The association of grip strength with cardiovascular diseases and all-cause mortality in people with hypertension:Findings from the Prospective Urban Rural Epidemiology China Study

Background:Both hypertension and grip strength(GS)are predictors of mortality and cardiovascular disease(CVD),but whether these risk factors interact to affect CVD and all-cause mortality is unknown.This study sought to investigate the associations of GS with the risk of major CVD incidence,CVD mortality,and all-cause mortality in patients with hypertension.Methods:GS was measured using a Jamar dynamometer(Sammons Preston,Bolingbrook,IL,USA)in participants aged 3570 years from 12 provinces included in the Prospective Urban Rural Epidemiology China Study.Cox frailty proportional hazards models were used to examine the associations of GS and hypertension and the outcomes of all-cause mortality and CVD incidence/mortality.Results:Among 39,862 participants included in this study,15,964 reported having hypertension,and 9095 had high GS at baseline.After a median follow-up of 8.9 years(interquartile range,6.79.9 years),1822 participants developed major CVD,and 1250 deaths occurred(388 as a result of CVD).Compared with normotensive participants with high GS,hypertensive patients with high GS had a higher risk of major CVD incidence(hazard ratio(HR)=2.39;95%confidence interval(95%CI):1.863.06;p<0.001)or CVD mortality(HR=3.11;95%CI:1.596.06;p<0.001)but did not have a significantly increased risk of all-cause mortality(HR=1.24;95%CI:0.921.68;p=0.159).These risks were further increased if hypertensive participants whose GS level was low(major CVD incidence,HR=3.31,95%CI:2.604.22,p<0.001;CVD mortality,HR=4.99,95%CI:2.649.43,p<0.001;and all-cause mortality,HR=1.93,95%CI:1.472.53,p<0.001).Conclusion:The present study demonstrates that low GS is associated with the highest risk of major CVD incidence,CVD mortality,and all-cause mortality among hypertensive patients.High levels of GS appear to mitigate long-term mortality risk among hypertensive patients.

Low Grip Strength and Increased Mortality Hazard among Middle-Aged and Older Chinese Adults with Chronic Diseases

Objective This study aims to evaluate the association between lower grip strength and mortality hazard.Methods We selected 10,280 adults aged 45 to 96 years old from the China Health and Retirement Longitudinal Study and used multivariate Cox proportional hazard models to assess the association of grip strength with mortality hazard.In addition,we explored the possibility of a nonlinear relationship using a 4-knot restricted spline regression.Results We found that elevated grip strength was associated with lower mortality up to a certain threshold.The baseline quartile values of grip strength were 30,37,and 44 kg for males and 25,30,and35 kg for females.After adjusting for confounders,with category 1 as the reference group,the adjusted HRs were 0.58(0.42-0.79)in males and 0.70(0.48-0.99)in females(category 4).We also found a linear association between grip strength values and all-cause death risk(males,P=0.274;females,P=0.883)using restricted spline regression.For males with a grip strength<37 kg and females with a grip strength<30 kg,grip strength and death were negatively associated.Conclusion Grip strength below a sex-specific threshold is inversely associated with mortality hazard among middle-aged and older Chinese adults with chronic diseases.

Somatotype Components, Aerobic Fitness and Grip Strength in Kuwaiti Males and Females

Introduction and Objective: We investigated the association of endo-, meso- and ecto-morphic components of somatotype with aerobic power, mid-trunk flexibility and grip strength. Methods: Healthy male (n = 226) and female (n = 86) subjects, aged 9 - 55 years, sedentary (n = 154) or participating in sports (n = 158) were studied. Anthro-pometrics (height, weight, 8 skin folds, arm and calf circumferences, elbow and knee diameters), maximal exercise O2 uptake, mid trunk flexibility, right and left grip strength were measured. Results: Sedentary adult females were endomorphic with mesomorph tendency, and had low aerobic power (27.8 ± 0.6 ml/Kg·min) and low (48.7 ± 1 Kg) grip strength. Sedentary males (young and adults) and Sports adult males were mesomorph with endomorphic tendency. Sports junior males were balanced mesomorph. Aerobic power was 54.1 ± 0.9 ml/Kg·min in sports young males, 53.8 ± 0.9 ml/Kg·min in sports adult males, 41.2 ± 4.3 ml/Kg·min in sedentary young males, and 39.5 ± 1 ml/Kg·min in sedentary adult males. Grip strength was 89.9 ± 1.7 Kg in sports adult males, 86.7 ± 2 Kg in sedentary adult males, 75.6 ± 2.2 Kg in sports junior males and 52 ± 9.1 Kg in young sedentary males. Step-wise multiple regression analysis of somatotype components on aerobic power revealed dominant negative contribution (P < 0.001) of endomorphy (r2 = 0.57, 57%), and small but significant positive contributions of mesomorphy (0.6%) and ectomorphy (0.6%): Aerobic power = [56.1 - 4.3 (endomorphy) + (mesomorphy) + 1.4 (ectomorphy)] ± 9.1 SEE. Height and somatotype components accounted for 69% of the variance (R2) in grip strength;height had greatest contribution (60%): Grip Strength = [1.7 (Height) - 6.5 (ectomorphy) - 3.4 (endomorphy) - 2 (mesomorphy) - 200] ± 12.9 SEE. Measured variables accounted for <2% of flexibility variance. Conclusion: Endomorphy contributes greatly and negatively to variance in aerobic power. Body height was the anthropometric variable with the greatest positive association with the variance in grip strength. Flexibility appears to be unrelated to somatotype components.

Optimal Grip Span for Measuring Maximum Handgrip Strength in Preschool Children

Background: Since the minimum grip span of a standard Smedley hand dynamometer is 4 cm, the handgrip strength (HGS) value at a less than 4 cm grip span has not been reported. Objective: The present study examined the impact of grip span on handgrip strength (HGS) in young children using a dynamometer ranging from 2 to 4.5 cm of grip span. Methods: A total of 93 (39 girls and 54 boys) children were recruited from a local kindergarten with the cooperation of their parents. Each participant performed one test trial and then five maximal trials using different grip spans (2.0, 3.0, 3.5, 4.0, and 4.5 cm) in random order and allowing a 1-minute rest between measures. Results: There was a statistically significant difference in HGS depending on which grip span was used, χ2(4) = 211.5 (p Conclusion: Our results recommended that the target grip span for measuring maximal HGS in young children is about 4 cm (4 ± 0.5 cm).

Different Resistance Exercise Interventions for Handgrip Strength in Apparently Healthy Adults: A Systematic Review

Background: Although handgrip strength is a biomarker for morbidity/mor-tality, there is lack of evidence on the effects of resistance training on handgrip strength in healthy adults of all ages. Objective: The aim of this systematic review was to assess the impact of resistance training on handgrip strength in healthy adults. Methods: Five databases/search engines were searched. Studies comparing different types of resistance exercise interventions versus a non-exercised control group on handgrip strength were included. The available data did not allow us to conduct the pre-planned meta-analyses;therefore, only descriptive statistics were performed to summarize the data. Results: Twenty studies (17 randomized and three non-randomized controlled trials) were included, most of which were conducted in older adults. Twelve studies reported no significant difference in the change in handgrip strength between the resistance training and control groups. Two studies showed increases in handgrip strength in the resistance training group compared with the control group. Other studies included results for multi-training groups or left/right hands and found increasing handgrip strength compared to controls, but only in one training group or one hand. Overall, the randomized and non-ran-domized clinical trials presented moderate risk of bias. Conclusions: Due to the lack of low risk-of-bias randomized controlled trials of young and middle-aged adults, different training protocols, and small sample sizes, the existing evidence appears insufficient to support resistance training for increasing handgrip strength in healthy adults. Future studies may seek to discern the optimal way to develop and employ resistance training to improve hand-grip strength.

Analysis of the Grip Strength Data Using Anti-Diagonal Symmetry Models

For the analysis of square contingency tables with the same row and column ordinal classifications, this article proposes new models which indicate the structures of symmetry with respect to the anti-diagonal of the table. Also, this article gives a simple decomposition in 3 ′ 3 contingency table using the proposed models. The proposed models are applied to grip strength data.

Optimal Cutoffs of Grip Strength for Definition as Weakness in the Elderly

Objective:?To indentify Optimal cutoffs of grip strength for definition as weakness in the elderly. Methods: Our study population comprised 1317 subjects (mean ± SD age: 67.6 ± 6.0 years;44.3% men) from the Hangu area of Tianjin, China. Data collection includes general physical examination, biochemical indicators and questionnaire. Mobility limitation was defined as a 4-m walking speed < 0.8 m/s and grip strength represents muscle strength. According to the ROC curve model, the cut-off point of grip strength was calculated, when mobility limitation was selected as the target variables. Results: According to the results of ROC curve, In man, grip strength is lower than 32.45 kg, the strength is weaker, Sensitivity is 79.7% and Specificity is 64.9%, the AUC is 0.764 (p < 0.001);In women, grip strength is lower than 18.20 kg, the strength is weaker, Sensitivity is 53.3% and Specificity is78.1%, the AUC is 0.703 (p < 0.001). Conclusions: Cut points for weakness derived from this large, diverse sample of older adults may be useful to identify populations who may benefit from interventions to improve muscle strength and function.

相位角与肌少症及相关诊断指标的Meta分析

目的:系统评价相位角与肌少症及相关诊断指标的相关性。方法:计算机检索PubMed、EMbase、Cochrane Library、Web of Science、中国知网、万方、维普和SinoMed数据库,收集关于相位角与肌少症及相关诊断指标相关的临床研究,检索时限均为各数据库建库至2024-05-08。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险。采用RevMan 5.3和Stata 14.0软件进行Meta分析。结果:经筛选共纳入50篇合格文献。Meta分析结果显示,与非肌少症人群对比,肌少症患者的相位角显著降低[SMD=-0.99,95%CI(-1.09,-0.90),P<0.00001]。亚组分析结果表明,重度肌少症以及亚洲肌少症患者相位角差值更加显著,并且伴有肌少症的恶性肿瘤和呼吸系统疾病患者的相位角降低更加明显。相位角与骨骼肌质量指数(Pearson’s r=0.565,P<0.00001)、握力(Pearson’s r=0.446,P<0.00001)、步速(Pearson’s r=0.405,P<0.00001)均呈中等正相关,但与四肢骨骼肌质量指数呈极弱正相关(Pearson’s r=0.139,P=0.02)。结论:与非肌少症人群对比,相位角在肌少症人群具有显著差异性,且与肌少症诊断指标均存在不同程度相关性,提示相位角在肌少症的客观诊断中具有一定的临床价值,但其结果可能受到肌少症严重程度、相位角检测仪器等因素的影响,且因受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Comparison of muscle strength between subjects with and without proteinuria

We compared the levels of muscle strength between subjects with and without proteinuria. We used data of 721 men and 1,063 women, aged 20-79 years, in this cross-sectional investigation study. Parameters at muscle strength i.e. grip strength, leg strength and leg strength per body weight were evaluated. Proteinuria was measured by urine strip devices. Thirty five men (4.9%) and 27 women (2.5%) were diagnosed as having the proteinuria (+: 30 mg/dl) ≦). Leg strength and leg strength per body weight in men with proteinuria was significantly lower than that in men without proteinuria after adjusting for age. Grip strength in men with proteinuria was also lower than that in men without, but not at a significant level. However such link was not noted in women after adjusting for age. Among Japanese, proteinuria might be a modifiable factor of muscle strength in Japanese men.

Relationship between muscle strength and anthropometric, body composition parameters in Japanese adolescents

We investigated the link between muscle strength and anthropometric, body composition parameters in Japanese adolescents. Forty eight men and 189 women, aged 15 - 19 years, were enrolled in this cross-sectional investigation study. Anthropometric and body composition parameters i.e. height, body weight, abdominal circumference, hip circumference and body fat percentage were measured. Muscle strength i.e. grip strength and leg strength were also evaluated. In men, grip strength was positively correlated with height and lean body mass. Leg strength was significantly correlated with height, body weight, hip circumference and lean body mass (r = 0.708). However, leg strength per body weight was negatively correlated with body mass index (BMI), abdominal circumference, hip circumference, body fat percentage (r = –0.719) and body fat mass. In women, grip strength was positively correlated with height. Leg strength was positively correlated with lean body mass (r = 0.482). Leg strength per body weight was negatively correlated with body fat percentage (r = –0.457) and body fat mass. Grip and leg strength was positively correlated with height and lean body mass, especially in men. However, leg strength per body weight was closely linked to body fat percentage in both sexes.

双向孟德尔随机化研究分析哮喘与肌少症的因果效应

目的采用孟德尔随机化研究(MR)探索哮喘与肌少症的因果效应。方法两样本MR评估哮喘数据集对肌少症关联的3个数据集(低手握力、四肢肌肉重量和行走速度)的因果关系。逆方差加权法结果作为主要指标,MR-Egger回归、加权中位值、基于众数的简单估计和基于众数的加权估计作为参考。逐步剔除法检验敏感性,Q检验检验异质性,MR-pleiotropy函数检验多效性。反向MR研究肌少症对哮喘的影响。结果哮喘与低手握力概率增加有关(OR=1.703,95%CI:1.206~2.405,P=0.003);与四肢肌肉重量减少有关(OR=0.733,95%CI:0.598~0.899,P=0.003);与行走速度降低有关(OR=0.930,95%CI:0.873~0.990,P=0.022)。逐步剔除法证实哮喘对肌少症3个数据集因果效应结果稳定。反向研究未发现肌少症对哮喘存在促进作用。结论哮喘促进肌少症的发生和发展,是肌少症的潜在不利因素。

社区高龄老人握力和生活质量的关系研究

目的 本研究基于社会隔离和抑郁2个中介变量,构建多重中介模型,探讨高龄老人的握力对其生活质量的影响机制。方法 于2020年10月-2021年4月,利用方便整群抽样法对上海市400名≥80岁社区高龄老人,采用Lubben社会网络量表(LSNS-6)、老年抑郁量表简表(GDS-5)、世界卫生组织生活质量评定量表老年模块(WHOQOL-OLD)和握力计对高龄老人的社会隔离、抑郁、生活质量及握力进行测量。采用SPSS PROCESS程序检验链式中介效应。结果 相关性分析结果显示:握力、社会隔离、抑郁和生活质量间显著相关(P<0.01)。中介效应,分析结果显示:握力可直接影响高龄老人的生活质量[效应值=0.394;95%CI=(0.219,0.532)],还可以通过3条中介效应链对生活质量造成影响:社会隔离[效应值=0.219;95%CI=(0.125,0.328)],抑郁[效应值=0.054;95%CI=(0.029,0.087)],及社会隔离、抑郁的链式作用[效应值=0.054;95%CI=(0.029,0.087)];总中介效应占总效应的51.2%。结论 握力降低是高龄老人生活质量下降的重要风险因素,且社会隔离和抑郁是这一影响的重要解释机制。社区卫生工作者应重视握力对高龄老人生活质量的影响,并基于社会隔离和抑郁的作用路径制定干预策略,以改善高龄老人的生活质量、促进健康老龄化。

Usefulness of Upper and Lower Limb Muscles Strength in the Evaluation of Clinical Severity of Heart Failure in Elderly Patients

Aim: Assess upper and lower limb functions in elderly with heart failure (HF) and evaluate its relation to HF severity. Methods: Handgrip strength (HGS) in kilograms (kgs.) of both hands using handle mechanical dynamometer and counting the repetitions (rep.) of stand and sit on a chair during 30 seconds [the 30 seconds chair-stand test (CST)] were used in 71 elderly (≥65 years old) patients with clinically stable HF and other matched 32 healthy elderly as a control. HF was diagnosed clinically, by plasma B-Type natriuretic peptide (BNP) and by echocardiography. The New York Heart Association (NYHA) functional classification of HF was used to obtain two groups: NYHA class I-II (33 patients), and NYHA class III (38 patients). Results: Showed significant decrease in both HGS and CST score in all HF patients (9.7 ± 4.4 kgs., 8.8 ± 3.1 rep., respectively) compared to controls (77.8 ± 11 kgs., 13.5 ± 1.1 rep., respectively, p Conclusion: Upper and lower limb muscles?strength, assessed by two easy andinexpensive tests (HGS and CST), may reflect clinical severity of HF in elderly patients who cannot usually perform exercise tests. Its prognostic value requires further follow-up studies to verify.

北京社区55~75岁高、低痴呆风险人群身体素质及其认知功能特点

目的分析预测社区中处于生命中期健康老年人痴呆风险因素。方法2021年7月至2023年4月招募北京市两个社区常住1年以上的55~75岁中老年人175例,收集心血管危险因素、衰老和痴呆(CAIDE)相关危险因素和其他一般人口资料,CAIDE风险评分≥9分为高危组,<9分为低危组。采用Stroop色词测验(SCWT)、两元素1-back任务范式、连线测验(TMT)进行评估;测量握力、30 s前臂屈曲测验和5次坐站试验;记录平地步行10 m的平均步速和步长。结果高危组CAIDE总分平均9.86分,低危组4.95分。两组年龄无显著性差异(P=0.188)。男性,受教育程度<7年、收缩压>140 mmHg、胆固醇>6.5 mmol/L、体质量指数>30 kg/m^(2)和缺乏体力活动人群CAIDE痴呆风险评分更高(χ^(2)>3.116,P<0.05)。高危组握力(t=-4.174)、步速(t=-2.414)、SCWT正确率(Z=-2.684)均差于低危组(P<0.05)。Logistic回归分析显示,步速(OR=25.483)、握力(OR=1.133),SCWT正确率(OR=37.430)是痴呆的独立危险因素(P<0.05)。结论握力弱、步速慢、抑制控制能力差可能预示痴呆风险增加。

骨骼肌质量和肌肉力量对缺血性脑卒中患者神经功能的预测效能评价

目的 探讨并评价缺血性脑卒中患者骨骼肌质量和肌肉力量对脑卒中后3个月神经功能预后的预测效能。方法 纳入117例缺血性脑卒中患者,根据脑卒中后3个月的改良Rankin量表(mRS)评分分为预后不良组(54例)和预后良好组(63例),比较两组骨骼肌质量、肌肉力量等相关指标的差异。采用Pearson相关分析骨骼肌质量、肌肉力量与mRS评分之间的相关性,采用logistic回归分析ASM/Ht2、握力与神经功能预后之间的关系,同时应用受试者工作特征(ROC)曲线评估其对神经功能预后的预测效能。结果 与预后良好组相比,预后不良组年龄均数较大、国立卫生研究院脑卒中量表(NIHSS)评分均数较高,合并低肌肉质量的患者比例、合并低肌肉力量的患者比例以及同时合并低肌肉质量与低肌肉力量的患者比例均较高;而ASM/Ht2和握力均数则较低,差异均有统计学意义(t分别=3.55、4.94,χ^(2)分别=7.27、20.35、11.51,t分别=-4.40、-9.56,P均<0.05)。ASM/Ht2、握力与mRS评分呈负相关(r分别=-0.56、-0.74,P均<0.05)。多因素logistic回归分析发现,ASM/Ht2和握力大是神经功能预后不良发生的保护因素(OR分别=0.64、0.54,P均<0.05)。ROC分析显示,握力的曲线下面积(AUC)为0.89,明显大于ASM/Ht2的AUC(0.71),差异有统计学意义(Z=3.05,P<0.05)。结论 脑卒中患者发病早期的骨骼肌质量和肌肉力量均与其康复期神经功能不良预后密切相关。骨骼肌质量和肌肉力量对脑卒中患者神经功能预后均具有较好的预测价值,尤其是握力,其预测效能更优。

两轮电动车骑车人头部损伤的生物力学分析

两轮电动车(powered two-wheeler,PTW)骑车人头部损伤是我国道路交通事故中一种常见的伤害类型,完善骑车人头部损伤评价标准对制定两轮电动车骑车人安全法规以降低碰撞损伤风险具有重要意义。本文采用头部具有详细解剖学结构的人体数值模型进行骑车人-车辆碰撞仿真,对头部进行生物力学分析和损伤评估,并与行人-车辆碰撞中行人头部损伤进行对比分析。研究发现行人和骑车人在车辆碰撞事故中运动学响应较为相似,但头部生物力学响应存在差异,骑车人头部损伤风险高于行人。同时发现骑车人握力因素影响头部的运动学响应,应考虑其在两轮电动车骑车人头部损伤评估中的影响。

C反应蛋白与白蛋白比值联合握力和血清前白蛋白在食管癌患者中的应用价值

目的 探讨C反应蛋白与白蛋白比值(CAR)联合握力和血清前白蛋白对食管癌患者生存期及营养不良的预测价值。方法 回顾性选取212例食管癌患者作为研究对象,收集患者的基本资料和治疗前CAR、握力、血清前白蛋白检测结果,评估患者营养不良情况并随访总生存期。采用受试者工作特征(ROC)曲线评估治疗前CAR、握力和血清前白蛋白水平对患者营养不良的预测价值,采用Kaplan-Meier生存曲线及Cox回归模型分析治疗前CAR、握力和血清前白蛋白水平对患者生存预后的预测价值。结果 ROC曲线分析结果显示,握力预测食管癌患者营养不良的曲线下面积(0.625)最大,其后依次为血清前白蛋白、CAR(分别为0.604、0.594);根据约登指数确定CAR、握力、血清前白蛋白的最佳截断值分别为0.732、23.1 kg、0.190 g/L,三者联合预测营养不良的灵敏度高达80.7%。Kaplan-Meier生存曲线分析结果显示,CAR增高(≥0.732)、握力降低(<23.1 kg)、血清前白蛋白水平降低(<0.190 g/L)患者的总生存期分别短于CAR<0.732、握力≥23.1 kg、血清前白蛋白水平≥0.190 g/L的患者,差异有统计学意义(P<0.01);多因素Cox回归分析结果显示,治疗前CAR增高(≥0.732)、握力降低(<23.1 kg)、血清前白蛋白水平降低(<0.190 g/L)是食管癌患者生存预后不良的独立危险因素(P<0.05)。结论 治疗前CAR、握力和血清前白蛋白是评估食管癌患者营养状态和生存预后的重要指标,三者联合检测有助于营养不良的早期诊断与及时干预,或可改善食管癌患者的生存预后。

1562例绝经后女性人群骨密度与握力相关性研究

目的分析1562例绝经后女性人群骨密度与握力之间的相关性。方法收集2022年5月~2023年8月于解放军总医院第一医学中心放射诊断科行骨密度检查与握力测试的1562例绝经后女性人群的骨密度检查结果与握力测试数据。按照年龄分成3组,分别是A组(<60岁,n=663)、B组(60~74岁,n=749)、C组(≥75岁,n=150)。对1562例绝经后女性进行腰椎与股骨近端骨密度检查及优势侧手握力测试。比较3组的骨密度和握力,分析骨密度与握力之间的相关性。结果腰椎骨密度T≤-2.5 SD的患者501例(32.07%);股骨颈骨密度T≤-2.5 SD的患者383例(24.52%);髋部骨密度T≤-2.5 SD的患者186例(11.91%)。A组患者的握力为(22.35±4.64)kg,B组患者的握力为(19.81±4.94)kg,C组患者的握力为(16.57±4.27)kg。握力、骨密度均随着年龄的增长逐渐降低(P<0.05)。共125例患者既往发生过骨折(8.00%),其中A组28例(4.22%),B组66例(8.81%),C组31例(20.67%)。随着患者年龄的增长,骨折的发生率升高(P<0.05)。相关性分析结果显示,绝经后女性人群的握力与股骨颈、髋部、腰椎骨的骨密度均呈正相关(r=0.936、0.938、0.935,P<0.05);握力、股骨颈骨密度、髋部骨密度、腰椎骨密度均与年龄呈负相关(r=-0.928、-0.967、-0.971、-0.970,P<0.05)。握力与腰椎、股骨颈、髋部骨密度均呈正相关(r=0.935、0.936、0.938,P<0.05);握力、股骨颈骨密度、髋部骨密度、腰椎骨密度均与BMI呈正相关(r=0.932、0.982、0.985、0.982,P<0.05)。结论绝经后女性人群的握力与骨密度相互依存,相互影响,呈正相关;握力、骨密度与绝经后女性人群的年龄呈负相关。

绝对握力与相对握力对老年结直肠癌病人术后并发症的预测价值

目的探究绝对握力与相对握力(握力/体质量、握力/BMI)对老年结直肠癌病人术后并发症的预测价值。方法选取2022年9月至2023年4月于江苏省人民医院择期行结直肠癌根治术的268例老年病人为研究对象,收集所有病人的一般资料、绝对握力、相对握力及术后并发症等数据。采用单因素分析及多因素Logistic回归分析探究绝对握力及相对握力与术后并发症的关联。绘制ROC曲线,进一步分析绝对握力与相对握力对病人术后并发症的预测能力。结果并发症组与非并发症组比较,年龄、服药数量、慢性病数量、绝对握力和相对握力差异均有统计学意义。Logistic回归结果显示,低绝对握力(分别按指南标准划分、按四分位数标准划分)、低握力/体质量、低握力/BMI均为病人发生并发症的独立预测因子,OR(95%CI)分别为2.825(1.436~5.557)、3.393(1.693~6.803)、2.371(1.210~4.647)、2.112(1.074~4.154)。ROC曲线分析结果显示,绝对握力与相对握力均可有效预测术后并发症的发生,其AUC约为0.63~0.65,在男性病人中,绝对握力及相对握力的预测效能均略高,AUC约为0.70。结论绝对握力与相对握力(握力/体质量、握力/BMI)均对老年结直肠癌病人术后并发症具有一定的预测价值,将握力评估纳入老年结直肠癌病人术前评估中,可为临床早期发现高危人群提供依据。

Prevalence and outcome of sarcopenia in non-alcoholic fatty liver disease

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.