Chao Yuan-Ping, Lai Yi-Fen, Kao Tung-Wei, Peng Tao-Chun, Lin Yuan-Yung, Shih Mu-Tsun, Chen Wei-Liang, Wu Li-Wei
Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Oncotarget. 2017 Jul 19;9(1):1311-1325. doi: 10.18632/oncotarget.19372. eCollection 2018 Jan 2.
Gamma gap is the difference in total serum proteins and albumin and an elevated gamma gap is related to infections, malignancy, and rheumatic diseases. An elevated gamma gap is also associated with higher mortality due to the correlation with inflammatory status. The study aimed to utilize mid-arm muscle circumference (MAMC) to assist in predicting all-cause mortality, cancer mortality, and cardiovascular mortality in people with elevated gamma gaps. Data were obtained from the third U.S. National Health and Nutrition Examination Survey (1988-1994), which contained 14,011 adults aged 20 to 90 years during up to 14.3 years of follow-up. The Primary analysis examined MAMC in tertiles and revealed the demographic and characteristics of the study population. Receiver operating characteristic curve analysis was used and the most suitable cut-off point of gamma gap was 3.65 g/dl. The secondary analysis employed Cox proportional hazards models stratified by age, gender and body mass index to evaluate the hazard ratios for all-cause mortality, cancer mortality, and cardiovascular mortality associated with the MAMC. As the MAMC tertiles increased in group with gamma gap ≥ 3.65 g/dl, individuals with elder age (60-90 years), normal range of body mass index (19-24.9 kg/m), and male gender tended to have lower hazard ratios for all-cause mortality, cancer mortality, and cardiovascular mortality. These substantial findings indicate that higher MAMC may be a protective factor of all cause-mortality, cancer mortality, and cardiovascular mortality among older male with normal body mass index and elevated gamma gaps.
γ间隙是血清总蛋白与白蛋白的差值，γ间隙升高与感染、恶性肿瘤和风湿性疾病有关。由于与炎症状态相关，γ间隙升高还与较高的死亡率相关。该研究旨在利用上臂中部肌肉周长（MAMC）来辅助预测γ间隙升高人群的全因死亡率、癌症死亡率和心血管死亡率。数据来自美国第三次国家健康和营养检查调查（1988 - 1994年），该调查包含14011名年龄在20至90岁的成年人，随访时间长达14.3年。初步分析按三分位数检查MAMC，并揭示了研究人群的人口统计学特征。采用受试者工作特征曲线分析，γ间隙最合适的截断点为3.65 g/dl。二次分析采用按年龄、性别和体重指数分层的Cox比例风险模型，以评估与MAMC相关的全因死亡率、癌症死亡率和心血管死亡率的风险比。在γ间隙≥3.65 g/dl的组中，随着MAMC三分位数的增加，年龄较大（60 - 90岁）、体重指数在正常范围（19 - 24.9 kg/m²）且为男性的个体全因死亡率、癌症死亡率和心血管死亡率的风险比往往较低。这些重要发现表明，较高的MAMC可能是体重指数正常且γ间隙升高的老年男性全因死亡率、癌症死亡率和心血管死亡率的保护因素。
