Huang Jiayi, Li Qian, Dou Yifan, Li Jiaping, Liu Luyao, Xu Yiqing, Yang Na, Jiang Zhaoqiang
Hangzhou Medical College, China.
Hangzhou Medical College, China.
Clin Nutr ESPEN. 2025 Apr;66:530-538. doi: 10.1016/j.clnesp.2025.02.022. Epub 2025 Feb 27.
While there is some evidence of the association between sedentary behavior and sarcopenia risk, it remains unclear whether systematic inflammation index (SII), 25(OH)D, and testosterone can mediate this association. This study aims to investigate whether sedentary behavior is associated with the prevalence of sarcopenia in the US population and further examine its potential mediators which have not been thoroughly explored, thereby presenting a novel approach to understanding the mechanism between sedentary behavior and sarcopenia.
We conducted a cross-sectional study involving a representative sample of the US national population of 9902 adults aged 18 years or older from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. The participants with sarcopenia were identified by Dual-energy X-ray (DXA) absorptiometry. Weighted multivariable logistic regressions based on the complex survey designs were used to explore the associations between a sedentary lifestyle and the risk of sarcopenia and restricted cubic spline (RCS) regression was used to examine the non-linear association. Causal mediation analysis using the quasi-Bayesian Monte Carlo method was applied to identify the mediating role of SII, 25(OH)D, and testosterone as potential mediators.
A total of 358 participants (3.6 %) had sarcopenia. Compared to those in the lowest quartile of sedentary time, participants in the highest quartile had a hazard ratio of 1.631 (95 % CI: 1.162 to 2.289) for the prevalence of sarcopenia. A non-linear relationship (P for non-linearity <0.001) between sedentary time and the risk of sarcopenia was observed using the RCS method. The odds ratio for sarcopenia was highest (OR = 3.427) when the sedentary time was 1080 min daily. Furthermore, SII, 25(OH)D, and testosterone showed a significant mediation in the association between sedentary time and sarcopenia risk, with a mediation effect of 3.39 %, 10.3 %, and 8.56 %, respectively.
This study demonstrated novel findings of the association between sedentary behavior and sarcopenia in the US population. Our study found that sedentary time was associated with the prevalence of sarcopenia. Vitamin D, SII, and testosterone served as mediating factors in the association of sedentary time with the risk of sarcopenia.
虽然有一些证据表明久坐行为与肌肉减少症风险之间存在关联，但尚不清楚系统性炎症指数（SII）、25（OH）D和睾酮是否能介导这种关联。本研究旨在调查久坐行为是否与美国人群中肌肉减少症的患病率相关，并进一步研究尚未得到充分探索的潜在中介因素，从而提出一种理解久坐行为与肌肉减少症之间机制的新方法。
我们进行了一项横断面研究，涉及来自2011 - 2018年美国国家健康与营养检查调查（NHANES）的9902名18岁及以上成年人的全国代表性样本。通过双能X线吸收法（DXA）确定肌肉减少症患者。基于复杂调查设计的加权多变量逻辑回归用于探索久坐生活方式与肌肉减少症风险之间的关联，受限立方样条（RCS）回归用于检验非线性关联。使用准贝叶斯蒙特卡罗方法进行因果中介分析，以确定SII、25（OH）D和睾酮作为潜在中介的中介作用。
共有358名参与者（3.6%）患有肌肉减少症。与久坐时间处于最低四分位数的参与者相比，最高四分位数的参与者患肌肉减少症的风险比为1.631（95%CI：1.162至2.289）。使用RCS方法观察到久坐时间与肌肉减少症风险之间存在非线性关系（非线性P<0.001）。当久坐时间为每天1080分钟时，肌肉减少症的优势比最高（OR = 3.427）。此外，SII、25（OH）D和睾酮在久坐时间与肌肉减少症风险之间的关联中显示出显著的中介作用，中介效应分别为3.39%、10.3%和8.56%。
本研究展示了美国人群中久坐行为与肌肉减少症之间关联的新发现。我们的研究发现久坐时间与肌肉减少症的患病率相关。维生素D、SII和睾酮在久坐时间与肌肉减少症风险的关联中起到了中介因素的作用。
