文章摘要
温俏睿,吴曼,刘琪,吕筠,郭彧,卞铮,裴培,杜怀东,陈君石,余灿清,陈铮鸣,李立明,代表中国慢性病前瞻性研究项目协作组.中国成年人慢性病与肌肉重量、力量及质量的相关性分析[J].中华流行病学杂志,2021,42(11):1948-1954
中国成年人慢性病与肌肉重量、力量及质量的相关性分析
Correlation between chronic diseases and low muscle mass, strength and quality in adults in China
收稿日期:2020-09-10  出版日期:2021-11-20
DOI:10.3760/cma.j.cn112338-20200910-01146
中文关键词: 慢性病;肌肉重量;手握力;肌肉质量
英文关键词: Chronic disease;Muscle mass;Handgrip strength;Muscle quality
基金项目:国家自然科学基金(81941018,91846303,91843302,81390540,81390541,81390544);国家重点研发计划精准医学研究重点专项(2016YFC0900500,2016YFC0900501,2016YFC0900504);中国香港Kadoorie Charitable基金;英国Wellcome Trust(212946/Z/18/Z,202922/Z/16/Z,104085/Z/14/Z,088158/Z/09/Z)
作者单位E-mail
温俏睿 北京大学公共卫生学院流行病与卫生统计学系 100191  
吴曼 北京大学公共卫生学院流行病与卫生统计学系 100191  
刘琪 北京大学公共卫生学院流行病与卫生统计学系 100191  
吕筠 北京大学公共卫生学院流行病与卫生统计学系 100191  
郭彧 中国医学科学院, 北京 100730  
卞铮 中国医学科学院, 北京 100730  
裴培 中国医学科学院, 北京 100730  
杜怀东 英国牛津大学纳菲尔德人群健康系临床实验与流行病学研究中心, 牛津OX3 7LF  
陈君石 国家食品安全风险评估中心, 北京 100022  
余灿清 北京大学公共卫生学院流行病与卫生统计学系 100191 yucanqing@pku.edu.cn 
陈铮鸣 英国牛津大学纳菲尔德人群健康系临床实验与流行病学研究中心, 牛津OX3 7LF  
李立明 北京大学公共卫生学院流行病与卫生统计学系 100191  
代表中国慢性病前瞻性研究项目协作组 1 北京大学公共卫生学院流行病与卫生统计学系 100191  
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中文摘要:
      目的 探索我国成年人主要慢性病与肌肉重量、力量和质量的关系。方法 主要利用中国慢性病前瞻性研究项目的第二次重复调查,采用logistic回归分析主要慢性病种类、个数及患病年限与肌肉重量、力量和质量的相关性。结果 在24 242名研究对象中,糖尿病、冠心病、脑卒中和慢性阻塞性肺疾病(慢阻肺)的患病率分别为9.6%、5.8%、3.2%和26.8%,患以上任一慢性病者占38.8%。患上述任一慢性病与低手握力和低上肢肌肉质量(AMQ)呈正相关,且其患病年限越长,风险越高(线性趋势P值均<0.001),患任一慢性病≥ 10年者低手握力和低AMQ的OR值(95%CI)分别为1.64(1.42~1.90)和1.83(1.60~2.10);患1、2、≥ 3种慢性病者低手握力的OR值(95%CI)分别为1.26(1.17~1.37)、1.42(1.23~1.64)和2.27(1.55~3.32),低AMQ的OR值(95%CI)分别为1.28(1.18~1.38)、1.67(1.46~1.92)和2.41(1.69~3.45),且关联均存在线性趋势(线性趋势P值均<0.001)。糖尿病、冠心病和脑卒中均与低手握力和低AMQ呈正相关;慢阻肺患者低四肢肌肉重量指数(ASMI)、低全身肌肉重量指数(TSMI)和低手握力的风险高于非慢阻肺患者,且风险与患病年限呈正相关(线性趋势P值均<0.05),患慢阻肺≥ 10年者低ASMI和低TSMI的OR值(95%CI)分别为2.39(1.36~4.20)和2.41(1.37~4.26)。结论 慢性病患者肌肉力量和质量更低,且随患慢性病个数及年限延长,低手握力、低AMQ的比例更高。
英文摘要:
      Objective To explore the correlation between chronic diseases and muscle mass, strength and quality in adults in China.Methods Based on the second resurvey of China Kadoorie Biobank (CKB) in 2013-2014, logistic regression models were used to analyze the correlation of different types, number and duration of chronic diseases with low muscle mass, handgrip strength and muscle quality.Results The prevalence rate of diabetes, coronary heart disease (CHD), stroke and chronic obstructive pulmonary disease (COPD) were 9.6%, 5.8%, 3.2% and 26.8%, respectively, and 38.8% of the participants had at least one disease, and they were more likely to have low handgrip strength and low arm muscle quality (AMQ), and the longer the chronic diseases duration, the higher the risk. The ORs (95%CIs) for low handgrip strength and low AMQ in patients with 1 chronic disease for more than 10 years was 1.64 (1.42-1.90) and 1.83 (1.60-2.10), respectively. The ORs (95%CIs) for low handgrip strength were 1.26 (1.17-1.37), 1.42 (1.23-1.64) and 2.27 (1.55-3.32) and the ORs (95%CIs) for low AMQ were 1.28 (1.18-1.38), 1.67 (1.46-1.92) and 2.41(1.69-3.45), respectively, in patients with 1, 2, ≥ 3 chronic diseases, the correlation showed a linear trend (P for trend <0.001). Diabetes, CHD and stroke were positively correlated with low handgrip strength and low AMQ. Compared with participants without COPD, COPD patients were more likely to have low appendicular skeletal muscle mass index (ASMI), low total skeletal muscle mass index (TSMI) and low handgrip strength, and the risk was positively correlated with disease duration.Conclusions Patients with chronic diseases were more likely to have lower muscle strength and muscle quality, especially the patients with multi diseases and longer disease duration. The proportion of low handgrip strength and low AMQ was higher in patients who reported multi-prevalence and longer duration of chronic diseases.
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