Muscle mass index as a predictor of longevity in older adults.

Muscle mass index as a predictor of longevity in older adults.
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DOI:
10.1016/j.amjmed.2014.02.007
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发表时间:
2014-06
影响因子:
5.9
通讯作者:
Karlamangla, Arun S.
Karlamangla, Arun S.
中科院分区:
医学2区
文献类型:
--
作者:
Srikanthan, Preethi;Karlamangla, Arun S.
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肥胖(按体重指数定义)与老年人的较高死亡率并不总是相关。然而,总体质量包括脂肪和肌肉,它们具有不同的代谢作用。这项研究旨在检验老年人肌肉质量增加与全因死亡率降低相关的假设。截至 2004 年,对全国健康和营养检查第三次调查的 3,659 名参与者进行了全因死亡率分析,这些参与者在调查时年龄为 55 岁(女性为 65 岁)或以上(1988-94 年)。体重不足或在随访的前两年内死亡的个体被排除在外,以便将体弱的老年人从样本中剔除。使用生物电阻抗测量骨骼肌质量,肌肉质量指数定义为肌肉质量除以身高平方。修正泊松回归和比例风险回归分别用于检查肌肉质量指数与全因死亡风险和死亡率的关系,并针对中心性肥胖(腰臀比)和其他显着协变量进行调整。在调整分析中,与第一个四分位数相比,肌肉质量指数第四个四分位数的总死亡率显着降低:调整后的风险比为 0.81(95% 置信区间 0.71 – 0.91),调整后的风险比为 0.80(95% 置信区间 0.66 – 0.97)。这项研究证明了相对肌肉质量的生存预测能力,并强调在评估老年人的健康状况时需要超越总体质量。
Obesity (as defined by body mass index) hasn’t been consistently associated with higher mortality in older adults. However, total body mass includes fat and muscle which have different metabolic effects. This study was designed to test the hypothesis that greater muscle mass in older adults will be associated with lower all-cause mortality. All-cause mortality was analyzed by the year 2004 in 3,659 participants from the National Health and Nutrition Examination Survey III, who were 55 years (65 years if women) or older at the time of the survey (1988–94). I ndividuals who were underweight or died in the first 2 years of follow-up, were excluded so as to remove frail elders from the sample. Skeletal muscle mass was measured using bioelectrical impedance and muscle mass index was defined as muscle mass divided by height squared. Modified Poisson regression and proportional hazards regression were used to examine the relationship of muscle mass index with all-cause mortality risk and rate respectively, adjusted for central obesity (waist hip ratio)and other significant covariates. In adjusted analyses, total mortality was significantly lower in the fourth quartile of muscle mass index compared to the first: adjusted risk ratio 0.81 (95% confidence interval 0.71 – 0.91) and adjusted hazard ratio 0.80 (95% confidence interval 0.66 – 0.97). This study demonstrates the survival predication ability of relative muscle mass and highlights the need to look beyond total body mass in assessing the health of older adults.
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