中国成年人慢性病与肌肉重量、力量及质量的相关性分析

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。     

Sarcopenic obesity using the ESPEN and EASO consensus statement criteria of 2022 – Results from the German KORA-Age study

ObjectiveThe recent consensus statement of ESPEN and EASO recommends reviewing existing datasets to assess the prevalence of sarcopenic obesity based on the new definition and diagnostic criteria. Therefore, this study aimed to determine the prevalence of sarcopenic obesity in a population-based study and to assess the association of this new definition with clinical traits.MethodsThe KORA (Cooperative Health Research in the Region of Augsburg)-Age baseline examination (2008/2009) comprised 1079 participants aged 65 years and older from southern Germany. Sarcopenic obesity was defined in 998 participants (mean age 75.6 years, 498 women) with complete data according to the 2022 ESPEN and EASO algorithm, which includes reduced handgrip strength, reduced skeletal muscle mass per weight, and elevated fat mass. Body composition was measured using bioelectrical impedance analysis. Associations between sarcopenic obesity and physical activity, disability, multimorbidity, and polypharmacy were assessed using logistic regression analysis.ResultsThe overall prevalence of sarcopenic obesity was 4.5 % (5.0 % in men, 4.0 % in women). Sarcopenic obesity was associated with disability (2.87 [CI 1.84–4.48]), multimorbidity (≥ 2 comorbidities; 2.59 [CI 1.23–5.46]), polypharmacy (≥ 5 drugs; 1.96 [CI 1.05–3.63]), cognitive impairment (3.03 [CI 1.51–6.06]) and arthritis (2.66 [CI 1.39–5.07]) after adjusting for age, sex and marital status.ConclusionSarcopenic obesity is prevalent in the older German population and is associated with several clinical traits. Future longitudinal studies are needed to further elucidate whether the observed associations could be causal.     

Synergistic effect of low handgrip strength and malnutrition on 4-year all-cause mortality in older males: A prospective longitudinal cohort study

BackgroundNo studies have yet examined the interrelationship of malnutrition and low handgrip strength in terms of mortality. The aim of the present study was to evaluate the potential synergistic effects of malnutrition and low handgrip strength on mortality among older adults living in a retirement community.MethodsThis prospective longitudinal cohort study recruited subjects aged 65 years and over from a veterans care home in Taiwan in 2013. Nutritional status was assessed using the Mini-Nutritional Assessment-Short Form (MNA-SF, malnutrition was MNA-SF<12); muscle strength was measured by handgrip strength (low handgrip strength was handgrip strength <26 kg). The Kaplan-Meier method with the log-rank test was used to estimate survival differences between groups and Cox proportional regression model was used to estimate the adjusted difference in 4-year all-cause mortality between groups.ResultsRecruited for the present study were 333 male participants (mean age 85.4 ± 5.7 years). Of these, 50.2% had malnutrition and 54.7% had low handgrip strength. Compared with subjects with no malnutrition and low handgrip strength, those with malnutrition had significantly greater risk of 4-year all-cause mortality (adjusted hazards ratio: 2.05, 95% confident interval [CI]: 1.04–4.01); hazard ratio increased to 3.41 (95% CI 1.93–6.04) for those with both malnutrition and low handgrip strength.ConclusionsMalnutrition was an independent risk factor for 4-year all-cause mortality and low handgrip strength with malnutrition synergistically increased the mortality risk. Further study is needed to confirm the effectiveness of integrated programs to assist those at risk.     

Age and Anthropometric Traits Predict Handgrip Strength in Healthy Normals

Hand grip strength is an inevitable component in the evaluation of rheumatoid arthritis, neuromuscular, preoperative, post operative patients and community dwelling older adults'' functional capacity. Hand grip varies greatly with age, gender and the anthropometric measures when measured by hand dynamometer. The influence of above variables on hand grip when measured by modified sphygmomanometer is unknown. Further, the prediction of hand grip from age and anthropometric traits is unknown. 229 subjects (115 males and 114 females) with age 23 ± 2 and 21 ± 2 respectively were included in the study after informed c nsent. Weight and height were obtained using standard techniques. Hand grip was measured using a modified sphygmomanometer. Information regarding physical activity and health status was obtained by interview, clinical screening and stratified. Stepwise multiple regression analysis was sought out for any influence of age, height, weight and Body Mass Index (BMI) on hand grip strength. Grip strength correlated moderate to high with age (r = 0.44, p = 0.00), height (r = 0.57, p = 0.00), weight (r = 0.57, p = 0.00) and BMI (r = 0.29, p = 0.00). The regression model for handgrip strength is Hand grip = −1790.54 + 4.93557 × Age–11.7429 × Weight + 1083.4 × Height + 34.194 × BMI. Age, height and weight are the i portant determinants of the handgrip evaluation. In clinical setting, the influence of age and anthropo etric traits on handgrip shall be borne in mind when measuring handgrip by modified sphygmomanometer in age group of 20–25 year patients.     

Handgrip and finger flexion strength in children: A cross-sectional assessment of age-related normative data and application as a clinical functional marker in paediatric neuromuscular disorders

BackgroundThe aim of this study was to evaluate handgrip and finger flexion strength (HGFS) as functional marker for disease progression in children with neuromuscular disorders (NMD) and present normative data in a paediatric healthy cohort.MethodsWe applied the fixed hand and finger dynamometer HFD 200 to assess HGFS under standardised, isometric and biomechanical conditions. In our cross-sectional study HGFS was analysed in n = 233 paediatric healthy controls (HC) and a cohort of n = 33 children with NMD between five and 18 years. In seven children with spinal muscular atrophy (SMA), HGFS were assessed prior to and under treatment with nusinersen over a two months period. HGFS of children with NMD was correlated with respiratory parameters, anthropometric data, hand function and motor scores.ResultsPatients with NMD exhibited a heterogenous HGFS pattern. HGFS was lower than in HC (p < 0.001). Children with SMA gained a significant increase in strength after two months of treatment (p < 0.05, r = 0.75–0.9).ConclusionHGFS is a sensitive functional marker in paediatric NMD to identify minimal changes in distal muscle strength. HGFS may evolve as a sensitive outcome measure to monitor upcoming therapeutic interventions in particular for non-ambulant patients with NMD.     

Clinically relevant determinants of body composition,function and nutritional status as mortality predictors in lung cancer patients

Lung cancer belongs to the type of tumors with a relatively high frequency of malnutrition, sarcopenia and cachexia, severe metabolic syndromes related to impairment of physical function and quality of life, resistance to therapy and short survival. Inexpensive and accessible methods of evaluating changes in body composition, physical function and nutrition status are for this reason of great importance for clinical practice to enable the early identification, monitoring, preventing and treatment of these nutritional deficiencies. This could lead to improved outcomes in the quality of life, physical performance and survival of patients with lung cancer. The aim of this article is to summarize the recent knowledge for the use of such methods, their predictability for patient outcomes and an association with other clinically relevant parameters, specifically with lung cancer patients, because such an article collectively describing their practical application in clinical practice is lacking. The interest of this article is in the use of anthropometry, handgrip dynamometry, bioelectrical impedance analysis derived phase angle and nutritional screening questionnaires in lung cancer patients.