Hsu Kuo-Jen, Chen Shu-Chen, Chien Kuei-Yu, Chen Chiao-Nan
Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Recreational Sports Management, Yu Da University of Science and Technology, Miaoli County, Taiwan.
Curr Dev Nutr. 2024 Jul 1;8(8):104412. doi: 10.1016/j.cdnut.2024.104412. eCollection 2024 Aug.
Low muscle mass and obesity are associated with mobility disability, cardiometabolic diseases, and loss of independence. Three skeletal muscle indices (SMIs) are proposed to adjust the body size of individuals. However, it is unknown which index is better correlated with mobility. Additionally, it remains unclear whether low muscle mass or abdominal obesity has a greater impact on the mobility and cardiometabolic health of older adults.
This study explored the association between different SMIs {appendicular skeletal muscle mass [ASM] adjusted by body height [Ht], body weight [Wt], or body mass index [BMI (kg/m)]} and mobility/cardiometabolic health. The roles of low muscle mass and abdominal obesity in the mobility and cardiometabolic health of individuals were also identified.
Four-hundred and twenty-seven community-dwelling middle-aged and older adults underwent body composition assessments [dual-energy x-ray absorptiometry and waist circumference (WC)], grip strength, and mobility (timed up-and-go test and chair stand test). Spearman's rank correlation coefficient and regression models were used to examine research questions. This study was registered in the Thai Clinical Trials Registry (registration number: TCTR20210521007).
All SMIs were positively correlated with the grip strength (ASM/Ht: = 0.392; ASM/Wt: = 0.439; ASM/BMI: = 0.569). Regarding mobility, only ASM/Ht wasn't relevant. After adjusting for age, sex, and WC, ASM/BMI was the only SMI associated with grip strength (β = 0.274). When age and sex were controlled, WC, but not SMI, was associated with mobility and cardiometabolic health.
ASM/Ht did not correlate with mobility in middle-aged and older adults, whereas ASM/Wt and ASM/BMI did. Abdominal obesity has a greater impact on mobility and cardiometabolic health than low muscle mass in middle-aged and older adults. We recommend using ASM/BMI to identify the low muscle mass of individuals. In addition, clinicians should note the important role of abdominal obesity when considering mobility in middle-aged and older adults.
低肌肉量和肥胖与行动不便、心脏代谢疾病以及生活不能自理相关。人们提出了三种骨骼肌指数（SMIs）来调整个体的体型。然而，尚不清楚哪种指数与行动能力的相关性更好。此外，低肌肉量或腹部肥胖对老年人的行动能力和心脏代谢健康的影响哪个更大仍不明确。
本研究探讨了不同的骨骼肌指数（通过身高[Ht]、体重[Wt]或体重指数[BMI（kg/m）]调整的四肢骨骼肌质量[ASM]）与行动能力/心脏代谢健康之间的关联。还确定了低肌肉量和腹部肥胖在个体行动能力和心脏代谢健康中的作用。
427名社区居住的中老年人接受了身体成分评估[双能X线吸收法和腰围（WC）]、握力和行动能力测试（定时起立行走测试和椅子站立测试）。采用Spearman等级相关系数和回归模型来研究相关问题。本研究已在泰国临床试验注册中心注册（注册号：TCTR20210521007）。
所有骨骼肌指数均与握力呈正相关（ASM/Ht：= 0.392；ASM/Wt：= 0.439；ASM/BMI：= 0.569）。关于行动能力，只有ASM/Ht不相关。在调整年龄、性别和腰围后，ASM/BMI是唯一与握力相关的骨骼肌指数（β = 0.274）。在控制年龄和性别后，腰围而非骨骼肌指数与行动能力和心脏代谢健康相关。
在中老年人中，ASM/Ht与行动能力不相关，而ASM/Wt和ASM/BMI与行动能力相关。在中老年人中，腹部肥胖对行动能力和心脏代谢健康的影响大于低肌肉量。我们建议使用ASM/BMI来识别个体的低肌肉量。此外，临床医生在考虑中老年人的行动能力时应注意腹部肥胖的重要作用。
