Department of Psychiatry, Zigong Mental Health Center, the Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China.
PLoS One. 2024 Aug 13;19(8):e0306982. doi: 10.1371/journal.pone.0306982. eCollection 2024.
Low handgrip strength (HGS) and abdominal obesity (AO) have been reported to be linked to an increased all-cause mortality risk in older adults. However, the combined impact of AO with low HGS and/or HGS asymmetry on mortality risk remains unclear. Therefore, this study aimed to investigate the synergistic effects of AO and abnormal HGS on mortality risk among Chinese older adults.
Baseline data of the China Health and Retirement Longitudinal Study in 2011, along with mortality outcomes obtained in 2018 were used for the analysis. Low HGS was identified as HGS <18 kg in women or <28 kg in men, while HGS asymmetry is defined as an HGS of either hand > 10% stronger than the other. AO was characterized by a waist circumference ≥90 cm in men and ≥85 cm in women. Logistic regression analysis was used to evaluate the relationship between AO, abnormal HGS and mortality risk.
A total of 5186 subjects aged 60 years or older were enrolled, 50.6% of whom were male. The proportions of participants with only AO, only low HGS, only HGS asymmetry, low HGS with asymmetry, both AO and low HGS, both AO and asymmetric HGS, and AO with both low HGS and asymmetry were 20.0%, 6.1%, 16.6%, 8.3%, 3.2%, 13.4%, and 3.9%, respectively. Over the course of a 7-year follow-up interval, 970 of these individuals died, with 13.4%, 12.4%, 13.6%, 15.5%, 4.1%, 10.1% and 6.9% of deaths in the above groups, respectively. The adjusted logistic regression analysis model confirmed that only low HGS (OR = 1.897, 95%CI: 1.386-2.596, p<0.001), low HGS with asymmetry (OR = 1.680, 95%CI: 1.265-2.231, p<0.001), and AO combined with both low HGS and asymmetry (OR = 2.029, 95%CI: 1.381-2.981, p<0.001) were associated with a higher risk of mortality.
Low HGS, with or without asymmetry, is associated with increased mortality risk in older Chinese adults without AO, and the combination of low HGS and HGS asymmetry further elevates mortality risk in those with AO.
低握力（HGS）和腹型肥胖（AO）与老年人全因死亡率增加有关。然而，AO 与低 HGS 以及/或 HGS 不对称联合对死亡率风险的影响尚不清楚。因此，本研究旨在探讨中国老年人中 AO 与异常 HGS 对死亡率风险的协同作用。
本研究利用 2011 年中国健康与退休纵向研究的基线数据和 2018 年的死亡率结局进行分析。低 HGS 定义为女性 HGS<18kg 或男性 HGS<28kg，HGS 不对称定义为任一手的 HGS 比另一手强 10%以上。AO 以男性腰围≥90cm 或女性腰围≥85cm 为特征。采用 logistic 回归分析评估 AO、异常 HGS 与死亡率风险的关系。
共纳入 5186 名 60 岁或以上的受试者，其中 50.6%为男性。仅存在 AO、仅存在低 HGS、仅存在 HGS 不对称、低 HGS 伴不对称、AO 与低 HGS 并存、AO 与 HGS 不对称并存、AO 与低 HGS 和 HGS 不对称并存的参与者比例分别为 20.0%、6.1%、16.6%、8.3%、3.2%、13.4%和 3.9%。在 7 年的随访期间，这些人中共有 970 人死亡，上述各组的死亡率分别为 13.4%、12.4%、13.6%、15.5%、4.1%、10.1%和 6.9%。调整后的 logistic 回归分析模型证实，仅低 HGS（OR=1.897，95%CI：1.386-2.596，p<0.001）、低 HGS 伴不对称（OR=1.680，95%CI：1.265-2.231，p<0.001）和 AO 合并低 HGS 和 HGS 不对称（OR=2.029，95%CI：1.381-2.981，p<0.001）与死亡率风险增加相关。
无 AO 的中国老年人群中，低 HGS （无论是否存在不对称）与死亡率风险增加相关，而低 HGS 和 HGS 不对称的联合则进一步增加了存在 AO 的人群的死亡率风险。
