Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Front Endocrinol (Lausanne). 2022 Dec 23;13:1054671. doi: 10.3389/fendo.2022.1054671. eCollection 2022.
Body mass index (BMI) is a common indicator in clinical practice, but it is not sufficient to predict insulin resistance (IR). Other anthropometric methods supplement BMI in the assessment of body composition, which can be predicted more accurately. This cross-sectional study aimed to evaluate the association between mid-upper arm circumference (MUAC), triceps skinfold (TSF) thickness, mid-arm muscle circumference (MAMC) and IR in Chinese adults.
This cross-sectional study analyzed data from the 2009 China Health and Nutrition Survey database. The study population was divided into four groups according to the MUAC quartiles, and the homeostasis mode assessment was used to evaluate the degree of IR. Logistic regression analysis was performed to calculate odds ratios (ORs) with 95% confidence intervals (CIs), with adjustments for multiple covariates. Subgroup analyses stratified by age, sex, BMI, waist circumference (WC), smoking status, and alcohol consumption were performed.
In total, 8,070 participants were included in the analysis. As MUAC increased, BMI, TSF thickness, MAMC, and the proportion of IR tended to increase. However, we found that there was a significant negative association between MUAC and MAMC and IR in the logistic regression analysis, independent of BMI and WC, the ORs for the highest quartiles compared with the lowest quartiles were 0.662 (95%CI: 0.540-0.811) and 0.723 (95%CI: 0.609-0.860), respectively. There was no significant association was observed between the TSF thickness and IR (OR=1.035 [95%CI: 0.870-1.231]). The inverse associations were more pronounced among participants with lower BMI and WC. No significant age-specific differences were observed (P-heterogeneity > 0.05).
After adjusting for BMI and WC, MUAC was negatively associated with IR in Chinese adults, and the association between MUAC and IR was derived from arm muscle instead of subcutaneous fat. MUAC could be an additional predictor of IR besides BMI and WC in clinical practice.
体重指数（BMI）是临床实践中的常用指标，但它不足以预测胰岛素抵抗（IR）。其他人体测量方法在评估身体成分方面补充了 BMI，可以更准确地预测。本横断面研究旨在评估中国成年人中中上臂围（MUAC）、三头肌皮褶厚度（TSF）、上臂肌围（MAMC）与 IR 之间的关系。
本横断面研究分析了 2009 年中国健康与营养调查数据库的数据。根据 MUAC 四分位数将研究人群分为四组，采用稳态模型评估法评估 IR 程度。采用 logistic 回归分析计算优势比（OR）及其 95%置信区间（CI），并进行了多变量调整。按年龄、性别、BMI、腰围（WC）、吸烟状况和饮酒状况进行了亚组分析。
共纳入 8070 名参与者。随着 MUAC 的增加，BMI、TSF 厚度、MAMC 和 IR 的比例呈上升趋势。然而，我们发现 MUAC 与 MAMC 和 IR 之间存在显著的负相关，这在 logistic 回归分析中是独立于 BMI 和 WC 的，与最低四分位相比，最高四分位的 OR 分别为 0.662（95%CI：0.540-0.811）和 0.723（95%CI：0.609-0.860）。TSF 厚度与 IR 之间无显著相关性（OR=1.035 [95%CI：0.870-1.231]）。在 BMI 和 WC 较低的参与者中，这种负相关更为明显。未观察到年龄特异性差异（P 异质性>0.05）。
在校正 BMI 和 WC 后，MUAC 与中国成年人的 IR 呈负相关，MUAC 与 IR 的相关性源于手臂肌肉而非皮下脂肪。MUAC 可能是临床实践中除 BMI 和 WC 之外预测 IR 的另一个指标。
