2015年中国15个省(自治区、直辖市)60岁及以上人群身体活动状况及其与肌肉衰减的关系

Relationship between physical activity and muscle mass loss among people aged 60 and above in 15 provinces of China in 2015

目的分析中国15个省(自治区、直辖市)60岁及以上老年人身体活动状况及其与肌肉衰减的关系。方法利用2015年“中国居民营养状况变迁的队列研究”调查资料,该项目采用问卷调查法收集个人基础资料和身体活动资料,利用连续3天24小时回顾法收集食物摄入量,通过生物电阻抗法测量体成分,获得四肢骨骼肌质量等信息,计算骨骼肌质量指数(skeletal muscle index,SMI),根据2019年亚洲肌肉衰减综合征工作组的推荐标准来判断是否发生肌肉衰减(男性SMI<7.0 kg/m^(2),女性SMI<5.7 kg/m^(2))。采用每周参加各种身体活动所花费的时间与相应的代谢当量(梅脱,metabolic equivalent of task,MET)的乘积来评估身体活动量。选取十五省有完整数据的4565名60岁及以上老年人作为研究对象,描述老年人4种类型身体活动(职业性、家务性、交通性和休闲性)、低强度身体活动(<3.0 METs)、中等强度身体活动(3.0~5.9 METs)和高强度身体活动(≥6.0 METs)状况。采用多水平Logistic回归模型分析不同强度身体活动时间与肌肉衰减的关联。结果2015年中国15个省(自治区、直辖市)60岁及以上老年女性参与家务性身体活动比例(91.7%)高于男性(62.3%),但职业性、交通性和休闲性身体活动比例均低于男性。女性每周参与低强度身体活动和中等强度身体活动比例和时间均高于男性(低强度身体活动:女性时间11.0 h/周vs.男性时间3.5 h/周,女性参与率89.9%vs.男性参与率62.8%;中等强度身体活动:女性时间7.0 h/周vs.男性时间4.7 h/周,女性参与率90.6%vs.男性参与率75.2%)。无论男性还是女性,高强度身体活动时间中位数均为0 h。调查人群肌肉衰减检出率为13.9%。肌肉衰减组每周低强度身体活动和中等强度身体活动时间分别为5.8 h和4.7 h,低于非肌肉衰减组的9.3 h和6.0 h。与每周中等强度身体活动时间小于3.5 h的人群相比,男性每周中等强度身体活动时间达到3.5~6.9 h人群出现肌肉衰减风险相对危险度为0.71(95%CI 0.42~0.98,P<0.05),女性每周中等强度身体活动时间达到3.5~6.9 h人群出现肌肉衰减相对危险度为0.67(95%CI 0.47~0.95,P<0.05)。结论2015年中国15个省(自治区、直辖市)老年居民身体活动以家务性身体活动和低强度身体活动为主。女性低强度身体活动和中等强度身体活动时间,男性中等强度身体活动时间与出现肌肉衰减呈负相关。

OBJECTIVE To analyze the relationship between physical activity and muscle mass loss among Chinese elderly aged 60 years and above in 15 provinces.METHODS Data was collected from 2015 China Nutritional Transition Cohort Study.Information on demographic characteristics and physical activity was investigated by questionnaire.Dietary intake was estimated from three consecutive 24-h recalls for each individual.Appendicular skeletal muscle mass(ASM)was assessed using the bioelectrical impedance analysis(BIA).Skeletal muscle mass(SMI)loss was diagnosed according Asian working group of sarcopenia(AWGS)2019 recommendation(male:SMI 7.0 kg/m^(2),female:5.7 kg/m^(2)).A total of 4565 participants aged 60 years and above from 15 provinces in China with complete information were included in the final analysis.Different domains(occupational,domestic,travel and leisure),light physical activity(3.0 METs),moderate physical activity(3.0-5.9 METs)and vigorous physical activity(≥6.0 METs)of physical activity among elderly adults were evaluated.Logistic multilevel model was used to analyze the relationship between low muscle mass and different intensity of physical activity duration.RESULTS Among all participants aged 60 years and above in 15 provinces of China in 2015,women's participation rate in domestic physical activity was 91.7%,which was higher than men's rate of 62.3%.However,men's participation rate in occupational,travel and leisure physical activity were higher than those of women.The participation rate,duration of light physical activity and moderate physical activity were higher in women than in men(light physical activity:female duration 11.0 h/week vs.male duration 3.5 h/week;female participation rate 89.9%vs.male participation rate 62.8%;moderate physical activity:female duration 7.0 h/week vs.male duration 4.7 h/week;female participation rate 90.6%vs.male participation rate 75.2%).The median vigorous physical activity was 0 h/week in both male and female group.The prevalence of muscle mass loss was 13.9%among subjects.The median weekly light physical activity and moderate physical activity in muscle mass loss group were 5.8 h and 4.7 h,which were lower than in non-muscle mass loss group(9.3 h and 6.0 h).The OR of muscle mass lass was 0.71(95%CI 0.42-0.98,P<0.05)for the male with 3.5-6.9 hours of moderate physical activity per week,compared to moderate physical activity less than 3.5 h/week.And OR of the female was 0.67(95%CI 0.47-0.95,P<0.05).CONCLUSION The vast majority of physical activity in China among the elderly is domestic and light physical activity.Light physical activity and moderate physical activity duration increments in female and moderate physical activity duration increments in male were associated with decreased risk of muscle mass loss.