肌肉疏松症成分对全因死亡率的预测价值:基于人群的队列研究结果。

IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Aging Clinical and Experimental Research Pub Date : 2024-06-06 DOI:10.1007/s40520-024-02783-x
Leo D Westbury, Nicholas C Harvey, Charlotte Beaudart, Olivier Bruyère, Jane A Cauley, Peggy Cawthon, Alfonso J Cruz-Jentoft, Elizabeth M Curtis, Kristine Ensrud, Roger A Fielding, Helena Johansson, John A Kanis, Magnus K Karlsson, Nancy E Lane, Laetitia Lengelé, Mattias Lorentzon, Eugene McCloskey, Dan Mellström, Anne B Newman, Claes Ohlsson, Eric Orwoll, Jean-Yves Reginster, Eva Ribom, Björn E Rosengren, John T Schousboe, Elaine M Dennison, Cyrus Cooper
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引用次数: 0

摘要

背景:低握力和步速与死亡率有关。目的:我们研究了握力和步速是否比更容易获得的临床风险因素更能提高对死亡率的判别能力:方法:我们对健康、衰老和身体成分研究、男性骨质疏松性骨折研究和赫特福德郡队列研究的参与者进行了分析。使用 DXA 确定关节瘦体重 (ALM);通过握力测定法确定肌肉力量;以及 2.4-6 米的正常步速。使用以队列为随机效应的 Cox 回归法研究了肌肉疏松症各组成部分与死亡率之间的关系;使用 Harrell's Concordance Index (C-index) 评估了判别能力:参与者(n = 8362)的平均(标清)年龄为 73.8(5.1)岁;5231(62.6%)人在 13.3 年的中位随访时间内死亡。握力(每标准差下降的危险比(95% CI):1.14(1.10,1.10,1.10)):在考虑了年龄、性别、体重指数(BMI)、吸烟状况、饮酒量、体力活动、种族、教育程度、骨折和跌倒史、股骨颈骨矿密度(BMD)、自评健康状况、认知功能和合并症数量后,在相互调整的模型中,握力(每 SD 下降的危险比(95% CI):1.14 (1.10,1.19))和步速(1.21 (1.17,1.26))与死亡率相关,而 ALM 指数(1.01 (0.95,1.06))与死亡率无关。然而,仅将年龄和性别作为暴露因子的模型得出的C指数(95% CI)为0.65(0.64,0.66),只有在纳入握力和步速后才增至0.67(0.67,0.68):结论:与其他更容易获得的风险因素相比,握力和步速只能提供适度的死亡率辅助风险信息。
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Predictive value of sarcopenia components for all-cause mortality: findings from population-based cohorts.

Background: Low grip strength and gait speed are associated with mortality. However, investigation of the additional mortality risk explained by these measures, over and above other factors, is limited.

Aim: We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors.

Methods: Participants from the Health, Aging and Body Composition Study, Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over 2.4-6 m. Verified deaths were recorded. Associations between sarcopenia components and mortality were examined using Cox regression with cohort as a random effect; discriminative capacity was assessed using Harrell's Concordance Index (C-index).

Results: Mean (SD) age of participants (n = 8362) was 73.8(5.1) years; 5231(62.6%) died during a median follow-up time of 13.3 years. Grip strength (hazard ratio (95% CI) per SD decrease: 1.14 (1.10,1.19)) and gait speed (1.21 (1.17,1.26)), but not ALM index (1.01 (0.95,1.06)), were associated with mortality in mutually-adjusted models after accounting for age, sex, BMI, smoking status, alcohol consumption, physical activity, ethnicity, education, history of fractures and falls, femoral neck bone mineral density (BMD), self-rated health, cognitive function and number of comorbidities. However, a model containing only age and sex as exposures gave a C-index (95% CI) of 0.65(0.64,0.66), which only increased to 0.67(0.67,0.68) after inclusion of grip strength and gait speed.

Conclusions: Grip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.

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来源期刊
CiteScore
7.90
自引率
5.00%
发文量
283
审稿时长
1 months
期刊介绍: Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.
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