BMC cardiovascular disorders · 2026
Heterogeneous grip strength trajectories and clinical determinants in middle-aged and older chinese patients with cardiovascular disease: a group-based trajectory modelling analysis of the CHARLS.
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Su Shuyan, Chen Zexin, Xu Tongchi, Wu Hongchao, Ma Xilun, Peng Ziting, Lin Minping, Xu Xiaoqin, Huang Ruibin, Zhong Chaosen, Tan Haizhu
Аннотация
BACKGROUND: Grip strength (GS) is a potent biomarker in cardiovascular disease (CVD). However, evidence is scarce regarding the long-term dynamic changes of GS and their multifactorial determinants. This study aimed to identify distinct GS trajectories and their determinants among middle-aged and older Chinese adults with CVD.
METHODS: We analyzed data from 2,189 patients with CVD across three waves (2011, 2013, 2015) of the China Health and Retirement Longitudinal Study (CHARLS). GS was measured using a standardized protocol. Sex-stratified group-based trajectory model (GBTM) was employed to identify distinct GS trajectories. Multinomial logistic regression was performed to identify factors associated with trajectory group membership using the high-level GS trajectory as the reference group.
RESULTS: GBTM identified three distinct parallel declining GS trajectories for each sex, classified as low-, middle-, and high-level GS groups. In fully adjusted models, older age, lower BMI, and higher FI were significantly associated with membership in both low- and middle-level GS groups compared to the high-level GS group for both sexes (all P < 0.05).
CONCLUSIONS: This study revealed three GS trajectories among patients with CVD, with older age, lower BMI, and higher FI emerging as robust determinants of the low GS trajectory. These findings highlight the potential value of longitudinal GS monitoring for identifying high-risk individuals. Whether interventions targeting modifiable factors such as nutritional status and frailty can influence GS trajectories and subsequent clinical outcomes warrants further investigation.
METHODS: We analyzed data from 2,189 patients with CVD across three waves (2011, 2013, 2015) of the China Health and Retirement Longitudinal Study (CHARLS). GS was measured using a standardized protocol. Sex-stratified group-based trajectory model (GBTM) was employed to identify distinct GS trajectories. Multinomial logistic regression was performed to identify factors associated with trajectory group membership using the high-level GS trajectory as the reference group.
RESULTS: GBTM identified three distinct parallel declining GS trajectories for each sex, classified as low-, middle-, and high-level GS groups. In fully adjusted models, older age, lower BMI, and higher FI were significantly associated with membership in both low- and middle-level GS groups compared to the high-level GS group for both sexes (all P < 0.05).
CONCLUSIONS: This study revealed three GS trajectories among patients with CVD, with older age, lower BMI, and higher FI emerging as robust determinants of the low GS trajectory. These findings highlight the potential value of longitudinal GS monitoring for identifying high-risk individuals. Whether interventions targeting modifiable factors such as nutritional status and frailty can influence GS trajectories and subsequent clinical outcomes warrants further investigation.