Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort
Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort
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DOI：
10.1093/gerona/61.1.72
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发表时间：
2006-01-01
影响因子：
5.1
通讯作者：
Harris, TB
中科院分区：
文献类型：
--
作者：
Newman, AB;Kupelian, V;Harris, TB
背景。虽然肌肉力量和质量高度相关，但直接测量低肌肉质量（肌肉减少）和强度与死亡率之间的关系尚未得到检验。在健康、衰老和身体组成（Health ABC）研究中，对2292名参与者（年龄在70-79岁之间，51.6%为女性，38.8%为黑人）的总死亡率进行了检查。用等速测力法测定膝关节伸展强度，用等速测力法测定握力。采用计算机断层扫描（CT）测量大腿肌肉面积，采用双能x线吸收仪（DXA）测定腿部和手臂瘦软组织质量。力量和肌肉大小在性别特异性Cox比例风险模型中进行评估，年龄、种族、合并症、吸烟状况、体力活动水平、CT脂肪面积或DXA脂肪量、身高和炎症标志物，包括白细胞介素-6、c反应蛋白和肿瘤坏死因子-被认为是潜在的混杂因素。在平均4.9年（标准差= 0.9）的随访期间，有286人死亡。股四头肌和握力与死亡率密切相关。对于股四头肌力量（每标准差为38 Nm），男性的粗风险比为1.51(95%可信区间，1.28-1.79)，女性的粗风险比为1.65（95%可信区间，1.19-2.30）。由CT面积或DXA局部瘦质量确定的肌肉大小与死亡率没有强烈相关性。在股四头肌力量和死亡率的模型中，调整肌肉面积或局部瘦质量只略微减弱了这种关联。进一步调整其他因素也对股四头肌力量与死亡率的关系影响甚微。握力与死亡率的关系相似。低肌肉质量并不能解释肌肉力量与死亡率之间的强烈联系，这表明在估计死亡风险时，肌肉力量作为肌肉质量的标志比肌肉数量更重要。握力提供了与股四头肌力量相似的风险估计。
Background. Although muscle strength and mass are highly correlated, the relationship between direct measures of low muscle mass (sareopenia) and strength in association with mortality has not been examined.Methods. Total mortality rates were examined in the Health, Aging and Body Composition (Health ABC) Study in 2292 participants (aged 70-79 years, 51.6% women, and 38.8% black). Knee extension strength was measured with isokinetic dynamometry, grip strength with isometric dynamometry. Thigh muscle area was measured by computed tomography (CT) scan, and leg and arm lean soft tissue mass were determined by dual energy x-ray absorptiometry (DXA). Both strength and muscle size were assessed as in gender-specific Cox proportional hazards models, with age, race, comorbidities, smoking status, level of physical activity, fat area by CT or fat mass by DXA, height, and markers of inflammation, including interleukin-6, C-reactive protein, and tumor necrosis factor-a considered as potential confounders.Results. There were 286 deaths over an average of 4.9 (standard deviation = 0.9) years of follow-up. Both quadriceps and grip strength were strongly related to mortality. For quadriceps strength (per standard deviation of 38 Nm), the crude hazard ratio for men was 1.51 (95% confidence interval, 1.28-1.79) and 1.65 (95% confidence interval, 1.19-2.30) for women. Muscle size, determined by either CT area or DXA regional lean mass, was not strongly related to mortality. In the models of quadriceps strength and mortality, adjustment for muscle area or regional lean mass only slightly attenuated the associations. Further adjustment for other factors also had minimal effect on the association of quadriceps strength with mortality. Associations of grip strength with mortality were similar.Conclusion. Low muscle mass did not explain the strong association of strength with mortality, demonstrating that muscle strength as a marker of muscle quality is more important than quantity in estimating mortality risk. Grip strength provided risk estimates similar to those of quadriceps strength.