Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital, The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, China.
Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.
Front Endocrinol (Lausanne). 2023 Oct 4;14:1215512. doi: 10.3389/fendo.2023.1215512. eCollection 2023.
Sarcopenia has been linked to adverse health outcomes, including an increased risk of mortality. This study aimed to assess the 7-year mortality risk of sarcopenia in a community-based population in China and explore the causal relationship between components of sarcopenia and any death.
Data were sourced from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2018. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Logistic regression, Kaplan-Meier (KM) survival analysis, and propensity score matching with inverse probability of treatment weighting were used. Mendelian randomization (MR) analyses, conducted using European population data, were utilized to assess causality between sarcopenia and any death.
The study included 9,006 participants: 3,892 had no sarcopenia, 3,570 had possible sarcopenia, 1,125 had sarcopenia, and 419 had severe sarcopenia. Over 7 years of follow-up, there were 871 deaths, including 196 with sarcopenia and 133 with severe sarcopenia. The KM curves showed that sarcopenia had a higher risk of mortality. Compared to those of no sarcopenia, the odds ratios (ORs) of sarcopenia for 7-year mortality were 1.41 (95% CI, 1.06-1.87) after adjusting for confounding variables ( < 0.05). The ORs of severe sarcopenia were 2.11 (95% CI, 1.51-2.95). Propensity score matching analysis and inverse probability of treatment weighting analysis confirmed these findings. The adjusted ORs of sarcopenia and 7-year mortality were 2.94 (95% CI, 1.6-5.39) in the 45-60 age group, 1.72 (95% CI, 1.11-2.68) in the 60-80 age group, and 5.03 (95% CI, 0.48-52.65) in the ≥80 age group. The ORs of severe sarcopenia and 7-year mortality were 6.92 (95% CI, 1.95-24.5) in the 45-60 age group, 2.59 (95% CI, 1.61-4.17) in the 60-80 age group, and 12.52 (95% CI, 1.18-133.18) in the ≥80 age group. The MR analyses, leveraging the inverse variance weighted (IVW) method, unveiled substantial causal links between low hand grip strength in individuals aged 60 and older, the usual walking pace, and mortality risk.
This study underscores the significant impact of sarcopenia and its components on mortality risk within the Chinese population. Particularly, low hand grip strength and usual walking pace emerged as noteworthy contributors to mortality risk.
肌少症与不良健康结局有关，包括死亡率增加。本研究旨在评估中国社区人群中肌少症的 7 年死亡率风险，并探讨肌少症各组成部分与任何死亡之间的因果关系。
数据来自于 2011 年至 2018 年进行的中国健康与退休纵向研究（CHARLS）。使用亚洲肌少症工作组（AWGS）2019 标准诊断肌少症。使用逻辑回归、卡普兰-迈耶（KM）生存分析和倾向评分匹配逆概率处理加权进行分析。使用欧洲人群数据进行孟德尔随机化（MR）分析，以评估肌少症与任何死亡之间的因果关系。
该研究纳入了 9006 名参与者：3892 名无肌少症，3570 名可能肌少症，1125 名肌少症，419 名严重肌少症。在 7 年的随访期间，有 871 人死亡，其中 196 人有肌少症，133 人有严重肌少症。KM 曲线显示肌少症的死亡风险更高。与无肌少症者相比，调整混杂因素后，肌少症 7 年死亡率的比值比（OR）为 1.41（95%置信区间，1.06-1.87）（<0.05）。严重肌少症的 OR 为 2.11（95%置信区间，1.51-2.95）。倾向评分匹配分析和逆概率处理加权分析证实了这些发现。在 45-60 岁年龄组，肌少症和 7 年死亡率的调整 OR 为 2.94（95%置信区间，1.6-5.39），在 60-80 岁年龄组为 1.72（95%置信区间，1.11-2.68），在≥80 岁年龄组为 5.03（95%置信区间，0.48-52.65）。严重肌少症和 7 年死亡率的 OR 在 45-60 岁年龄组为 6.92（95%置信区间，1.95-24.5），在 60-80 岁年龄组为 2.59（95%置信区间，1.61-4.17），在≥80 岁年龄组为 12.52（95%置信区间，1.18-133.18）。利用逆方差加权（IVW）法进行的 MR 分析揭示了 60 岁及以上人群中低握力、通常步行速度与死亡率风险之间存在显著的因果关系。
本研究强调了肌少症及其组成部分对中国人群死亡率风险的重大影响。特别是，低握力和通常的步行速度是死亡率风险的重要因素。
