| ObjectivesTo describe the distribution of grip strength of general population in Han population in Shaanxi province, discuss associated factors of grip strength, Preliminary use GAMLSS method to establish grip strength reference model by, in order to provide important theoretical basis for establishing grip strength reference of Chinese general population reference. MethodThis Study used multi-stage cluster sampling method. People who aged 8~80 years old and had lived in Xi ’an city, Hanzhong city, Hu country or Qishan county of Shaanxi province more than one year were recorded to investigating for questionnaires and physical examination. Questionnaires included demographic characteristics(ethnic, gender, date of birth, personal income, etc.), disease status(personal history of disease) and behavior factors(physical labor and physical exercise, etc.). Physical examination included grip strength, height, sitting height, and weight. Data were entered into computer using Epi Data double entry of data by two people. Continuous variables were described as mean ± standard deviation; Comparison between groups used T test or Analysis of Variance. Multiple comparison used SNK method. Categorical variables were described as the number(constituent ratio). Comparison between groups used chisquare test. Analysis of grip influencing factors used simple linear correlation, Analysis of Variance and multiple linear regression. Application SAS 9.4 software for these analyses. Model fitting for reference value by GAMLSS method by GAMLSS package of R software. Results1. Demographic characteristics of respondents: 6349 respondents(male 2680, female 3669) were included in this study.2. Distribution of grip strength: Except 12~13 years(P=0.0683), grip strength of men was larger than that of women in each age group(P<0.05). Men showed a rapid rise in childhood of grip strength, kept stable in adulthood, and then gradually declined like the parabolic. Women showed a rapidly increasing of grip strength at first, and then declined smoothly. The trend of increasing of grip strength in female is lower than male. In men, the means of grip peaked at 20~29 years(41.16 kg), remained to 30~39 years, and declined after 40~49 years. In women, the means of grip peaked at 30~39 years(24.12 kg), remained to 40~49 years, and declined after 50~59 years. Grip strength of male in rural is lower than male in urban between 40~49 years and 60~69 years. Grip strength of female in urban is higher than female in rural in 12~13 years to 14~15 years and 50~59 years to 70~80 years. Grip strength of female in urban is lower than female in rural in 30~39 years.3. Multiple linear regression analysis of grip strength:Age, height, sitting height and weight were associated factors in both male and female. Binomial coefficient of age is negative(male βAge2=-0.01, female βAge2=-0.01) and monomial coefficient of age is positive(male βAge= 0.77, female βAge= 0.39). It complied with the parabolic relationship between age and grip strength. Grip strength increased along with the increase of height, sitting height and weight. In male, grip strength of heavy manual workers had no significant difference to light manual labor workers, the middle manual workers’ grip strength was 0.78 kg higher than light manual labor workers. Grip strength of monthly income in(1000 ~ 1999) yuan people was 1.33 kg higher than the monthly income in(0~999) yuan people. Grip strength of monthly income in 2000 yuan or above people was 1.51 kg higher than monthly income in 0~999 yuan. In female, rural residents’ grip strength value was 0.43 kg lower than urban residents.4. Investigating the normal reference model: GAMLSS method was used to develop model and calculate reference range of grip strength. Grip strength of male was normal distribution. Grip strength of female was skewed distribution. Reference value of grip strength showed the trend for first increasing and then decreasing with age increasing, and the trend for increasing with height increasing. Conclusion1. The mean grip strength of Han population in Shaanxi province was(27.80±10.14)kg. The mean grip strength of male was(35.95±9.37)kg. The mean grip strength of female was(21.85±5.45)kg. Grip strength of male was generally greater than female in different age. By age increasing, there was a trend of increasing at first and declining subsequently.2. Common associated factors of grip strength in male and female were age, height, sitting height, and weight. Grip strength increased with height, sitting height, body weight. In male, the middle manual workers’ grip strength was higher than light manual labor workers, grip strength of heavy manual workers had no significant difference to light manual labor workers. Grip strength of people whose monthly income in(1000 ~ 1999) yuan or more than 2000 yuan was higher than whose monthly income in(0~999) yuan people. In female, urban residents’ grip strength value was higher than rural residents.3. The age and height combined effect on grip strength can be reflected by GAMLSS method. Developing grip strength tables of the lower limit of normal provided an important basis to establish a national full age group of 8-80 years reference value. |
PDF Full Text Request