Malnutrition mediates the association between handgrip status and asthma risk: an observational and prospective
Jun Wen1, Xiaowen Shi1, Yan Liu1
1Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China.
Background:
Epidemiological investigations on the association of handgrip status and asthma risk still remain understudied. This research aims to investigate the associations of handgrip strength (HGS), relative handgrip strength (RHGS), low HGS, and asthma risk, as well as the mediating role of nutritional status, using data from the Survey of Health, Ageing and Retirement in Europe (SHARE).
Method:
This investigation included 27,185 participants for a cross-sectional study and 18,047 participants for a prospective cohort study from SHARE. Four machine learning models, the Shapley Additive Explanations (SHAP) model, restricted cubic spline (RCS), cumulative occurrence curve, logistic regression, and Cox regression were used to comprehensively evaluate the performance of handgrip status in predicting asthma risk. Finally, the mediation effect model was employed to evaluate the role of nutritional status in the relationship between grip strength and asthma risk.
Result:
The cross-sectional investigation suggested that both HGS (OR: 0.98, 95% CI: 0.98-0.99) and RHGS (OR: 0.61, 95% CI: 0.51-0.73) were negatively linked to the risk of asthma, and low HGS was a risk factor for asthma (OR: 1.52, 95% CI: 1.24-1.87). And the prospective cohort investigation with a median follow-up time of 30 months further confirmed that both HGS (HR: 0.98, 95% CI: 0.97-1.00) and RHGS (HR: 0.52, 95% CI: 0.37-0.73) were negatively linked to the risk of asthma. Among the four machine learning models used to evaluate handgrip status and the risk of asthma, eXtreme Gradient Boosting (XGBoost) showed better predictive performance. The SHAP model based on XGBoost suggested that the top five crucial indicators for predicting asthma risk were RHGS, HGS, country, age, and chronic lung disease. Finally, the mediation effect model suggested that malnutrition partially mediated the relationship between low HGS and increased risk of asthma, with a mediation proportion of 2.71%.
Conclusion:
This investigation suggested that lower HGS and RHGS were linked to a higher risk of asthma, and handgrip status could be used as an independent marker of asthma risk in European populations. And malnutrition partially mediated the relationship between low HGS and asthma risk. Improving muscle strength could be a potential preventive strategy against asthma, with implications for public health and clinical practice.
Related Concept Videos
01:29Asthma-I: Introduction
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:30Asthma-IV: Nursing Management
First, in...