Wang Yilun, Wu Ziying, Zhang Yuqing, Yang Zidan, Li Changjun, Wei Jie, Lei Guanghua, Zeng Chao
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Changsha, China.
Ann Med. 2025 Dec;57(1):2537353. doi: 10.1080/07853890.2025.2537353. Epub 2025 Jul 26.
Step count is a well-established measure of physical activity, and step-based recommendations offering practical public guidance. However, the bidirectional associations between step count and sarcopenia remain unclear, limiting the application of step-based interventions for sarcopenia prevention. This study examined the directional association between daily steps and sarcopenia.
Data were collected from the Xiangya Step Study (a population-based longitudinal study) between January 2020 and December 2022. Average daily steps were tracked smartphones linked to WeChat, a social networking platform. Sarcopenia was diagnosed using the Asian Workgroup of Sarcopenia 2019 criteria. A two-wave cross-lagged panel model was used to evaluate bidirectional associations between daily steps and sarcopenia. Additionally, logistic regression examines the association between daily steps and incident sarcopenia risk in participants without sarcopenia at baseline. The area under the curve (AUC) was calculated to evaluate the predictive performance of baseline daily steps for incident sarcopenia.
The study included 1,281 participants (30.1% women), averaging 52.1 years. A significant bidirectional association was observed: fewer daily steps at baseline were associated with sarcopenia status one year later (cross-lagged path coefficient [β]=-1.20, 95%CI: -1.90 to -0.50, = 0.001), and sarcopenia status at baseline was associated with decreased daily steps one year later (β=-0.19, 95%CI: -0.23 to -0.15, < 0.001). Logistic regression indicated that each standard deviation increase in daily steps was associated with a lower risk of incident sarcopenia (adjusted OR = 0.28, 95%CI: 0.09 to 0.89, = 0.03). The AUC for daily steps was 0.74 (95%CI: 0.56 to 0.92), with an optimal cutoff of 4,888 steps (sensitivity = 0.62, specificity = 0.85).
This study highlights a bidirectional inverse association between average daily steps and sarcopenia. Increasing daily steps, especially to 5,000, might help mitigate sarcopenia development. Future research could explore interventions that increase daily steps to prevent sarcopenia and investigate whether sarcopenia reversal could improve physical activity levels.
步数是一种公认的身体活动衡量指标，基于步数的建议为公众提供了实用的指导。然而，步数与肌肉减少症之间的双向关联仍不明确，这限制了基于步数的干预措施在预防肌肉减少症方面的应用。本研究探讨了每日步数与肌肉减少症之间的方向性关联。
数据收集自2020年1月至2022年12月的湘雅步数研究（一项基于人群的纵向研究）。通过与社交网络平台微信相连的智能手机追踪平均每日步数。采用亚洲肌肉减少症工作组2019年标准诊断肌肉减少症。使用两波交叉滞后面板模型评估每日步数与肌肉减少症之间的双向关联。此外，逻辑回归分析了基线时无肌肉减少症的参与者中每日步数与新发肌肉减少症风险之间的关联。计算曲线下面积（AUC）以评估基线每日步数对新发肌肉减少症的预测性能。
该研究纳入了1281名参与者（30.1%为女性），平均年龄52.1岁。观察到显著的双向关联：基线时每日步数较少与一年后的肌肉减少症状态相关（交叉滞后路径系数[β]= -1.20，95%CI：-1.90至-0.50，P = 0.001），而基线时的肌肉减少症状态与一年后每日步数减少相关（β = -0.19，95%CI：-0.23至-0.15，P < 0.001）。逻辑回归表明，每日步数每增加一个标准差与新发肌肉减少症风险降低相关（调整后的OR = 0.28，95%CI：0.09至0.89，P = 0.03）。每日步数的AUC为0.74（95%CI：0.56至0.92），最佳截断值为4888步（敏感性 = 0.62，特异性 = 0.85）。
本研究强调了平均每日步数与肌肉减少症之间的双向负相关。增加每日步数，尤其是增加到5000步，可能有助于减轻肌肉减少症的发展°未来的研究可以探索增加每日步数以预防肌肉减少症的干预措施，并研究肌肉减少症的逆转是否可以提高身体活动水平°
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