Aortic Calcification is Associated with Five-Year Decline in Handgrip Strength in Older Women
Aortic Calcification is Associated with Five-Year Decline in Handgrip Strength in Older Women
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DOI：
10.1007/s00223-018-0458-5
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发表时间：
2018-12-01
影响因子：
4.2
通讯作者：
Prince, Richard L.
中科院分区：
文献类型：
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作者：
Rodriguez, Alexander J.;Lewis, Joshua R.;Prince, Richard L.
该研究的目的是确定AAC与5年内神经肌肉功能之间的关系。本研究的参与者是居住在西澳大利亚珀斯的70岁以上的流动妇女，她们参加了钙摄入骨折结果研究，这是一项钙补充的随机对照试验。纳入1046名女性（平均年龄=74.9±2.6岁，BMI=27.1±4.4kg/m(2)）。在骨密度测试期间捕获的侧脊柱图像在基线时对AAC进行评分（AAC24; 0-24）。重度AAC（AAC(sev)）根据既定切点（AAC246）进行定义。在基线和随访时，使用测力仪评估等距握力。移动性通过time - up -and- go （TUG）测试进行评估。根据预先定义的标准，肌肉无力被认为是握力。一部分女性在基线和随访时通过双能x线吸收仪检测出阑尾瘦质量（ALM） （n=261）。193例（18.5%）女性有明显的AAC(7)。5年后，AAC（sev）组握力平均下降幅度大于无AAC组（3.6 +/- 3.7 vs. 2.9 +/- 4.2kg; p=0.034）。在调整了年龄、治疗分配、糖尿病、吸烟史、肾功能、病历来源的流行血管疾病、BMI和身体活动等因素后，这一结果仍然显著（=-0.184；95%可信区间：-0.361,-0.008;p=0.040）。在单变量或多变量分析中，AAC（sev）与TUG或ALM的5年变化无关（均p < 0.05）。在老年妇女中，严重的主动脉钙化与5年肌力下降有关，但与TUG或ALM无关。这些发现支持了血管疾病可能对肌肉力量丧失有影响的概念。
The objective of the study was to determine the association between AAC and neuromuscular function over 5years. Participants in this study were ambulant women over 70years old residing in Perth, Western Australia who participated in the Calcium Intake Fracture Outcomes Study, a randomised controlled trial of calcium supplementation. 1046 women (mean age=74.9 +/- 2.6years; BMI=27.1 +/- 4.4kg/m(2)) were included. Lateral spine images captured during bone density testing were scored for AAC (AAC24; 0-24) at baseline. Severe AAC (AAC(sev)) was defined using established cut points (AAC246). At baseline and follow-up, isometric grip strength was assessed using a dynamometer. Mobility was assessed by the Timed-Up-and-Go (TUG) test. Using pre-defined criteria, muscle weakness was considered as grip strength10.2s. A subset of women had appendicular lean mass (ALM) determined by dual-energy X-ray absorptiometry at baseline and follow-up (n=261). AAC(sev) was evident in 193 (18.5%) women. Average decline in grip strength after 5years was greater in those with AAC(sev) than those without (3.6 +/- 3.7 vs. 2.9 +/- 4.2kg; p=0.034). This remained significant after adjustment for age, treatment allocation, diabetes, smoking history, renal function, medical record-derived prevalent vascular disease, BMI and physical activity (=-0.184; 95% confidence interval: -0.361, -0.008; p=0.040). AAC(sev) was not associated with 5-year changes in TUG or ALM in univariable or multivariable analyses (all p>0.05). In older women, severe aortic calcification was associated with greater 5-year decline in muscle strength, but not TUG or ALM. These findings support the concept that vascular disease may have an effect on the loss of muscular strength.