Archives of Osteoporosis

, 14:2 | Cite as

Sarcopenia-related features and factors associated with low muscle mass, weak muscle strength, and reduced function in Chinese rural residents: a cross-sectional study

  • Hong-qi Xu
  • Ji-peng Shi
  • Chong Shen
  • Yu Liu
  • Jing-Min LiuEmail author
  • Xiu-yuan Zheng
Original Article



Muscle strength and function declined more than the concomitant loss of muscle mass. Measures of muscle strength and function are an effective way to assess functional ability and physical health in older people. A healthy lifestyle such as physical exercise, good nutrition, and higher BMI can benefit older people.


The study investigated the characteristics of aging-related differences in appendicular lean mass (ALM/Ht2), handgrip strength (HGS), usual gait speed (UGS), repeated chair stands (RCS), Timed Up and Go (TUG) test, and their associated factors in 6703 rural residents.


We assessed their anthropometry, body composition, muscle strength and function, bone mineral density, blood pressure, and blood biochemical indices via clinical examination or laboratory tests and investigated demographic characteristics, lifestyle, medical history, physical activity, and dietary intake via questionnaire. Stepwise logistic regression was used to determine the associated factors of low muscle mass, weak muscle strength, reduced physical performance, and sarcopenia.


The mean values of muscle strength and function decreased more rapidly with age than the mean values of muscle mass, especially in females. The prevalence of low ALM/Ht2, weak HGS, slow UGS, long RCS, long TUG, and sarcopenia increased (P < 0.01). Higher body mass index (BMI) and daytime sleep were associated with high ALM/Ht2. Comorbidity factors such as hypertension, bone mineral density loss, central adiposity, metabolic syndrome, and tumors were associated with the risk of weak muscle strength and reduced physical performance, while physical activity and better nutrition were associated with better muscle strength and physical performance.


At the higher decades of life, the decline of muscle strength and function is greater than the loss in muscle mass. Measures of muscle strength and function are an effective way to assess functional ability and physical health in older people. Maintaining a healthy lifestyle by means such as physical exercise, good nutrition, and higher BMI throughout the course of life may be benefit older people by improving their muscle mass, strength, and function.


Sarcopenia Muscle mass Muscle strength Muscle function Physical performance 



Asian Working Group for Sarcopenia


European Working Group on Sarcopenia in Older People


Nanjing Medical University


body mass index


waist circumference


Body Composition Analyzer II


lean body mass


fat mass


muscle mass


bone mass


percentage fat mass


appendicular lean muscle mass


dividing ALM by the square of height


dividing LBM by the square of height


bone mineral density


speed of sound


blood pressure


Dietary Reference Intakes


physical activity


metabolic equivalents


bone mass density


handgrip strength


usual gait speed


repeated chair stands


Timed Up and Go


odds ratios



This work was supported by Jurong Center for Disease Control and Prevention, School of Public Health of Nanjing Medical University, School of Sports Science and Physical Education of Northeast Normal University, and by the Division of Sports Science and Physical Education of Tsinghua University. We gratefully acknowledge the efforts of participants, staff, and volunteers for this project. We would like to thank LetPub ( for providing linguistic assistance during the preparation of this manuscript. The authors would like to thank the three anonymous reviewers for their constructive comments which have improved the study in numerous ways.

Authors’ contributions

HX participated in the design, data collection and analysis, and drafted the manuscript. JS, CS, YL, and JL contributed to data acquisition, interpretation, and performed the statistical analysis. JL and XZ conceived of the study and participated in its design and coordination and helped to draft the manuscript. All authors have read and approved the final version of the manuscript and agree with the order of presentation of the authors.


This work was supported by the Ministry of Science and Technology of China (2017YFF0206601 and 2013FY110200) and the Fundamental Research Funds for the Central Universities (2412017ZD002).

Compliance with ethical standards

Ethics approval and consent to participate

The authors declare that all the experiments of this study complied with the current laws of China in which they were performed. The study was approved by the local ethical committee of the public health school of Nanjing Medical University (NMU) and Jurong Center for Disease Control and Prevention (Jurong CDC) approved the study protocol. Each participant provided informed written consent prior to participation.

Consent for publication

Not applicable.

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Hong-qi Xu
    • 1
  • Ji-peng Shi
    • 1
  • Chong Shen
    • 2
  • Yu Liu
    • 3
  • Jing-Min Liu
    • 4
    Email author
  • Xiu-yuan Zheng
    • 4
  1. 1.Research Center of Sports and Health Science, School of Sports Science and Physical EducationNortheast Normal UniversityChangchunChina
  2. 2.Department of Epidemiology and Biostatistics, School of Public HealthNanjing Medical UniversityNanjingChina
  3. 3.Jurong Center for Disease Control and PreventionJurongChina
  4. 4.Research Center of Sports and Health Science, Division of Sports Science and Physical EducationTsinghua UniversityBeijingChina

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