老年人四肢骨骼肌质量指数与肌肉力量的相关性研究:基于2024年全国常态化国民体质监测数据

Cross-sectional Analysis of ASMI and Muscle Strength in Older Adults: Based on the 2024 National Routine Physical Fitness Surveillance Database

  • 摘要: 目的 探索老年人四肢骨骼肌质量指数(appendicular skeletal muscle index,ASMI)与肌肉力量的计量效应关系。方法 以2024年全国常态化国民体质监测数据库中60~79岁老年人作为研究对象,采用ASMI评价其肌肉质量,采用握力、30 s坐站次数反映其肌肉力量。控制年龄与体质量指数,对ASMI与握力、30 s坐站次数进行线性回归分析,并应用限制性立方样条模型(restricted cubic spline,RCS)进行剂量效应分析。结果 共纳入60~79岁老年人68 038名,其中女性占比56.3%,平均年龄(68.0±5.4)岁。男性握力(33.6±7.8)kg比(23.4±5.6) kg,P<0.001、ASMI(13.6±1.3) kg/m2比(11.4±1.2) kg/m2P<0.001显著高于女性。线性回归分析结果显示,ASMI与握力(β=0.940,95% CI:0.93~0.95,P<0.001)及30 s坐站次数(β=0.008,95% CI:0.005~0.011,P<0.001)均呈显著正相关,且在不同性别中亦均存在显著正相关。RCS结果显示,老年男性ASMI对握力影响的临界值为13.55 kg/m2P<0.001),而对30 s坐站次数未呈现出计量效应关系(P=0.090);老年女性ASMI对握力、30 s坐站次数影响的临界值均为11.25 kg/m2P均<0.001)。当老年人ASMI低于临界值时,其肌肉力量随ASMI减少而快速下降。结论 老年人肌肉质量与肌肉力量间存在显著正相关性。当老年男性ASMI低于13.55 kg/m2,老年女性ASMI低于11.25kg/m2时,应为其提供个性化的肌肉健康干预方案。

     

    Abstract: Objective To explore the dose-response correlation between appendicular skeletal muscle index (ASMI) and muscle strength in older adults. Methods This study included adults aged 60-79 years from the 2024 National Routine Physical Fitness Surveillance database. ASMI was used to assess muscle mass, while handgrip strength and 30-second chair stand test (30-s CST) repetitions were employed to evaluate muscle strength. Linear regression analyses, adjusted for age and body mass index (BMI), were performed to examine the associations between ASMI and handgrip strength/30-s CST. Additionally, restricted cubic spline (RCS) models were applied for dose-response analysis. Results A total of 68 038 older adults (56.3% female, mean age 68.0 ± 5.4 years) were included. Males exhibited significantly higher handgrip strength (33.6 ± 7.8 kg vs. 23.4 ± 5.6 kg, P < 0.001) and ASMI (13.6 ± 1.3 kg/m2 vs. 11.4 ± 1.2 kg/m2, P < 0.001) than females. Linear regression revealed significant positive associations between ASMI and both handgrip strength (β = 0.940, 95% CI: 0.93-0.95, P < 0.001) and 30-s CST repetitions (β = 0.008, 95% CI: 0.005-0.011, P < 0.001), with consistent trends across genders. RCS analysis identified a threshold effect of ASMI on handgrip strength in older men (cut-off: 13.55 kg/m2, P < 0.001), but not on 30-s CST (P = 0.090). In women, significant thresholds were observed for both handgrip strength and 30-s CST (cut-off: 11.25 kg/m2, P < 0.001). Below these thresholds, muscle strength declined rapidly with decreasing ASMI. Conclusion Muscle mass and strength are significantly positively correlated in older adults. Personalized muscle health interventions should be considered when ASMI falls below 13.55 kg/m2 in men or 11.25 kg/m2 in women.

     

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