Chen Yu, Ge Wenzhen, Parvez Faruque, Bangalore Sripal, Eunus Mahbub, Ahmed Alauddin, Islam Tariqul, Rakibuz-Zaman Muhammad, Hasan Rabiul, Argos Maria, Levy Diane, Sarwar Golam, Ahsan Habibul
Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA.
Int J Epidemiol. 2014 Aug;43(4):1187-96. doi: 10.1093/ije/dyu082. Epub 2014 Apr 7.
Epidemiological studies have observed protective effects of mid-upper arm circumference (MUAC) against all-cause mortality mostly in Western populations. However, evidence on cause-specific mortality is limited.
The sample included 19 575 adults from a population-based cohort study in rural Bangladesh, who were followed up for an average of 7.9 years for mortality. Cox proportional hazards regression was used to evaluate the effect of MUAC, as well as the joint effect of body mass index (BMI) and MUAC, on the risk of death from any cause, cancer and cardiovascular disease (CVD).
During 154 664 person-years of follow-up, 744 deaths including 312 deaths due to CVD and 125 deaths due to cancer were observed. There was a linear inverse relationship of MUAC with total and CVD mortality. Each 1-cm increase in MUAC was associated a reduced risk of death from any cause [hazard ratio (HR) = 0.85; 95% confidence interval (C), 0.81-0.89) and CVD (HR = 0.87; 95% CI, 0.80-0.94), after controlling for potential confounders. No apparent relationship between MUAC and the risk of death from cancer was observed. Among individuals with a low BMI (<18.5 kg/m(2)), a MUAC less than 24 cm was associated with increased risk for all-cause (HR = 1.81; 95% CI, 1.52-2.17) and CVD mortality (HR = 1.45; 95% CI, 1.11-1.91).
MUAC may play a critical role on all-cause and CVD mortality in lean Asians.
流行病学研究大多在西方人群中观察到上臂中部周长（MUAC）对全因死亡率的保护作用。然而，关于特定病因死亡率的证据有限。
样本包括来自孟加拉国农村一项基于人群的队列研究的19575名成年人，对其进行了平均7.9年的死亡率随访。采用Cox比例风险回归来评估MUAC以及体重指数（BMI）和MUAC的联合作用对任何原因、癌症和心血管疾病（CVD）死亡风险的影响。
在154664人年的随访期间，观察到744例死亡，其中包括312例因CVD死亡和125例因癌症死亡。MUAC与总死亡率和CVD死亡率呈线性负相关。在控制潜在混杂因素后，MUAC每增加1厘米，任何原因导致的死亡风险降低[风险比（HR）=0.85；9５%置信区间（CI），0.81 - 0.89]，CVD死亡风险降低（HR = 0.87；95%CI，0.80 - 0.94）。未观察到MUAC与癌症死亡风险之间存在明显关系。在BMI较低（<18.5kg/m²）的个体中，MUAC小于24厘米与全因（HR = 1.81；95%CI，1.52 - 2.17）和CVD死亡率增加（HR = 1.45；95%CI，1.11 - 1.91）相关。
MUAC可能在瘦亚洲人的全因和CVD死亡率中起关键作用。
