Association of Muscle Mass, Muscle Quality, and Function with Mortality in Community-Dwelling Older Adults: Focus on Segmental Phase Angle and Extracellular to Intracellular Water Ratio.

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-09-27 DOI:10.1016/j.clnesp.2025.09.022

Yujiro Asano, Kenji Tsunoda, Koki Nagata, Namhoon Lim, Taishi Tsuji, Kyohei Shibuya, Tomohiro Okura

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引用次数: 0

Abstract

Background & aims: We investigated the prospective association between muscle quality indicators-phase angle (PhA) and the extracellular to intracellular water (ECW/ICW) ratio-and all-cause mortality in community-dwelling older adults over a 12-year period by comparing them with traditional body composition and performing physical function tests.

Methods: This longitudinal study included a total of 868 older adults aged ≥65 years who underwent examinations from 2011 to 2019, and mortality data were monitored through to 2023 using the city's municipal database. Body composition was measured using multi-frequency bioelectrical impedance analysis to assess whole-body and leg PhA, ECW/ICW resistance ratio (muscle quality), appendicular lean muscle mass index (ALMI), leg SMI, and fat mass percentage (fat%) (body quantity). Physical function was evaluated using hand grip strength, a 5-m habitual walk (5-m walk), and a 5-repetition sit-to-stand test (chair stand). We performed Cox regression analysis to examine the prospective association of bioelectrical impedance analysis (BIA) and physical function variables with all-cause mortality and applied restricted cubic splines to reveal the dose-response relationship between them.

Results: The adjusted Cox model showed significant associations between lower leg PhA (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.64-0.97), leg ECW/ICW resistance ratio (HR: 0.79, 95% CI: 0.64-0.98), slower 5-m walk (HR: 0.83, 95% CI: 0.60-0.95), and fewer chair stands (HR: 0.87, 95% CI: 0.76-0.999) and mortality (z-scores obtained for all dependent variables and good values set to positive). A dose-response relationship indicated a higher risk for individuals with values below the median in restricted cubic splines. No associations were found between ALMI, fat%, hand grip strength, and mortality.

Conclusion: Muscle quality, particularly leg PhA and ECW/ICW ratio, are key predictors of mortality in community-dwelling older adults.

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社区老年人肌肉质量、肌肉质量和功能与死亡率的关系：关注节段相位角和细胞外与细胞内水分比。

背景与目的：我们通过将肌肉质量指标-相位角（PhA）和细胞外/细胞内水（ECW/ICW）比与传统的身体组成和进行身体功能测试进行比较，研究了社区居住老年人12年期间肌肉质量指标-细胞外/细胞内水（ECW/ICW）比-与全因死亡率之间的前瞻性关联。方法：这项纵向研究包括868名年龄≥65岁的老年人，他们在2011年至2019年期间接受了检查，并使用该市的市政数据库监测死亡率数据至2023年。采用多频生物电阻抗分析测量体成分，评估全身和腿部PhA、ECW/ICW阻力比（肌肉质量）、阑尾瘦肌肉质量指数（ALMI）、腿部SMI和脂肪质量百分比（脂肪%）（体质量）。通过手握力、5米习惯性步行（5米步行）和5次重复的坐立测试（椅子站立）来评估身体功能。我们使用Cox回归分析来检验生物电阻抗分析（BIA）和身体功能变量与全因死亡率的前瞻性关联，并应用限制性三次样条来揭示它们之间的剂量-反应关系。结果：调整后的Cox模型显示，下肢PhA（风险比[HR] 0.79, 95%置信区间[CI] 0.64-0.97）、腿部ECW/ICW阻力比（HR: 0.79, 95% CI: 0.64-0.98）、5米步行较慢（HR: 0.83, 95% CI: 0.60-0.95）、较少的椅子架（HR: 0.87, 95% CI: 0.76-0.999）和死亡率（所有因变量的z得分均为正）之间存在显著关联。剂量-反应关系表明，在限制三次样条中值以下的个体风险较高。没有发现ALMI、脂肪百分比、握力和死亡率之间的关联。结论：肌肉质量，特别是腿部PhA和ECW/ICW比值是社区居住老年人死亡率的关键预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.