握力不对称与多种健康结局的关联。
Associations of Grip Strength Asymmetry With Multiple Health Outcomes.
作者信息
Liu Wei, Lai Xuefeng, Shi Da, Wang Hao, Fan Lieyang, Shi Wendi, Yu Linling, Liang Ruyi, Chen Weihong, Wang Bin
机构信息
Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Medical Big Data and Bioinformatics Research Centre, First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Am J Prev Med. 2025 May;68(5):974-981. doi: 10.1016/j.amepre.2025.02.003. Epub 2025 Feb 12.
INTRODUCTION
The relationships between grip strength asymmetry and cardiovascular, respiratory, and cancer outcomes and all-cause mortality remain unclear.
METHODS
Among 443,132 UK Biobank participants enrolled from 2006 to 2010, grip strength asymmetry was defined as the ratio of left-hand grip strength (kg) to right-hand grip strength (kg) <0.9 or >1.1. The Cox proportional model was employed to assess the associations of grip strength asymmetry with cardiovascular, respiratory, and cancer outcomes and all-cause mortality. Net reclassification improvement was assessed to evaluate the improvement in risk discrimination for outcomes after adding grip strength asymmetry to the model with established office-based risk factors.
RESULTS
After a mean follow-up of 12.1 years, 28,478 (6.4%) deaths occurred. grip strength asymmetry was significantly associated with all-cause (hazard ratio: 1.096; 95% CI=1.070, 1.122), cardiovascular disease (hazard ratio: 1.141; 95% CI=1.071, 1.216), respiratory disease (hazard ratio: 1.183; 95% CI=1.076, 1.301), chronic obstructive pulmonary disease (hazard ratio: 1.284; 95% CI=1.087, 1.516), and cancer (hazard ratio: 1.051; 95% CI=1.017, 1.086) mortality. Significant associations of grip strength asymmetry with cardiovascular disease (hazard ratio: 1.029; 95% CI=1.004, 1.054), respiratory disease (hazard ratio: 1.074; 95% CI=1.051, 1.103), chronic obstructive pulmonary disease (hazard ratio: 1.123; 95% CI=1.038, 1.215), and colorectal cancer (hazard ratio: 1.051; 95% CI=1.037, 1.066) incidence were observed. Moreover, adding grip strength asymmetry to a model with established office-based risk factors significantly improved the ability to predict all-cause, cardiovascular disease, and respiratory disease mortality.
CONCLUSIONS
Grip strength asymmetry was associated with a range of adverse health outcomes and may have clinical use in predicting all-cause, cardiovascular disease, and respiratory disease mortalities. Further studies are warranted to validate the clinical value of the grip strength asymmetry assessment.
引言
握力不对称与心血管、呼吸和癌症结局以及全因死亡率之间的关系尚不清楚。
方法
在2006年至2010年招募的443132名英国生物银行参与者中，握力不对称定义为左手握力（千克）与右手握力（千克）的比值<0.9或>1.1。采用Cox比例模型评估握力不对称与心血管、呼吸和癌症结局以及全因死亡率之间的关联。评估净重新分类改善情况，以评估在将握力不对称添加到具有既定办公室风险因素的模型后，结局风险辨别能力的改善。
结果
平均随访12.1年后，发生了28478例（6.4%）死亡。握力不对称与全因（风险比：1.096；95%置信区间=1.070，1.122）、心血管疾病（风险比：1.141；95%置信区间=1.071，1.216）、呼吸系统疾病（风险比：1.183；95%置信区间=1.076，1.301）、慢性阻塞性肺疾病（风险比：1.284；95%置信区间=1.087，1.516）和癌症（风险比：1.051；95%置信区间=1.017，1.086）死亡率显著相关。观察到握力不对称与心血管疾病（风险比：1.029；95%置信区间=1.004，1.054）、呼吸系统疾病（风险比：1.074；95%置信区间=1.051，1.103）、慢性阻塞性肺疾病（风险比：1.123；95%置信区间=1.038,1.215）和结直肠癌（风险比：1.051；95%置信区间=1.037，1.066）发病率显著相关。此外，将握力不对称添加到具有既定办公室风险因素的模型中，显著提高了预测全因、心血管疾病和呼吸系统疾病死亡率的能力。
结论
握力不对称与一系列不良健康结局相关，可能在预测全因、心血管疾病和呼吸系统疾病死亡率方面具有临床应用价值。有必要进行进一步研究以验证握力不对称评估的临床价值。
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