The association between sarcopenia and peak expiratory flow decline in middle-aged and older adults: a nationwide cross-sectional and longitudinal study in China
4 affiliations
- 1National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan China
- 2Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan China
- 3Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan China
- 4Liver Transplant Center, Transplant Center, West China Hospital, Sichuan University, Chengdu, Sichuan China
Abstract
Background: Evidence suggests an association between sarcopenia and impaired respiratory function; however, longitudinal population-based data on the relationship between sarcopenia, its individual components, and peak expiratory flow (PEF) decline remain limited. This study aimed to investigate the cross-sectional and longitudinal associations of sarcopenia and its components with PEF measures among middle-aged and older Chinese adults.
Methods: Data were obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Cross-sectional associations between sarcopenia and PEF measures were examined using multivariable logistic and linear regression models. Longitudinal associations between baseline sarcopenia and subsequent PEF decline were evaluated using multivariable logistic regression models.
Results: A total of 9452 participants were included in the cross-sectional analysis. Compared with participants without sarcopenia, those with sarcopenia and severe sarcopenia had higher odds of severe airflow limitation (SAL) (OR = 1.41, 95% CI: 1.20–1.65 and OR = 1.56, 95% CI: 1.26–1.94, respectively). Sarcopenia and its individual components were also associated with lower PEF and PEF% predicted. In the longitudinal analysis of 4804 participants, low muscle strength was the strongest and most consistent predictor of subsequent PEF decline. Participants with low muscle strength had a higher risk of new-onset SAL (OR = 1.54, 95% CI: 1.20–1.98) and a 56%–64% greater risk of PEF% predicted decline across different thresholds. Severe sarcopenia and low muscle mass were also associated with greater risks of moderate-to-severe PEF% predicted decline.
Conclusion: Sarcopenia was associated with poorer cross-sectional PEF measures, whereas low muscle strength showed the strongest and most consistent longitudinal associations with subsequent PEF decline. These findings highlight the potential importance of muscle strength preservation for maintaining respiratory health in middle-aged and older adults.
Graphical Abstract: This study aimed to investigate the association between sarcopenia and its components with PEF decline using data from the China Health and Retirement Longitudinal Study (CHARLS), employing both cross-sectional and longitudinal analyses. The findings demonstrated that sarcopenia was associated with poorer cross-sectional PEF measures, whereas low muscle strength emerged as the strongest and most consistent predictor of subsequent PEF decline among middle-aged and older adults in China.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12890-026-04451-4.
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BibTeX
@article{hu2026association,
title = {{The association between sarcopenia and peak expiratory flow decline in middle-aged and older adults: a nationwide cross-sectional and longitudinal study in China}},
author = {Fengjuan Hu and Gongchang Zhang and Hu Liu and Tingting Huang and Wanyu Zhao and Xiaolei Liu and Ning Huang and Birong Dong and Meiling Ge},
journal = {BMC Pulmonary Medicine},
year = {2026},
month = jul,
doi = {10.1186/s12890-026-04451-4},
url = {https://doi.org/10.1186/s12890-026-04451-4},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - The association between sarcopenia and peak expiratory flow decline in middle-aged and older adults: a nationwide cross-sectional and longitudinal study in China
AU - Fengjuan Hu
AU - Gongchang Zhang
AU - Hu Liu
AU - Tingting Huang
AU - Wanyu Zhao
AU - Xiaolei Liu
AU - Ning Huang
AU - Birong Dong
AU - Meiling Ge
PY - 2026
DA - 2026/07/17
JO - BMC Pulmonary Medicine
DO - 10.1186/s12890-026-04451-4
UR - https://doi.org/10.1186/s12890-026-04451-4
AB - Background: Evidence suggests an association between sarcopenia and impaired respiratory function; however, longitudinal population-based data on the relationship between sarcopenia, its individual components, and peak expiratory flow (PEF) decline remain limited. This study aimed to investigate the cross-sectional and longitudinal associations of sarcopenia and its components with PEF measures among middle-aged and older Chinese adults. Methods: Data were obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Cross-sectional associations between sarcopenia and PEF measures were examined using multivariable logistic and linear regression models. Longitudinal associations between baseline sarcopenia and subsequent PEF decline were evaluated using multivariable logistic regression models. Results: A total of 9452 participants were included in the cross-sectional analysis. Compared with participants without sarcopenia, those with sarcopenia and severe sarcopenia had higher odds of severe airflow limitation (SAL) (OR = 1.41, 95% CI: 1.20–1.65 and OR = 1.56, 95% CI: 1.26–1.94, respectively). Sarcopenia and its individual components were also associated with lower PEF and PEF% predicted. In the longitudinal analysis of 4804 participants, low muscle strength was the strongest and most consistent predictor of subsequent PEF decline. Participants with low muscle strength had a higher risk of new-onset SAL (OR = 1.54, 95% CI: 1.20–1.98) and a 56%–64% greater risk of PEF% predicted decline across different thresholds. Severe sarcopenia and low muscle mass were also associated with greater risks of moderate-to-severe PEF% predicted decline. Conclusion: Sarcopenia was associated with poorer cross-sectional PEF measures, whereas low muscle strength showed the strongest and most consistent longitudinal associations with subsequent PEF decline. These findings highlight the potential importance of muscle strength preservation for maintaining respiratory health in middle-aged and older adults. Graphical Abstract: This study aimed to investigate the association between sarcopenia and its components with PEF decline using data from the China Health and Retirement Longitudinal Study (CHARLS), employing both cross-sectional and longitudinal analyses. The findings demonstrated that sarcopenia was associated with poorer cross-sectional PEF measures, whereas low muscle strength emerged as the strongest and most consistent predictor of subsequent PEF decline among middle-aged and older adults in China. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12890-026-04451-4.
SN - 1471-2466
ER -