Wang Ning, Zhang Yuqing, Xie Junqing, Lu Na, Zheng Aojie, Li Changjun, Wei Jie, Zeng Chao, Lei Guanghua, Wang Yilun
Department of Orthopaedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Kaifu District, Changsha, 410008, China, 86 073184327326.
Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China.
JMIR Aging. 2025 Jul 28;8:e65374. doi: 10.2196/65374.
Individuals with probable sarcopenia have shown excess mortality, yet no specific treatment regimen has been established. While lifestyle factors improve health and longevity in general populations, their role in probable patients with sarcopenia remains unclear due to differing lifestyle patterns. Clarifying this could inform strategies to address this unmet need.
We aim to quantify the impact of a healthy lifestyle on all-cause and cause-specific mortality in probable sarcopenic populations using a large-scale prospective cohort study.
Participants were selected from the UK Biobank, aged 40-69 years, during 2006-2010. Probable sarcopenia was identified according to EWGSOP2 (European Working Group on Sarcopenia in Older People 2) criteria, resulting in 20,654 participants being included in this study. Death dates and underlying causes were obtained from the National Health Service Information Center. Cox proportional hazard models and population-attributable risk were used to assess the associations between healthy lifestyle factors and premature mortality risk.
A total of 20,654 individuals with probable sarcopenia were included in this study. The median age of the population was 62.0 (IQR 56.0-66.0) years, and 60.6% (n=12,528) were women. During a median follow-up duration of 11.5 (IQR 10.8-12.3) years, 2447 participants died. All healthy lifestyle factors, including nonsmoking (P<.001), moderate alcohol intake (P<.001), regular physical activity (P<.001), a healthy diet (P=.01), limited television-watching time (P<.001), adequate sleep duration (P=.001), and strong social connections (P<.001), were independently associated with lower mortality risk. To evaluate the cumulative associations between modifiable lifestyle factors and mortality outcomes (all-cause and cause-specific) among patients with probable sarcopenia, we developed a healthy lifestyle index. Participants were assigned one point per adherence to each optimal lifestyle factor. Compared with individuals with 0-2 healthy lifestyle scores, hazard ratios of all-cause mortality for those with 3 to 6-7 factors were 0.67 (95% CI 0.59-0.76), 0.51 (95% CI 0.45-0.57), 0.43 (95% CI 0.38-0.49), and 0.33 (95% CI 0.29-0.39), respectively (P for trend <.001). There was also a dose-response relationship between the number of healthy lifestyle factors and mortality from cancer, cardiovascular disease, respiratory disease, digestive disease, and other causes (all P for trend<.001). Population-attributable risk analysis indicated that 25.7% (95% CI 22%-29%) of deaths were attributable to a poor lifestyle (scoring 0-5).
A healthy lifestyle is associated with a lower risk of all-cause mortality and mortality due to cancer, cardiovascular disease, respiratory disease, and digestive disease among individuals with probable sarcopenia. Adopting a healthy lifestyle (scoring 6-7) could prevent 25.7% of deaths in this population.
可能患有肌肉减少症的个体已显示出更高的死亡率，但尚未确立具体的治疗方案。虽然生活方式因素通常能改善普通人群的健康状况并延长寿命，但由于生活方式模式不同，它们在可能患有肌肉减少症的患者中的作用仍不明确。阐明这一点可为满足这一未满足需求的策略提供依据。
我们旨在通过一项大规模前瞻性队列研究，量化健康生活方式对可能患有肌肉减少症人群的全因死亡率和特定病因死亡率的影响。
研究对象选自2006年至2010年期间年龄在40 - 69岁的英国生物银行参与者。根据欧洲老年人肌肉减少症工作组（EWGSOP2）标准确定可能患有肌肉减少症的情况，共有20654名参与者纳入本研究。死亡日期和潜在病因来自英国国家医疗服务体系信息中心。使用Cox比例风险模型和人群归因风险来评估健康生活方式因素与过早死亡风险之间的关联。
本研究共纳入20654名可能患有肌肉减少症的个体。人群的中位年龄为62.0（四分位间距56.0 - 66.0）岁，60.6%（n = 12528）为女性。在中位随访期11.5（四分位间距10.8 - 12.3）年期间，2447名参与者死亡。所有健康生活方式因素，包括不吸烟（P <.001）、适度饮酒（P <.001）、定期体育锻炼（P <.001）、健康饮食（P =.01）、有限的看电视时间（P <.001）、充足的睡眠时间（P =.001）以及紧密的社会联系（P <.001），均与较低的死亡风险独立相关。为了评估可改变的生活方式因素与可能患有肌肉减少症患者的死亡结局（全因和特定病因）之间的累积关联，我们制定了一个健康生活方式指数。参与者每坚持一项最佳生活方式因素得1分。与健康生活方式得分为0 - 2分的个体相比，得分为3至6 - 7分的个体全因死亡率的风险比分别为0.67（95%置信区间0.59 - 0.76）、0.51（95%置信区间0.45 - 0.57）、0.43（95%置信区间0.38 - 0.49）和0.33（95%置信区间0.29 - 0.39）（趋势P <.001）。健康生活方式因素的数量与癌症、心血管疾病、呼吸系统疾病、消化系统疾病及其他病因导致的死亡率之间也存在剂量反应关系（所有趋势P <.001）。人群归因风险分析表明，25.7%（95%置信区间22% - 29%）的死亡可归因于不良生活方式（得分0 - 5分）。
健康生活方式与可能患有肌肉减少症的个体全因死亡率以及癌症、心血管疾病、呼吸系统疾病和消化系统疾病导致的死亡率较低相关。采用健康生活方式（得分6 - 7分）可预防该人群中25.7%的死亡。
