Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
J Nutr Health Aging. 2024 Jan;28(1):100014. doi: 10.1016/j.jnha.2023.100014. Epub 2023 Dec 21.
We aimed to investigate longitudinal associations of overall social support and its sub-domains with risk of sarcopenia and its related traits in community-dwelling Chinese aged ≥ 50 years. We also explored interaction effects of potential factors on such associations.
A prospective cohort study.
Community-based setting in western China.
We included participants aged ≥50 years with complete information necessary for analysis from the WCHAT study who did not have sarcopenia at baseline (2018) and had sufficient data for sarcopenia assessment during 2021-2023.
Exposures included overall social support, subjective support, objective support and support utilization, which were assessed with the Social Support Rating Scale. Outcomes included sarcopenia, low muscle mass (LMM), low muscle strength and low physical performance, which were diagnosed with the 2019 AWGS consensus. Longitudinal associations between the exposures and outcomes were estimated by logistic regression, with generalized estimating equations (GEE) as sensitivity analyses. Subgroup analyses by potential covariates were conducted to detect interaction effects.
A total of 1905 participants were finally included in the analytic sample, of whom 326 (17.1%) developed incident sarcopenia during 5-year follow-up. After controlling for confounders, higher degree of overall social support (OR = 0.87, 95%CI 0.76-0.99), subjective support (OR = 0.88, 95%CI 0.77-0.99) and support utilization (OR = 0.87, 95%CI 0.77-0.99) correlated with lower sarcopenia risk, among which higher support utilization degree was indicative of lower risk for LMM (OR = 0.88, 95%CI 0.79-0.98). GEE further revealed that overall support degree was negatively associated with risk for sarcopenia (OR = 0.86, 95%CI 0.76-0.98) and LMM (OR = 0.87, 95%CI 0.77-0.99). Objective support was neither significantly associated with sarcopenia nor its traits. No significant interaction effect was observed between overall support and the concerned confounders on sarcopenia (interaction P-value > 0.05).
Overall social support degree was negatively associated with sarcopenia risk, possibly primarily through affecting muscle mass rather than muscle strength or physical performance, and such an association remained robust across subgroups with distinct characteristics. This holds implications for policymakers to conduct population-based risk assessment, and supportive strategies against sarcopenia should focus on enhancing subjective support and support utilization rather than objective support alone.
本研究旨在探讨总体社会支持及其各维度与中国≥50 岁社区居民发生肌少症及其相关特征的纵向关联。我们还探讨了潜在因素对这些关联的交互作用。
前瞻性队列研究。
中国西部的社区环境。
我们纳入了来自 WCHAT 研究的≥50 岁、基线(2018 年)时无肌少症且 2021-2023 年期间有足够肌少症评估数据的参与者。
暴露因素包括总体社会支持、主观支持、客观支持和支持利用,这些均通过社会支持评定量表进行评估。结局包括肌少症、低肌肉量(LMM)、低肌肉力量和低身体表现,这些均通过 2019 年 AWGS 共识进行诊断。通过逻辑回归估计暴露因素与结局之间的纵向关联,广义估计方程(GEE)作为敏感性分析。通过潜在协变量进行亚组分析,以检测交互作用。
在 1905 名最终纳入分析样本的参与者中,有 326 名(17.1%)在 5 年随访期间发生了肌少症。在控制了混杂因素后,较高的总体社会支持程度(OR=0.87,95%CI 0.76-0.99)、主观支持(OR=0.88,95%CI 0.77-0.99)和支持利用(OR=0.87,95%CI 0.77-0.99)与较低的肌少症风险相关,其中较高的支持利用程度预示着较低的 LMM 风险(OR=0.88,95%CI 0.79-0.98)。GEE 进一步表明,总体支持程度与肌少症(OR=0.86,95%CI 0.76-0.98)和 LMM(OR=0.87,95%CI 0.77-0.99)的风险呈负相关。客观支持与肌少症或其特征均无显著相关性。在肌少症方面,总体支持与相关混杂因素之间未观察到显著的交互作用(交互 P 值>0.05)。
总体社会支持程度与肌少症风险呈负相关,这可能主要是通过影响肌肉量而不是肌肉力量或身体表现来实现的,且这种关联在具有不同特征的亚组中仍然稳健。这为政策制定者进行基于人群的风险评估提供了依据,针对肌少症的支持策略应注重提高主观支持和支持利用,而不仅仅是客观支持。