中国中老年人群肌肉力量变化与心血管疾病风险：一项前瞻性队列研究的证据。

Changes in muscle strength and risk of cardiovascular disease among middle-aged and older adults in China: Evidence from a prospective cohort study.

机构信息

Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China.

Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China.

出版信息

Chin Med J (Engl). 2024 Jun 5;137(11):1343-1350. doi: 10.1097/CM9.0000000000002968. Epub 2024 Feb 26.

DOI:10.1097/CM9.0000000000002968

PMID:38407330

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11191030/

Abstract

BACKGROUND

Evidence indicates that low muscle strength is associated with an increased cardiovascular diseases (CVDs) risk. However, the association between muscle strength changes based on repeated measurements and CVD incidence remains unclear.

METHODS

The study used data from the China Health and Retirement Longitudinal Study in 2011 (Wave 1), 2013 (Wave 2), 2015 (Wave 3), and 2018 (Wave 4). Low muscle strength was defined as handgrip strength <28 kg for men or <18 kg for women, or chair-rising time ≥12 s. Based on changes in muscle strength from Waves 1 to 2, participants were categorized into four groups of Normal-Normal, Low-Normal, Normal-Low, and Low-Low. CVD events, including heart disease and stroke, were recorded using a self-reported questionnaire during Waves 3 and 4 visits. Cox proportional hazards models were used to investigate the association between muscle strength changes and CVD incidence after multivariable adjustments. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated with the Normal-Normal group as the reference.

RESULTS

A total of 1164 CVD cases were identified among 6608 participants. Compared to participants with sustained normal muscle strength, the CVD risks increased progressively across groups of the Low-Normal (HR = 1.20, 95% CI: 1.01-1.43), the Normal-Low (HR = 1.35, 95% CI: 1.14-1.60), and the Low-Low (HR = 1.76, 95% CI: 1.49-2.07). Similar patterns were observed for the significant associations between muscle strength status and the incidence risks of heart disease and stroke. Subgroup analyses showed that the significant associations between CVD and muscle strength changes were consistent across age, sex, and body mass index (BMI) categories.

CONCLUSIONS

The study found that muscle strength changes were associated with CVD risk. This suggests that continuous tracking of muscle status may be helpful in screening cardiovascular risk.

摘要

背景

有证据表明，肌肉力量较弱与心血管疾病（CVD）风险增加有关。然而，基于重复测量的肌肉力量变化与 CVD 发病率之间的关联尚不清楚。

方法

本研究使用了 2011 年（第 1 波）、2013 年（第 2 波）、2015 年（第 3 波）和 2018 年（第 4 波）中国健康与退休纵向研究的数据。肌肉力量较弱定义为男性握力<28kg 或女性握力<18kg，或起坐时间≥12 秒。根据第 1 波到第 2 波之间肌肉力量的变化，参与者被分为四组：正常-正常、低-正常、正常-低和低-低。通过第 3 波和第 4 波的自我报告问卷记录 CVD 事件，包括心脏病和中风。在多变量调整后，使用 Cox 比例风险模型来研究肌肉力量变化与 CVD 发病率之间的关系。使用正常-正常组作为参考，估计危险比（HRs）和 95%置信区间（95%CI）。

结果

在 6608 名参与者中，共发现 1164 例 CVD 病例。与持续正常肌肉力量的参与者相比，低-正常（HR=1.20，95%CI：1.01-1.43）、正常-低（HR=1.35，95%CI：1.14-1.60）和低-低（HR=1.76，95%CI：1.49-2.07）组的 CVD 风险逐渐增加。肌肉力量状况与心脏病和中风发病率之间的显著关联也存在类似的模式。亚组分析表明，CVD 与肌肉力量变化之间的显著关联在年龄、性别和身体质量指数（BMI）类别中是一致的。