中国老年居民肌少症与全因死亡率的关联实证分析

An empirical analysis on the association between sarcopenia and all-cause mortality in Chinese elderly residents

  • 摘要:
    目的 探索不同程度的肌少症与我国老年人全因死亡率的关联,为老年人群肌少症的预防与控制提供参考。
    方法 数据来自2011—2020年中国健康与养老追踪调查(CHARLS),根据一定的纳排标准纳入2 792例65岁及以上的研究对象。采用单因素和多因素的Cox比例风险回归分析研究我国老年人全因死亡率的潜在影响因素,并使用Kaplan‑Meier曲线直观展示不同肌少症状态下老年人的生存状况;最后使用多次调整的Cox比例风险回归模型控制混杂因素,分析肌少症与全因死亡率的关联。
    结果 在调整潜在协变量前,单因素和多因素Cox比例风险回归模型显示,10年全因死亡率与可能肌少症(HR=1.40,95%CI:1.17~1.68,P<0.001)、轻中度肌少症(HR=1.49,95%CI:1.20~1.86,P<0.001)、重度肌少症(HR=1.68,95%CI:1.29~2.19,P<0.001)均存在相关性;在对所有混杂因素调整后,10年全因死亡率与可能肌少症(HR=1.38,95%CI:1.15~1.66,P<0.001)、轻中度肌少症(HR=1.48,95%CI:1.19~1.84,P<0.001)和重度肌少症患者(HR=1.71,95%CI:1.31~2.23,P<0.001)仍明显相关。
    结论 在中国老年居民中,肌少症与10年全因死亡风险增加有关,并随着肌少症的病程进展死亡风险增加。

     

    Abstract:
    Objective To investigate the association between variant degree of sarcopenia and all-cause mortality in Chinese elderly residents, and to provide insights into the prevention and control of sarcopenia in the elderly population.
    Methods Data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 and 2020 were analyzed, and a total of 2 792 subjects aged 65 years or older were selected according to the inclusion and exclusion criteria. Univariate and multivariate Cox proportional hazards regression analysis were performed to explore the potential factors influencing all-cause mortality among the elderly in China, and Kaplan-Meier curves were used to visualize the survival of elderly people with variant degree of sarcopenia. Finally, a multiple-adjusted Cox proportional hazards regression model was used to control the confounding factors and explore the association between sarcopenia and all-cause mortality.
    Results Before adjusting potential covariates, univariate and multivariate Cox proportional hazards regression models showed that 10-year all-cause mortality was significantly associated with variant degree of sarcopenia, namely possible sarcopenia (HR=1.40, 95%CI: 1.1‒1.68, P<0.001), mild-to-moderate sarcopenia (HR=1.49, 95%CI:1.20‒1.86, P<0.001), and severe sarcopenia (HR=1.68, 95%CI: 1.29‒2.19, P<0.001); after adjusting all confounders, 10-year all-cause mortality remained to be significantly associated with variant degree of sarcopenia, including probable sarcopenia (HR=1.38, 95%CI: 1.15‒1.66, P<0.001), mild-to-moderate sarcopenia (HR=1.48, 95%CI: 1.19‒1.84, P<0.001) and severe sarcopenia (HR=1.71, 95%CI: 1.31‒2.23, P<0.001).
    Conclusion In Chinese elderly residents, sarcopenia is positively associated with an increased risk of 10-year all-cause mortality, and the progression of sarcopenia is positively associated with an increased risk of death.

     

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