料相比，可能的肌肉减少症患病率呈正相关（模型3中调整后OR=1.34，95%CI：1.14，1.57，P<0.01）。
我们的研究结果表明，烹饪用固体燃料及固体燃料的使用次数可能会促进肌肉流失和肌肉减少症的发生及发展。
