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英国生物银行队列研究中无糖尿病者血糖指标与握力之间的横断面和纵向关联。

Cross-sectional and longitudinal associations between glycaemic measures and grip strength in people without diabetes in the UK Biobank cohort study.

作者信息

Granic Antoneta, Cooper Rachel, Hurst Christopher, Hillman Susan J, Dodds Richard M, Witham Miles D, Sayer Avan A

机构信息

AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, The Health Innovation Neighbourhood, Biomedical Research Building, Newcastle Upon Tyne, NE4 5PL, UK.

NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Cumbria Northumberland Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences Newcastle University, Newcastle Upon Tyne, UK.

出版信息

Eur Geriatr Med. 2025 Feb;16(1):67-77. doi: 10.1007/s41999-024-01119-2. Epub 2024 Nov 29.

Abstract

PURPOSE

To investigate associations between glycaemic measures (HbA1c, random glucose), and grip strength (GS) in adults without prevalent diabetes.

METHODS

We included 381,715 UK Biobank participants aged 38-73 years without diabetes (any type) with complete baseline measures for GS and HbA1c (main analyses), and glucose (supplementary analyses). Cross-sectional sex- and age-stratified associations between each glycaemic measure, GS, and probable sarcopenia (low GS) were examined with regression analyses. Changes in GS over 8.9 years were classified into four groups (decline, stable low, stable high, or reference (increase or maintained within the normal range)) in 36,228 participants and associations with baseline glycaemic measures explored using multinomial regression.

RESULTS

Higher HbA1c (mmol/mol) was associated with weaker mean GS (kg) (regression coefficient and 95% confidence intervals (CI): - 0.08 (- 0.09, - 0.07)), and increased odds of probable sarcopenia (odds ratio (OR) and 95% CIs: 1.02 (95% CI: 1.01, 1.02)) in males and across the age groups. In females, higher HbA1c was associated with weaker mean GS only in mid-life (e.g., 50-59 years: - 0.06 (- 0.07, - 0.05)). In males, but not in females with repeated GS, higher HbA1c was associated with decreased odds of stable high (0.97 (0.96, 0.99) and increased odds of stable low (1.03 (1.01, 1.04)) GS pattern (0.98 (0.97, 0.980)) over the follow-up. The results for glucose in supplementary analyses were mixed, especially in females.

CONCLUSIONS

The associations between HbA1c and GS in people without diabetes warrant replication and consideration of the effect on muscle strength when interventions to promote normoglycaemia are trialled.

摘要

目的

研究无糖尿病病史成年人的血糖指标(糖化血红蛋白、随机血糖)与握力(GS)之间的关联。

方法

我们纳入了381,715名年龄在38 - 73岁之间、无任何类型糖尿病的英国生物银行参与者,他们具备完整的握力和糖化血红蛋白基线测量值(主要分析)以及血糖测量值(补充分析)。通过回归分析研究了每种血糖指标、握力和可能的肌肉减少症(低握力)之间的横断面性别和年龄分层关联。在36,228名参与者中,将8.9年内握力的变化分为四组(下降、稳定低、稳定高或参照组(增加或维持在正常范围内)),并使用多项回归探索与基线血糖指标的关联。

结果

较高的糖化血红蛋白(mmol/mol)与较低的平均握力(kg)相关(回归系数和95%置信区间(CI):-0.08(-0.09,-0.07)),并且在男性和所有年龄组中,发生可能的肌肉减少症的几率增加(优势比(OR)和95% CI:1.02(95% CI:1.01,1.02))。在女性中,仅在中年时期(例如,50 - 59岁:-0.06(-0.07,-0.05)),较高的糖化血红蛋白与较低的平均握力相关。在有重复握力测量的男性而非女性中,较高的糖化血红蛋白与随访期间稳定高握力模式的几率降低(0.97(0.96,0.99))以及稳定低握力模式的几率增加(1.03(1.01,1.04))相关(0.98(0.97,0.980))。补充分析中血糖的结果不一,尤其是在女性中。

结论

无糖尿病者糖化血红蛋白与握力之间的关联值得在推广正常血糖干预措施时进行重复研究并考虑其对肌肉力量的影响。

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