Wang Xiaoxiao, Ying Youyou, Pei Minyue, Ma Xinjie, Sun Yuehao, Wang Yupeng, Li Nan
Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
Clin Nutr. 2023 Mar;42(3):277-281. doi: 10.1016/j.clnu.2023.01.002. Epub 2023 Jan 7.
Previous studies have described an association between single time point calf circumference (CC) and mortality. Evidence of associations between CC change and mortality is lacking. We aimed to determine the relationship between the CC change over time and all-cause mortality.
We conducted a retrospective cohort study of 906 participants in the 2014-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Restricted cubic splines were used to analyze associations between the relative CC change (exposure) and all-cause mortality (primary outcome). When there was evidence of non-linearity, a piecewise Cox regression model was next fitted, adjusting for sociodemographic characteristics, health behaviours, health status and baseline CC.
The mean (SD) age was 83.8 (12.2) years old, and 50.2% (455/906) of participants were male. We observed a U-shaped association between the relative CC change (%) and all-cause mortality (P for non-linearity <0.001). Participants with stable CC over time had the lowest risk of death. After adjusting for covariates, when CC decreased over time, the hazard ratio per 10% higher in CC change was 1.32 (1.01-1.69). When CC increased over time, the hazard ratio per 10% higher in CC change was 1.35 (1.10-1.66).
Stable CC over time was associated with the lowest mortality risk. Our findings indicate the practical significance of monitoring CC change in older adult.
既往研究描述了单次测量的小腿围度（CC）与死亡率之间的关联。但缺乏CC变化与死亡率之间关联的证据。我们旨在确定随时间变化的CC与全因死亡率之间的关系。
我们对2014 - 2018年中国老年健康长寿纵向调查（CLHLS）中的906名参与者进行了一项回顾性队列研究。使用受限立方样条来分析相对CC变化（暴露因素）与全因死亡率（主要结局）之间的关联。当有非线性证据时，接下来拟合分段Cox回归模型，并对社会人口学特征、健康行为、健康状况和基线CC进行调整。
平均（标准差）年龄为83.8（12.2）岁，50.2%（455/906）的参与者为男性。我们观察到相对CC变化（%）与全因死亡率之间呈U形关联（非线性P<0.001）。随时间CC稳定的参与者死亡风险最低。在调整协变量后，当CC随时间下降时，CC变化每升高10%，风险比为1.32（1.01 - 1.69）。当CC随时间升高时，CC变化每升高10%，风险比为1.35（1.10 - 1.66）。
随时间稳定的CC与最低的死亡风险相关。我们的研究结果表明监测老年人CC变化具有实际意义。
