Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons
Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons
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DOI：
10.1093/gerona/60.3.324
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发表时间：
2005-03-01
影响因子：
5.1
通讯作者：
Harris, TB
中科院分区：
文献类型：
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作者：
Visser, M;Goodpaster, BH;Harris, TB
背景较低的肌肉质量与身体功能差相关：然而，没有研究前瞻性地研究这种关系。本研究旨在探讨是否低肌肉质量，低肌肉力量，以及更多的脂肪浸润到肌肉预测事件的活动受限。我们的研究队列包括3075名参与健康、衰老和身体成分研究的70-79岁功能良好的黑人和白色男性和女性。参与者被跟踪了2.5年。在大腿中部通过计算机断层扫描测量肌肉横截面积和肌肉组织衰减（脂肪浸润的测量），并使用KinCom测力计测量膝伸肌力量。活动受限事件定义为连续两次自我报告行走四分之一英里或爬10步困难。22.3%的男性和31.8%的女性出现了行动受限。考克斯的比例风险模型，调整人口统计学，生活方式和健康因素，显示风险比为1.90 [95%置信区间（CI），1.27-2.84]在男性和1.68（95% CI，1.23-2.31）在女性的最低相比，最高的四分位数的肌肉面积（p <0.01的趋势）。肌力结果分别为2.02（95% CI，1.39-2.94）和1.91（95% CI，1.39-2.94）。1.41-2.58），p <0.001趋势，肌肉衰减为1.91（95% CI，1.31-2.83）和1.69（95% CI，1.20- 2.35），p <0.01趋势。当包括在一个模型中时，只有肌肉衰减和肌肉力量独立地预测活动受限（p <0.05）。在男性和女性中，黑人和白人的相关性相似。较低的肌肉质量（较小的大腿肌肉横截面积），更多的脂肪浸润到肌肉中，以及较低的膝伸肌肌力与老年男性和女性活动能力丧失的风险增加有关，低肌肉质量和功能下降之间的关联似乎是潜在的肌肉力量的函数。
Background. Lower muscle mass has been correlated with poor physical function: however, no studies have examined this relationship prospectively. This study aims to investigate whether low muscle mass, low muscle strength, and greater fat infiltration into the muscle predict incident mobility limitation.Methods. Our study cohort included 3075 well-functioning black and white men and women aged 70-79 years participating in the Health, Aging, and Body Composition study. Participants were followed for 2.5 years. Muscle cross-sectional area and muscle tissue attenuation (a measure of fat infiltration) were measured by computed tomography at the mid-thigh, and knee extensor strength by using a KinCom dynamometer. Incident mobility limitation was defined as two consecutive self-reports of any difficulty walking one-quarter mile or climbing 10 steps.Results. Mobility limitations were developed by 22.3% of the men and by 31.8% of the women. Cox's proportional hazards models, adjusting for demographic, lifestyle, and health factors, showed a hazard ratio of 1.90 [95% confidence interval (CI), 1.27-2.84] in men and 1.68 (95% CI, 1.23-2.31) in women for the lowest compared to the highest quartile of muscle area (p < .01 for trend). Results for muscle strength were 2.02 (95% CI, 1.39-2.94) and 1,91 (95% Cl. 1.41-2.58), p < .001 trend, and for muscle attenuation were 1.91 (95% CI, 1.31-2.83) and 1.69 (95% CI, 1.20-2,35), p < .01 for trend. When included in one model, only muscle attenuation and muscle strength independently predicted mobility limitation (p < .05). Among men and women, associations were similar for blacks and whites.Conclusion. Lower muscle mass (smaller cross-sectional thigh muscle area), greater fat infiltration into the muscle, and lower knee extensor muscle strength are associated with increased risk of mobility loss in older men and women, The association between low muscle mass and functional decline seems to be a function of underlying muscle strength.