Zhang Xiang-Tao, Zeng Qing-Tian, Zhang Hong-Jin, Zhou Si-Ping
Department of Cardiology, Yichun People's Hospital, Yichun, China.
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Acta Diabetol. 2025 Apr 19. doi: 10.1007/s00592-025-02494-3.
Relative muscle strength (RMS) serves as a valuable indicator of skeletal muscle function. As the body ages, skeletal muscle function declines gradually, leading to a range of adverse effects. Cardiometabolic multimorbidity (CMM) is a prevalent co-morbidity in middle-aged and elderly populations. However, there are few studies to investigate the association between RMS and CMM.
This study adopted a cross-sectional design, including participants from the China Health and Retirement Longitudinal Study (CHARLS) of 2011. Appendicular skeletal muscle mass (ASM) was estimated using previously validated anthropometric equations. RMS was defined as the ratio of maximum hand grip strength (HGS) to ASM. CMM was characterized by the presence of at least two cardiometabolic disorders (cardiopathy, stroke, and diabetes), as assessed through self-reported physician diagnoses. The relationship between RMS and CMM was evaluated through multifactor logistic regression analysis.
A total of 9,200 participants with a mean age of 59.49 years were included in this study. Among them, 6,844 (74.4%) had no cardiometabolic disease (CMD), 2,052 (22.3%) had a single CMD, and 304 (3.3%) had cardiometabolic multimorbidity (CMM). Multifactor logistic regression was used to evaluate the relationship between them. In the initial model, there was a negative correlation between RMS and CMM. After adjusting for confounders, this association remained statistically significant. Specifically, for each additional unit increase in RMS, the risk of CMM was reduced by 40% (OR: 0.60, 95%CI: (0.45, 0.78)). Additionally, the highest RMS value group had a lower risk of CMM compared to the lowest value group (OR: 0.46, 95%CI: (0.31, 0.67)). As indicated by the restricted cubic spline plots, there was an L-shape correlation between RMS and CMM (P for nonlinear = 0.003).
The RMS, calculated based on HGS and ASM, was a potential indicator of CMM in middle-aged and elderly adults in China.
相对肌肉力量（RMS）是骨骼肌功能的一个重要指标。随着身体衰老，骨骼肌功能逐渐下降，会导致一系列不良影响。心脏代谢多重疾病（CMM）是中老年人群中普遍存在的一种共病。然而，很少有研究调查RMS与CMM之间的关联。
本研究采用横断面设计，纳入了2011年中国健康与养老追踪调查（CHARLS）的参与者。使用先前验证过的人体测量方程估算四肢骨骼肌质量（ASM）。RMS定义为最大握力（HGS）与ASM的比值。通过自我报告的医生诊断评估，CMM的特征是存在至少两种心脏代谢疾病（心脏病、中风和糖尿病）。通过多因素逻辑回归分析评估RMS与CMM之间的关系。
本研究共纳入9200名平均年龄为59.49岁的参与者。其中，6844人（74.4%）无心脏代谢疾病（CMD），2052人（22.3%）患有一种CMD，304人（3.3%）患有心脏代谢多重疾病（CMM）。采用多因素逻辑回归评估它们之间的关系。在初始模型中，RMS与CMM之间存在负相关。调整混杂因素后，这种关联仍具有统计学意义。具体而言，RMS每增加一个单位，CMM的风险降低40%（比值比：0.60，95%置信区间：（0.45，0.78））。此外，与最低RMS值组相比，最高RMS值组患CMM的风险更低（比值比：0.46，95%置信区间：（0.31，0.67））。受限立方样条图显示，RMS与CMM之间存在L形相关性（非线性P值 = 0.003）。
基于HGS和ASM计算得出的RMS是中国中老年人CMM的一个潜在指标。
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