Rantanen T, Masaki K, Foley D, Izmirlian G, White L, Guralnik J M
Epidemiology, Demography, and Biometry Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA.
J Appl Physiol (1985). 1998 Dec;85(6):2047-53. doi: 10.1152/jappl.1998.85.6.2047.
The aim of this study was to describe changes in grip strength over a follow-up period of approximately 27 yr and to study the associations of rate of strength decline with weight change and chronic conditions. The data are from the Honolulu Heart Program, a prospective population-based study established in 1965. Participants at exam 1 were 8,006 men (ages 45-68 yr) who were of Japanese ancestry and living in Hawaii. At follow-up, 3,741 men (age range, 71-96 yr) participated. Those who died before the follow-up showed significantly lower grip-strength values at baseline than did the survivors. The average annualized strength change among the survivors was -1.0%. Steeper decline (>1.5%/yr) was associated with older age at baseline, greater weight decrease, and chronic conditions such as stroke, diabetes, arthritis, coronary heart disease, and chronic obstructive pulmonary disease. The risk factors for having very low hand-grip strength at follow-up, here termed grip-strength disability (</=21 kg, the lowest 10th percentile), were largely same as those for steep strength decline. However, the age-adjusted correlation between baseline and follow-up strength was strong (r = 0.557, P < 0.001); i.e., those who showed greater grip strength at baseline were also likely to do so 27 yr later. Consequently, those in the lowest grip-strength tertile at baseline had about eight times greater risk of grip-strength disability than those in the highest tertile because of their lower reserve of strength. In old age, maintenance of optimal body mass may help prevent steep strength decrease and poor absolute strength.
本研究的目的是描述在约27年的随访期内握力的变化，并研究力量下降速率与体重变化和慢性病之间的关联。数据来自檀香山心脏项目，这是一项于1965年建立的基于人群的前瞻性研究。第一次检查时的参与者为8006名年龄在45 - 68岁之间、具有日本血统且居住在夏威夷的男性。随访时，有3741名男性（年龄范围为71 - 96岁）参与。那些在随访前死亡的人在基线时的握力值显著低于幸存者。幸存者中力量的平均年化变化为 -1.0%。下降幅度更大（>1.5%/年）与基线时年龄较大、体重下降较多以及中风、糖尿病、关节炎、冠心病和慢性阻塞性肺疾病等慢性病有关。随访时握力非常低（在此称为握力残疾，即≤21 kg，处于最低的第10百分位数）的危险因素与力量急剧下降的危险因素基本相同。然而，基线和随访时力量的年龄调整相关性很强（r = 0.557，P < 0.001）；也就是说，那些在基线时握力较大的人在27年后也可能如此。因此，由于力量储备较低，基线时处于握力最低三分位数的人发生握力残疾的风险比处于最高三分位数的人高约八倍。在老年时，维持最佳体重可能有助于防止力量急剧下降和绝对力量不足。
