我国成人握力与心血管疾病风险的相关性研究  

Predictive Value of Grip Strength for the Risk of Cardiovascular Disease in Chinese Adults

作　　者：邓卿 刘炜达 韩国亮 游凯[3] 金辉[4] 刘国钦 胡泊 王杨 DENG Qing;LIU Weida;HAN Guoliang;YOU Kai;JIN Hui;LIU Guoqin;HU Bo;WANG Yang(Medical Research&Biometrics Center,National Center for Cardoivascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)

机构地区：[1]中国医学科学院、北京协和医学院、国家心血管病中心、阜外医院医学研究统计中心,北京市100037 [2]中国医学科学院、北京协和医院、医学科学研究中心 [3]北京市顺义区疾病预防控制中心 [4]北京积水潭医院社区医学保健科 [5]静乐县人民医院病理科

出　　处：《中国循环杂志》2022年第12期1245-1249,共5页Chinese Circulation Journal

基　　金：国家重点研发计划(2020YFC1107902)。

摘　　要：目的:验证我国成人握力与心血管疾病风险的相关性并比较握力与传统人体测量学指标用于预测心血管疾病及死亡风险的关联度强弱。方法:本研究依托前瞻性城乡流行病学研究中国地区(PURE China)队列,自2005~2009年通过标准化问卷及体格检查对受试者进行基线调查,通过Jamar握力计进行握力测量。之后每三年进行一次随访,本研究分析随访事件截至2017年,主要研究终点为主要不良心血管事件(MACE)。通过多因素Cox共享脆弱模型分析握力每下降5 kg与心血管疾病风险的关联,并将握力及传统人体测量学指标进行标化,比较它们每标准差变化与心血管疾病风险的关联强度。结果:平均随访(7.8±2.7)年,1417例(8.5%)男性发生MACE,1251例(5.4%)女性发生MACE。多因素Cox共享脆弱模型分析表明,握力每下降5 kg,MACE风险增加14%(HR=1.14,95%CI:1.11~1.17,P<0.001),全因死亡风险增加12%(HR=1.12,95%CI:1.08~1.16,P<0.001),心血管死亡风险增加16%(HR=1.16,95%CI:1.08~1.24,P<0.001),以上结果在不同性别人群中相似。除此之外,研究结果提示,握力(HR=1.28,95%CI:1.21~1.36,P<0.001)与MACE风险的关联度强于传统人体测量学指标[收缩压(HR=1.25,95%CI:1.20~1.29,P<0.001)、体重指数(HR=1.08,95%CI:1.04~1.13,P<0.001)和腰臀比(HR=1.09,95%CI:1.05~1.13,P<0.001)]以及新兴指标身体形态指数(HR=1.10,95%CI:1.06~1.14,P<0.001)。结论:我国成人握力较低与MACE风险增加有关;相较于传统人体测量学指标,握力与MACE风险的关联度较强。Objectives:To explore the association between the grip strength and the risk of cardiovascular disease in Chinese adults,and to compare the value of grip strength with that of traditional anthropometric parameters in predicting the risk of cardiovascular disease.Methods:Data from present analyses were derived from the PURE China cohort study.From 2005 to 2009,subjects were surveyed at baseline through standardized questionnaires and physical examinations,and grip strength was measured by Jamar grip dynamometer.Follow-up was conducted every three years,and the follow-up results were analyzed in this study until 2017.The primary endpoint was major adverse cardiovascular events(MACE).The multivariate Cox shared fragility model was used to analyze the association of each 5 kg decrease in grip strength with the risk of cardiovascular disease;the grip strength and common anthropometric parameters were standardized,and their association strength per standard deviation change with the incidence of cardiovascular disease was compared.Results:After a mean follow-up of(7.8±2.7)years,a total of 1417(8.5%)males and 1251(5.4%)females developed MACE.The study data showed that for every 5 kg decrease in grip strength,the risk of MACE increased by 14%(HR=1.14,95%CI:1.11-1.17,P<0.001),and the risk of all-cause mortality increased by 12%(HR=1.12,95%CI:1.08-1.16,P<0.001),the risk of cardiovascular death increased by 16%(HR=1.16,95%CI:1.08-1.24,P<0.001),and the above results were similar in different sex populations.In addition,the findings suggested that grip strength(HR=1.28,95%CI:1.21-1.36,P<0.001)was more strongly associated with the risk of MACE than traditional indicators(systolic blood pressure[HR=1.25,95%CI:1.20-1.29,P<0.001],body mass index[HR=1.08,95%CI:1.04-1.13,P<0.001],and waist-to-hip ratio[HR=1.09,95%CI:1.05-1.13,P<0.001])and an emerging indicator,body shape index(HR=1.10,95%CI:1.06-1.14,P<0.001).Conclusions:Lower grip strength is associated with an increased risk of cardiovascular disease in Chinese adults.Grip stren

关 键 词：握力 心血管疾病 队列研究 人体测量学指标 风险比 

分 类 号：R54[医药卫生—心血管疾病]