呼气峰值流速的基线和纵向变化作为老年人肌肉减少症的预测因子：一项为期4年的队列研究

IF 4 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging Pub Date : 2025-07-24 DOI:10.1016/j.jnha.2025.100640

Hui Qian , Qifeng Chen , Kangkang Chen

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引用次数: 0

摘要

目的呼气流量峰值（PEFR）是一种廉价、简便的评估气道通畅和呼吸肌力量的工具。到目前为止，PEFR的影响，特别是其纵向变化，对肌少症的患病率和发病率仍未得到充分探讨。因此，我们进行了横断面和纵向研究来解决这一差距。方法分析中国健康与退休纵向研究（CHARLS）的数据。2011年，共有5280名老年人被选为队列，其中3686人在基线时被证实无肌肉减少症，并随访至2015年。在2011年和2013年测量PEFR的纵向变化，有2904名受试者的完整配对数据。肌少症是根据2019年亚洲肌少症工作组（AWGS）诊断的。多变量logistic回归和离散时间比例风险模型用于评估基线PEFR、2年PEFR变化和肌肉减少症风险之间的关联，并对潜在混杂因素进行调整。结果基线PEFR降低1个标准偏差（SD）与流行肌少症的几率增加56%相关（OR = 1.56, 95% CI = 1.38 ~ 1.75）， PEFR（%预测）和PEFR（%预测）增加80%相关（OR = 1.93, 95% CI = 1.49 ~ 2.50）。在4年的随访中，这些减少与发生肌肉减少症的风险增加有关（HR = 1.26, 95% CI = 1.13 - 1.40, HR = 1.47, 95% CI = 1.17 - 1.84）。从PEFR（%预测）≥80%下降到<；80%与120%的几率增加相关（OR = 2.20, 95% CI = 1.31 - 3.71），而从<；80%改善到≥80%与30%的几率降低相关（OR = 0.70, 95% CI = 0.50 - 0.96）。结论基线PEFR较慢及其纵向下降与肌少症风险增加相关，而向上变化与风险降低相关。这些发现表明PEFR可以作为一种实用的早期标志物，用于识别老年人肌肉减少症的高风险。

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Baseline and longitudinal changes in peak expiratory flow rate as predictors of sarcopenia in older adults: A 4-year cohort study

Objective

Peak expiratory flow rate (PEFR) is a cheap and simple tool for assessing airway patency and respiratory muscle strength. So far, the impact of PEFR, particularly its longitudinal changes, on the prevalence and incidence of sarcopenia remains underexplored. Therefore, we conducted a cross-sectional and longitudinal study to address this gap.

Methods

We analyzed data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 5,280 older adults were selected as a cohort in 2011, of whom 3,686 were confirmed sarcopenia-free at baseline and followed through 2015. Longitudinal changes in PEFR were measured in 2011 and 2013, with complete paired data available for 2,904 subjects. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia (AWGS). Multivariable logistic regression and discrete-time proportional hazards models were used to assess associations between baseline PEFR, 2-year PEFR changes, and sarcopenia risk, adjusting for potential confounders.

Results

A 1-standard deviation (SD) decrease in baseline PEFR was associated with 56% higher odds of prevalent sarcopenia (OR = 1.56, 95% CI = 1.38−1.75), and PEFR (% predicted) <80% with 93% higher odds (OR = 1.93, 95% CI = 1.49–2.50). Over the 4-year follow-up, these reductions were linked to increased risk of incident sarcopenia (HR = 1.26, 95% CI = 1.13−1.40, and HR = 1.47, 95% CI = 1.17−1.84, respectively). A decline from PEFR (% predicted) ≥80% to <80% was associated with 120% higher odds (OR = 2.20, 95% CI = 1.31−3.71), while improvement from <80% to ≥80% was linked to 30% lower odds (OR = 0.70, 95% CI = 0.50−0.96).

Conclusions

Lower baseline PEFR and its longitudinal decline were associated with increased risk of sarcopenia, while upward changes were linked to lower risk. These findings suggest that PEFR may serve as a practical early marker for identifying older adults at elevated risk of sarcopenia.

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来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.