Sex-specific associations between cardiovascular risk factors and physical function: the Gambian Bone and Muscle Ageing Study.
Sex-specific associations between cardiovascular risk factors and physical function: the Gambian Bone and Muscle Ageing Study.
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DOI：
10.1002/jcsm.13069
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发表时间：
2023-02
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影响因子：
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在撒哈拉以南非洲地区，由于快速城市化，肥胖、心血管疾病 (CVD) 和身体机能受损的患病率不断增加。我们调查了冈比亚成年人心脏负荷、动脉僵硬度、外周血管钙化（PVC）和身体功能之间关系的性别差异。总共招募了 488 名 40 至 75 岁以上的冈比亚人（男性：239 人；女性：249 人）。测量仰卧位血压和心率以计算心率压力乘积和脉压。通过胫骨周边定量计算机断层扫描确定 PVC 的存在。通过椅子上升测试（CRT）、单人双腿跳跃（s2LJ）和握力测试（HGS）评估身体功能。通过双能X射线吸收法测量身体成分；体型校正用于计算脂肪质量指数（FMI）和四肢瘦肉质量指数（ALMI）。估计肾小球滤过率（eGFR）是根据空腹血样测量的。使用线性回归测试心率压力乘积、脉压或 PVC 的存在（自变量）与身体功能参数（因变量）之间的关系。根据年龄、eGFR 和 ALMI/FMI 调整性别相互作用进行测试 (p-int)。结果表示为男性和女性之间的平均差异，置信区间为 95%。中介分析使用 ALMI/FMI 作为中介。与男性相比，女性体重更轻（54.7 kg ± 10.3 对比 59.9 kg ± 10.3），身材更矮（157.8 cm ± 6.0 对比 169.2 cm ± 7.0）（均 P < 0.0001）。女性的 FMI 较高（6.8 kg/m2 ± 2.9 对比 2.9 kg/m2 ± 2.0，P < 0.0001）和 eGFR（263.7 mL/min/1.73 m2 ± 133.1 对比 237.6 mL/min/1.73 m2 ± 134.6），但 ALMI 较低（6.2 kg/m2 ± 0.7 vs. 8.02 kg/m2 ± 1.0，P < 0.0001）与男性相比。仅在调整了年龄、eGFR 和 FMI 后，男性和女性在心率压力乘积、s2LJ 功率 (−1.08 [−1.21, -0.95]) 和力量 (−0.57 [−0.63, -0.51]) 方面存在显着平均差异。脉压与 CRT 功率 (-0.28 [-0.31, -0.25])、s2LJ 功率 (-1.07 [-1.20, -0.93]) 和 HGS (-11.94 [-13.35, -10.54]) 之间的关联存在显着的平均差异；调整年龄、eGFR 和 FMI 后，这些差异比 ALMI 更大。 PVC 和身体机能参数之间的关联也存在类似的差异。在男性中，FMI 调节心率压力乘积与 CRT 功率 (P = 0.002)、s2LJ 力 (P < 0.001) 和 s2LJ 功率 (P = 0.001) 之间的关联。 ALMI 不介导男性或女性的关联。 CVD 的多种危险因素与男性较差的身体功能有关，并由 FMI 介导。有必要制定战略来减缓/预防撒哈拉以南非洲地区不断上升的心血管疾病负担和身体机能不佳的情况。
In Sub‐Saharan Africa, the prevalence of obesity, cardiovascular disease (CVD) and impaired physical function are increasing due to rapid urbanization. We investigated sex differences in associations between cardiac workload, arterial stiffness, peripheral vascular calcification (PVC) and physical function in Gambian adults. A total of 488 Gambians aged 40–75+ years were recruited (men: 239; and women: 249). Supine blood pressure and heart rate were measured to calculate rate pressure product and pulse pressure. Presence of PVC was determined from tibia peripheral quantitative computed tomography scans. Physical function was assessed by chair rise test (CRT), single two‐legged jump (s2LJ) and hand grip strength (HGS). Body composition was measured by dual‐energy x‐ray absorptiometry; body size corrections were used to calculate fat mass index (FMI) and appendicular lean mass index (ALMI). Estimated glomerular filtration rate (eGFR) was measured from fasting blood samples. The relationship between rate pressure product, pulse pressure or presence of PVC (independent variable) with physical function parameters (dependent variable) was tested using linear regression. Sex‐interactions were tested (p‐int) adjusting for age, eGFR and ALMI/FMI. Results were expressed as mean differences between men and women with 95% confidence intervals. Mediation analyses used ALMI/FMI as mediator. Women weighed less (54.7 kg ± 10.3 vs. 59.9 kg ± 10.3) and were shorter (157.8 cm ± 6.0 vs. 169.2 cm ± 7.0) compared with men (both P < 0.0001). Women had higher FMI (6.8 kg/m2 ± 2.9 vs. 2.9 kg/m2 ± 2.0, P < 0.0001) and eGFR (263.7 mL/min/1.73 m2 ± 133.1 vs. 237.6 mL/min/1.73 m2 ± 134.6), but lower ALMI (6.2 kg/m2 ± 0.7 vs. 8.02 kg/m2 ± 1.0, P < 0.0001) compared with men. There were significant mean differences between men and women in rate pressure product and s2LJ power (−1.08 [−1.21, −0.95]) and force (−0.57 [−0.63, −0.51]), only after adjusting for age, eGFR and FMI. There were significant mean differences in the associations between pulse pressure and CRT power (−0.28 [−0.31, −0.25]), s2LJ power (−1.07 [−1.20, −0.93]) and HGS (−11.94 [−13.35, −10.54]); these differences were greater after adjusting for age, eGFR and FMI, than ALMI. There were similar differences in the associations between PVC and physical function parameters. In men, FMI mediated the association between rate pressuree product and CRT power (P = 0.002), s2LJ force (P < 0.001) and s2LJ power (P = 0.001). ALMI did not mediate associations for either men or women. Multiple risk factors for CVD were associated with poorer physical function in men and were mediated by FMI. There is a need to identify strategies to slow/prevent the rising CVD burden and poor physical function in Sub‐Saharan Africa.
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影响因子：
4.1
作者：
Patsch, Janina M.;Zulliger, Martin A.;Vilayphou, Nicolas;Samelson, Elizabeth J.;Cejka, Daniel;Diarra, Danielle;Berzaczy, Gundula;Burghardt, Andrew J.;Link, Thomas M.;Weber, Michael;Loewe, Christian
通讯作者：
Loewe, Christian
影响因子：
8.3
作者：
Narkiewicz, K;Phillips, BG;Somers, VK
通讯作者：
Somers, VK
影响因子：
5
作者：
Laughlin, Gail A.;Barrett-Connor, Elizabeth;Langenberg, Claudia
通讯作者：
Langenberg, Claudia
影响因子：
2.2
作者：
Orwoll, E;Blank, JB;Stone, K
通讯作者：
Stone, K
低肌肉力量和增加的动脉僵硬齐头并进。
影响因子：
4.6
作者：
König M;Buchmann N;Seeland U;Spira D;Steinhagen-Thiessen E;Demuth I
通讯作者：
Demuth I