Ouyang Yifei, Zhang Xiaofan, Huang Feifei, Wang Liusen, Bai Jing, Hu Haojie, Hu Xiao, Guan Fangxu, Zhang Bing, Wang Huijun
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Wei Sheng Yan Jiu. 2023 Jul;52(4):528-540. doi: 10.19813/j.cnki.weishengyanjiu.2023.04.002.
To analyze the relationship between physical activity and muscle mass loss among Chinese elderly aged 60 years and above in 15 provinces.
Data was collected from 2015 China Nutritional Transition Cohort Study. Information on demographic characteristics and physical activity was investigated by questionnaire. Dietary intake was estimated from three consecutive 24-h recalls for each individual. Appendicular skeletal muscle mass(ASM) was assessed using the bioelectrical impedance analysis(BIA). Skeletal muscle mass(SMI) loss was diagnosed according Asian working group of sarcopenia(AWGS) 2019 recommendation(male: SMI <7.0 kg/m2, female: <5.7 kg/m2). A total of 4565 participants aged 60 years and above from 15 provinces in China with complete information were included in the final analysis. Different domains(occupational, domestic, travel and leisure), light physical activity(<3.0 METs), moderate physical activity(3.0-5.9 METs) and vigorous physical activity(≥6.0 METs) of physical activity among elderly adults were evaluated. Logistic multilevel model was used to analyze the relationship between low muscle mass and different intensity of physical activity duration.
Among all participants aged 60 years and above in 15 provinces of China in 2015, women's participation rate in domestic physical activity was 91.7%, which was higher than men's rate of 62.3%. However, men's participation rate in occupational, travel and leisure physical activity were higher than those of women. The participation rate, duration of light physical activity and moderate physical activity were higher in women than in men(light physical activity: female duration 11.0 h/week vs. male duration 3.5 h/week; female participation rate 89.9% vs. male participation rate 62.8%; moderate physical activity: female duration 7.0 h/week vs. male duration 4.7 h/week; female participation rate 90.6% vs. male participation rate 75.2%). The median vigorous physical activity was 0 h/week in both male and female group. The prevalence of muscle mass loss was 13.9% among subjects. The median weekly light physical activity and moderate physical activity in muscle mass loss group were 5.8 h and 4.7 h, which were lower than in non-muscle mass loss group(9.3 h and 6.0 h). The OR of muscle mass lass was 0.71(95%CI 0.42-0.98, P<0.05) for the male with 3.5-6.9 hours of moderate physical activity per week, compared to moderate physical activity less than 3.5 h/week. And OR of the female was 0.67(95%CI 0.47-0.95, P<0.05).
The vast majority of physical activity in China among the elderly is domestic and light physical activity. Light physical activity and moderate physical activity duration increments in female and moderate physical activity duration increments in male were associated with decreased risk of muscle mass loss.
分析中国15个省份60岁及以上老年人身体活动与肌肉量流失之间的关系。
数据来自2015年中国营养转型队列研究。通过问卷调查收集人口统计学特征和身体活动信息。根据每个人连续3天的24小时膳食回顾来估计膳食摄入量。使用生物电阻抗分析（BIA）评估四肢骨骼肌量（ASM）。根据亚洲肌少症工作组（AWGS）2019年的建议诊断骨骼肌量（SMI）流失（男性：SMI<7.0kg/m²，女性：<5.7kg/m²）。最终分析纳入了来自中国15个省份的4565名60岁及以上且信息完整的参与者。评估了老年人身体活动的不同领域（职业、家务、出行和休闲）、轻度身体活动（<3.0代谢当量）、中度身体活动（3.0 - 5.9代谢当量）和剧烈身体活动（≥6.0代谢当量）。使用逻辑多水平模型分析低肌肉量与不同强度身体活动持续时间之间的关系。
在2015年中国15个省份所有60岁及以上的参与者中，女性家务身体活动参与率为91.7%，高于男性的62.3%。然而，男性在职业、出行和休闲身体活动方面的参与率高于女性。女性轻度身体活动和中度身体活动的参与率及持续时间高于男性（轻度身体活动：女性持续时间为每周11.0小时，男性为每周3.5小时；女性参与率89.9%，男性参与率62.8%；中度身体活动：女性持续时间为每周7.0小时，男性为每周4.7小时；女性参与率90.6%，男性参与率75.2%）。男性和女性组的剧烈身体活动中位数均为每周0小时。受试者中肌肉量流失的患病率为13.9%。肌肉量流失组的每周轻度身体活动和中度身体活动中位数分别为5.8小时和4.7小时，低于非肌肉量流失组（9.3小时和6.0小时）。每周进行3.5 - 6.9小时中度身体活动的男性，与每周中度身体活动少于3.5小时相比，肌肉量流失的比值比（OR）为0.71（95%置信区间0.42 - 0.98，P<0.05）。女性的OR为0.67（95%置信区间0.47 - 0.95，P<0.05）。
中国老年人的身体活动绝大多数是家务和轻度身体活动。女性轻度身体活动和中度身体活动持续时间的增加以及男性中度身体活动持续时间的增加与肌肉量流失风险降低相关。
