成年农村居民绝对握力和握力体重指数与代谢综合征患病关系

Associations of absolute grip strength and grip strength-weight index with metabolic syndrome among adult residents in rural Shandong

目的了解成年农村居民绝对握力和握力体重指数与代谢综合征(MS)患病的关系,为MS危险因素的早期识别和综合防治提供理论依据。方法收集2017年10月—2019年9月山东省自然人群队列中济南市平阴县39个村3997名握力指标和MS相关指标信息完整的18~80岁成年居民相关数据,分析绝对握力和握力体重指数与MS患病风险的关联。结果平阴县成年农村居民的MS患病率为18.71%,其中男性居民MS患病率为18.15%,女性居民MS患病率为18.97%。MS组男性居民绝对握力[(38.53±8.32)kg]高于非MS组男性居民绝对握力[(36.67±9.16)kg],MS组女性居民绝对握力[(24.28±5.38)kg]低于非MS组女性居民绝对握力[(25.07±5.40)kg](均P<0.01);MS组总体、男性和女性居民握力体重指数分别为(40.66±11.21)、(50.39±10.86)和(36.45±8.40),均低于非MS组的(46.30±12.36)、(55.74±12.96)和(41.99±9.30)(均P<0.001)。相关分析结果显示,男性居民绝对握力与体质指数(BMI)、舒张压(DBP)和甘油三酯(TG)均呈正相关(均P<0.001),与收缩压(SBP)和高密度脂蛋白胆固醇(HDL-C)均呈负相关(均P<0.05),握力体重指数与HDL-C呈正相关(r=0.20,P<0.001),与BMI、SBP、TG和空腹血糖(FPG)均呈负相关(均P<0.001);女性居民绝对握力与BMI呈正相关(r=0.13,P<0.001),与SBP、HDL-C和FPG均呈负相关(均P<0.01),握力体重指数与HDL-C呈正相关(r=0.15,P<0.001),与BMI、SBP、DBP、TG和FPG均呈负相关(均P<0.001)。趋势性χ2检验结果显示,随着绝对握力的增加,男性居民MS、超重和/或肥胖、血脂紊乱患病率均随之上升,高血压患病率随之下降(均P<0.05);女性居民超重和/或肥胖患病率随之上升,MS、高血压、高血糖患病率均随之下降(均P<0.01);随着握力体重指数的增加,男性和女性居民MS、超重和/或肥胖、高血压、血脂紊乱、高血糖患病率均随之下降(均P<0.001)。在调整了年龄、文化程度、吸烟情况、饮酒情况、体力活动情况、心血管病家族史、高血压家族史、高脂血症家族史和糖尿病家族史等混杂因素后,多因素logistic回归分析结果显示,男性和女性居民绝对握力最高四分位数组患超重和/或肥胖的风险分别为绝对握力最低四分位数组的2.34和1.90倍(均P<0.001);男性和女性居民握力体重指数最高四分位数组患MS、超重和/或肥胖、高血压、血脂紊乱、高血糖的风险分别为握力体重指数最低四分位数组的0.16和0.19倍、0.12和0.09倍、0.51和0.42倍、0.25和0.48倍、0.36和0.55倍(均P<0.001)。结论握力体重指数与MS及其组分发生风险均呈负相关,可作为MS的筛查指标进一步推广。

Objective To explore associations of absolute grip strength and grip strength-weight index(absolute grip strength/weight×100)with the risk of metabolic syndrome(MS)among adult rural residents and to provide evidences for early identification and comprehensive prevention of MS in the population.Methods The participants of the study were3997 adult(18–80 years)residents in 39 rural villages of Pingyin county,Shandong province.The participants′complete data on anthropometric measurements(including grip strength)and MS-related physical examination and laboratory test were collected during a period from October 2017 through September 2019.The MS risk associated absolute grip strength and grip strength-weight index were estimated based on statistical analyses on the data collected.Results The prevalence of MS among the participants was 18.71%(18.15%for males and 18.97%for females).The absolute grip strength of male participants with MS was significantly higher than that of males without MS(38.53±8.32 kg vs.36.67±9.16 kg)but the female participants with MS had a significantly lower absolute grip strength than the females without MS(24.28±5.38 kg vs.25.07±5.40 kg)(both P<0.01);in comparison with that of the participants without MS,the grip strength-weight index of the participants with MS were significantly lower(40.66±11.21 vs.46.30±12.36 for the all,50.39±10.86 vs.55.74±12.96 for the males,and 36.45±8.40 vs.41.99±9.30 for the females;all P<0.001).Correlation analysis results demonstrated that among the male participants,the absolute grip strength was positively correlated with body mass index(BMI),diastolic blood pressure(DBP)and triglyceride(TG)(P<0.001)but reversely correlated with systolic blood pressure(SBP)and high density lipoprotein cholesterol(HDL-C)(P<0.05);while the grip strength-weight index was positively correlated with HDL-C(r=0.20,P<0.001)and reversely correlated with BMI,SBP,TG and fasting plasma glucose(FPG)(P<0.001);the results also revealed that among the female participants,the absolute grip strength was positively correlated with BMI(r=0.13,P<0.001)but reversely correlated with SBP,HDL-C,and FPG(all P<0.01),whereas the grip strengthweight index was positively correlated with HDL-C(r=0.15,P<0.001)but reversely correlated with BMI,SBP,DBP,TG,and FPG(all P<0.001).The results of Chi-square test-based trend analyses revealed that with the increment of grip strengthweight index,the prevalence of MS,overweight and/or obesity,and dyslipidemia increased and the prevalence of hypertension decreased significantly among the male participants(all P<0.05);while among the female participants,the prevalence of overweight and/or obesity increased and the prevalence of MS,hypertension and hyperglycemia decreased with the increment of absolute grip strength(all P<0.01);the prevalence of MS,overweight and/or obesity,hypertension,dyslipidemia,and hyperglycemia decreased significantly with the increment of grip strength-weight index in both the male and female participants(all P<0.001).After adjusting for age,education,smoking,alcohol drinking,physical activity,and family history of cardiovascular disease/hypertension/hyperlipidemia/diabetes,the results of multivariate logistic regression analysis indicated that the participants with the absolute grip strength values within the highest quartile had an increased risk of overweight and/or obesity(for the males:odds ratio[OR]=2.34,for the females:OR=1.90;both P<0.05)compared to those with the values within the lowest quartile;the results also revealed decreased risks of MS(OR=0.16 and 0.19),overweight and/or obesity(OR=0.12 and 0.09),hypertension(OR=0.51 and 0.42),dyslipidemia(OR=0.25 and 0.48),and hyperglycemia(OR=0.36 and 0.55)in both male and female participants with the grip strength-weight index values within the highest quartile compared to the male and female participants with the index values within the lowest quartile after adjusting potential confounders mentioned above(all P<0.001).Conclusion The grip strength-weight index is inversely associated with MS and its components significantly among rural adult residents and the index could be used as an indicator in MS screening.