Abstract
张振伟,赵玉明,陈泓洲,李方玙,齐力,周锦辉,陈晨,王君,吕跃斌,石文惠,施小明.中国18个长寿地区65岁及以上老年人肌肉重量和力量的分布特征[J].Chinese journal of Epidemiology,2024,45(5):656-665
中国18个长寿地区65岁及以上老年人肌肉重量和力量的分布特征
Distribution characteristics of skeletal muscle mass and grip strength in the elderly aged 65 years and older in 18 longevity areas in China
Received:February 27, 2024  
DOI:10.3760/cma.j.cn112338-20240227-00083
KeyWord: 老年人  肌肉重量  握力  横断面研究
English Key Word: Elderly  Muscle mass  Grip strength  Cross-sectional studies
FundProject:国家自然科学基金(82025030,82222063)
Author NameAffiliationE-mail
Zhang Zhenwei National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China  
Zhao Yuming National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China  
Chen Hongzhou National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China  
Li Fangyu National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
School of Public Health, China Medical University, Shenyang 110122, China 
 
Qi Li National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China  
Zhou Jinhui National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China  
Chen Chen National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China  
Wang Jun National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China  
Lyu Yuebin National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China  
Shi Wenhui National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China  
Shi Xiaoming National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China shixm@chinacdc.cn 
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Abstract:
      目的 了解中国18个长寿地区≥65岁老年人肌肉重量和力量的分布特征。方法 研究对象来自在我国18个长寿地区开展的中国老年健康生物标志物队列研究,将2021年横断面调查的4 662名≥65岁老年人纳入研究。通过问卷调查和体格检查收集研究对象的社会人口学特征、生活方式、膳食摄入等信息,采用专业电子握力计测量手握力,生物电阻抗分析法测量全身肌肉重量(TSM),同时采用身高的平方和BMI调整后得到相对指标TSMHt2和TSMBMI,并根据亚洲肌少症工作组(AWGS)推荐的方法判定人群低肌肉重量和力量的比例。描述性分析研究对象肌肉重量和手握力的人群和地区分布特征,并采用广义可加模型分析肌肉重量和手握力随年龄的变化趋势。结果 4 662名研究对象年龄为(82.69±10.54)岁;男性占46.85%(2 184名);汉族占96.27%(4 488名)。男性TSM、TSMHt2和TSMBMIMQ1Q3)分别为23.30(20.50,26.20) kg、9.02(8.13,9.89) kg/m2、1.01(0.90,1.13) kg·(kg/m2-1,均高于女性[18.20(15.70,20.70) kg、8.18(7.42,9.07) kg/m2、0.79(0.69,0.90) kg·(kg/m2-1],差异有统计学意义(均P<0.001)。男性手握力[MQ1Q3):24.50(17.80,30.80) kg]高于女性[MQ1Q3):15.60(11.10,19.90) kg],差异有统计学意义(P<0.001)。南方男性老年人TSM、TSMHt2均低于北方男性老年人(均P<0.001),但南北方男性老年人的TSMBMI差异无统计学意义(P>0.05);南方女性老年人的TSMHt2、TSMBMI均高于北方女性老年人(均P<0.001),而南北方女性老年人的TSM差异无统计学意义(P>0.05)。进一步根据AWGS推荐的方法判定后,低肌肉量和低握力老年人均具有年龄较大、小学以下文化程度、未婚/离异/丧偶、咀嚼能力差、日常生活活动能力损伤、位于南方地区等特征。结论 中国18个长寿地区≥65岁老年人肌肉重量和力量存在人群和地区差异,且随着年龄增加呈下降趋势。
English Abstract:
      Objective To investigate the distribution characteristics of skeletal muscle mass and strength in the older adults over 65 years old in 18 longevity areas in China. Methods The subjects were selected from the Healthy Aging and Biomarkers Cohort Study conducted in 18 longevity areas of China. A total of 4 662 older adults over 65 years old from a cross- sectional survey in 2021 were included in the study. The information about their sociodemographic characteristics, lifestyle, nutrient intake and other factors were collected through questionnaire surveys and physical examinations. Grip strength was measured by using professional electronic grip dynamometer. Total skeletal muscle mass (TSM) was measured using bioelectrical impedance analysis, and TSM was adjusted by height squared and BMI to obtain TSMHt2 and TSMBMI. The proportion of individuals with low muscle mass and strength was determined according to the recommended method by the Asian Working Group for Sarcopenia (AWGS). Descriptive analysis was conducted on the population and regional distribution characteristics of people with different muscle mass and grip strength. A generalized additive model was used to analyze the age-related trends of muscle mass and grip strength. Results The age of 4 662 study subjects was (82.69±10.54) years, men accounted for 46.85% (2 184 cases) and Han Chinese accounted for 96.27% (4 488 cases). The M(Q1Q3) of TSM, TSMHt2 and TSMBMI in men were 23.30 (20.50, 26.20) kg, 9.02 (8.13, 9.89) kg/m2, and 1.01 (0.90, 1.13) kg·(kg/m2)-1, respectively, which were all higher than those in women [TSM: 18.20 (15.70, 20.70) kg, TSMHt2: 8.18 (7.42, 9.07) kg/m2 and TSMBMI: 0.79 (0.69, 0.90) kg·(kg/m2)-1], the differences were significant (all P<0.001). The grip strength of men [M(Q1Q3): 24.50 (17.80, 30.80) kg] was higher than that of women [M(Q1Q3): 15.60 (11.10, 19.90) kg], the difference was significant (P<0.001). Southern elderly men had lower TSM and TSMHt2 compared with northern elderly men (all P<0.001), while there was no significant regional difference in TSMBMI (P>0.05). Southern elderly women had higher TSMHt2 and TSMBMI compared with northern elderly women (all P<0.001), while there was no significant regional difference in TSM (P>0.05). Furthermore, according to the method recommended by AWGS, the elderly with low muscle mass and grip strength were characterized by older age, illiteracy, being unmarried/divorced/widowed, poor chewing ability, impaired activity of daily living and living in southern region. Conclusion There were population and regional differences in muscle mass and grip strength in the older adults over 65 years in 18 longevity areas of China, and these differences showed decreasing trends with age.
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