Strong Relation Between Muscle Mass Determined by D3-creatine Dilution, Physical Performance, and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men
Strong Relation Between Muscle Mass Determined by D3-creatine Dilution, Physical Performance, and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men
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DOI：
10.1093/gerona/gly129
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发表时间：
2019-06-01
影响因子：
5.1
通讯作者：
Evans, William J.
中科院分区：
文献类型：
--
作者：
Cawthon, Peggy M.;Orwoll, Eric S.;Evans, William J.
背景：直接评估老年人的骨骼肌质量在临床上具有挑战性。瘦体重和晚年结果之间的关系一直不一致。D-3-肌酸稀释法提供了一个直接的评估muscle mass.Methods：肌肉质量进行了评估的D3-肌酸（D3 Cr）稀释在1,382名男性（平均年龄，84.2岁）。参与者完成了短期体能测试（SPPB）;通常的步行速度（6米）;和双X射线吸收测定法（DXA）瘦体重。男性自我报告活动受限（行走2-3个街区或爬10级台阶困难）;经常性福尔斯（2+）;以及次年严重伤害性福尔斯。在D3 Cr肌肉质量/身体质量的四分位数中，多变量线性模型计算SPPB和步态速度的平均值;多变量logistic模型计算活动受限或福尔斯事件的比值比。结果：与最高四分位数的男性相比，D3 Cr肌肉质量/身体质量最低四分位数的男性步态速度较慢（Q1：1.04 vs Q4：1.17 m/s）; SPPB较低（Q1：8.4分vs Q4：10.4分）;发生严重伤害性福尔斯跌倒事件的可能性更大（比值比[OR] Q1 vs Q4：2.49，95%置信区间[CI]：1.37，4.54）;普遍存在活动受限（OR Q1 vs Q4，：6.1，95% CI：3.7，10.3）和偶发活动受限（OR Q1 vs Q4：2.15，95% CI：1.42，3.26）; p为趋势
Background: Direct assessment of skeletal muscle mass in older adults is clinically challenging. Relationships between lean mass and late-life outcomes have been inconsistent. The D-3-creatine dilution method provides a direct assessment of muscle mass.Methods: Muscle mass was assessed by D3-creatine (D3Cr) dilution in 1,382 men (mean age, 84.2 years). Participants completed the Short Physical Performance Battery (SPPB); usual walking speed (6 m); and dual x-ray absorptiometry (DXA) lean mass. Men self-reported mobility limitations (difficulty walking 2-3 blocks or climbing 10 steps); recurrent falls (2+); and serious injurious falls in the subsequent year. Across quartiles of D3Cr muscle mass/body mass, multivariate linear models calculated means for SPPB and gait speed; multivariate logistic models calculated odds ratios for incident mobility limitations or falls.Results: Compared to men in the highest quartile, those in the lowest quartile of D3Cr muscle mass/body mass had slower gait speed (Q1: 1.04 vs Q4: 1.17 m/s); lower SPPB (Q1: 8.4 vs Q4: 10.4 points); greater likelihood of incident serious injurious falls (odds ratio [OR] Q1 vs Q4: 2.49, 95% confidence interval [CI]: 1.37, 4.54); prevalent mobility limitation (OR Q1 vs Q4,: 6.1, 95% CI: 3.7, 10.3) and incident mobility limitation (OR Q1 vs Q4: 2.15 95% CI: 1.42, 3.26); p for trend