Sarcopenia, Grip Strength, Walking Pace, and New-Onset Stroke Risk: A UK Biobank Study
Li-Li Tang1, Yu-Hui Huang2, Yu-Jia Jin1
1Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China (L.-L.T., Y.-J.J., K.-C.Y., F.G., L.-S.T.).
Background:
Novel stroke risk factors have received widespread attention. This study examined the association between sarcopenia status, grip strength, and walking pace with incident stroke (any stroke, ischemic stroke, and hemorrhagic stroke) and poststroke mortality.
Methods:
This prospective study included 482 699 participants from the UK Biobank, a large-scale, population-based cohort. Sarcopenia status was assessed according to the EWGSOP2 criteria (European Working Group on Sarcopenia in Older People 2). Incident strokes were ascertained based on health records. Stroke risk was assessed using multivariable-adjusted Cox proportional hazards models, whereas poststroke mortality was compared using the Kaplan-Meier analysis with log-rank tests. A 2-sample Mendelian randomization analysis, utilizing genetic instruments from public genome-wide association studies, was conducted to infer causal associations.
Results:
The cohort (mean age±SD: 56.4±8.1 years; 45.37% were men; n=219 015) had a probable sarcopenia prevalence of 4.7% and a confirmed sarcopenia prevalence of 0.4%. Participants with probable sarcopenia had a higher risk of any stroke (adjusted hazard ratio [aHR], 1.30 [95% CI, 1.21-1.39]), ischemic stroke (aHR, 1.31 [95% CI, 1.22-1.42]), and hemorrhagic stroke (aHR, 1.41 [95% CI, 1.20-1.67]) than those without. Among those who had a stroke, probable or confirmed sarcopenia was associated with increased all-cause mortality. Higher risk of any stroke was associated with lower grip strength (absolute: aHR, 1.07 [95% CI, 1.06-1.09] per 5 kg; relative: aHR, 1.36 [95% CI, 1.28-1.44] per 1 kg/[kg/m2]) and a slow walking pace (aHR, 1.64 [95% CI, 1.54-1.75]; compared with brisk pace). Mendelian randomization analysis demonstrated that a faster walking pace was associated with a lower risk of any stroke (odds ratio, 0.94 [95% CI, 0.90-0.97] per-SD increase) and ischemic stroke (odds ratio, 0.95 [95% CI, 0.91-0.98] per-SD increase).
Conclusions:
Sarcopenia status, lower grip strength, and slower walking pace were associated with an increased risk of incident stroke and all-cause poststroke mortality.
