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Barcın-Güzeldere HK, Aksoy M, Demircan T, Yavuz M, Beler M. Association between the anthropometric measurements and dietary habits on telomere shortening in healthy older adults: A-cross-sectional study. Geriatr Gerontol Int 2023. [PMID: 37329271 DOI: 10.1111/ggi.14620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/22/2023] [Accepted: 05/28/2023] [Indexed: 06/19/2023]
Abstract
AIM This study aimed to evaluate the effect of anthropometric measurements and dietary habits on telomere length in healthy older residents in rural and urban areas. METHODS This was a cross-sectional study. The study population included 81 healthy older individuals aged ≥80 years. A quantitative food frequency questionnaire was used to determine dietary habits. Anthropometric measurements were taken by researchers. The telomere length of individuals was determined from leukocytes using quantitative polymerase chain reaction. RESULTS Urban women had longer telomeres than rural women (P < 0.05). Rural men had significantly higher hip circumference, middle-upper arm circumference and fat-free mass than urban men (P < 0.05). It was shown that while fresh vegetable consumption was higher in rural areas, carbonated drink consumption was higher in urban areas (P < 0.05). In women, homemade bread and sugar consumption were higher in rural areas, and honey consumption was higher in urban (P < 0.05). Red meat, milk-based dessert and pastry consumption explain telomere shortening by 22.5%, 24.8% and 17.9%, respectively. In addition, the model based on anthropometric measurements also contributes to explaining telomere shortening by 42.9%. CONCLUSION Red meat, milk-based dessert and pastry consumption, and waist circumference, hip circumference, waist-to-hip ratio and waist-to-height ratio are associated with telomere length. Longer telomeres are associated with a healthy, balanced, adequate diet and maintaining a healthy body weight/proportion, and they are crucial for achieving healthy aging. Geriatr Gerontol Int 2023; ••: ••-••.
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Affiliation(s)
- Hatice Kübra Barcın-Güzeldere
- Department of Nutrition and Dietetic, Istanbul Medeniyet University, Istanbul, Turkey
- Institue of Health Science, Istanbul Medipol University, Istanbul, Turkey
| | | | - Turan Demircan
- School of Medicine, Department of Medical Biology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Mervenur Yavuz
- Institute of Health Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Mahmut Beler
- Fethiye School of Health Service, Muğla Sıtkı Koçman University, Fethiye, Turkey
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Abstract
BACKGROUND Recommendations in current guidelines on the use of calf circumference (CC) as a diagnostic measure in sarcopenia is conflicting. In this study, we incorporated CC into conventional models of sarcopenia and compared their predictive scores on mortality. OBJECTIVE To clarify the predictive capacity of CC-added models of sarcopenia on and establish the correlation of CC with mortality risk. DESIGN, SETTING AND SUBJECTS From the National Health and Nutrition Examination Survey 1999-2002, 2,532 participants aged 50-85 and comprising 51.7% male were included. METHODS Our definitions contained four sarcopenic components, low CC (C), low muscle strength (S), low muscle mass (M) and low gait speed (G). Cox proportional hazard models and the receiver-operator characteristic curves for all-cause, cardiovascular (CV) and cancer mortality were conducted to compare the different sarcopenia definitions. RESULTS For all-cause mortality, the hazard ratio (HR) of C + S + M + G was 15.062, which was substantially higher than the conventional definition S + M + G (HR = 6.433). Other CC-added definitions such as C + M (HR = 2.260), C + G (HR = 4.978), C + S + M (HR = 5.761) also revealed higher HR than their without-CC counterparts. Similar patterns were observed in CV mortality, for instance, HR of C + S + M + G was 31.812 comparing to the conventional definition S + M + G (HR = 18.434). Concerning accuracy in predicting mortality, the area under the curve (AUC) of CC + S + G + M (AUC = 0.702) and C + S + G (AUC = 0.708) were higher than the conventional definition S + G + M (AUC = 0.697). A significant correlation was found between CC and each of the three conventional components of sarcopenia. CONCLUSIONS CC-added definitions of sarcopenia correlated with higher all-cause and CV mortality risks. CC is potentially a simple but valuable screening tool for sarcopenia that could improve diagnostic accuracy when used with other parameters.
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Affiliation(s)
- Shou-En Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan 11490, 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 11490, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan 11490, 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 11490, Republic of China
- Department of Biochemistry, National Defense Medical Center, Taiwan 11490, Republic of China
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Li X, Lang X, Peng S, Ding L, Li S, Li Y, Yin L, Liu X. Calf Circumference and All-Cause Mortality: A Systematic Review and Meta-Analysis Based on Trend Estimation Approaches. J Nutr Health Aging 2022; 26:826-838. [PMID: 36156674 DOI: 10.1007/s12603-022-1838-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To perform a systematic review and meta-analysis and quantify the associations of total mortality with calf circumference (CC) in adults 18 years and older via combining various analyses based on empirical dichotomic CC, continuous CC, and dose-response CC. METHODS We conducted a systematic search of relevant studies in PubMed, EMBASE, Cochrane Library, and Web of Science published through April 12, 2022. This systematic review includes longitudinal observational studies reporting the relationships of total mortality with CC. We calculated the pooled relative risk (RR) and 95% confidence interval (CI) of total mortality with CC per 1 cm for each study and combined the values using standard meta-analysis approaches. Newcastle-Ottawa scale (NOS), Grading of Recommendations, Assessment, Development and Evaluations approach (GRADE), and the Instrument for assessing the Credibility of Effect Modification Analyses (ICEMAN) were assessed for meta-analyses. RESULTS Our analysis included a total of 37 cohort studies involving 62,736 participants, across which moderate heterogeneity was observed (I2=75.7%, P<0.001), but no publication bias was found. Study quality scores ranged from 6 to 9 (mean 7.7), with only three studies awarded a score of 6 (fair quality). We observed an inverse trend between total death risk and CC per 1 cm increase (RR, 0.95, 95% CI, 0.94-0.96; P<0.001; GRADE quality=high). Only a very slight difference was found among residents of nursing homes (6.9% mortality risk reduction per one cm CC increase), community-dwellers (5.4%), and those living in hospitals (4.8%), respectively (P for meta-regression=0.617). Low credible subgroup difference was found based on the ICEMAN tool. CONCLUSIONS Calf circumference is a valid anthropometric measure for mortality risk prediction in a community, nursing home, or hospital.
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Affiliation(s)
- X Li
- Lu Yin, Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Beijing 102300, China. E-mail: ; Xiaomei Liu, Department of Emergency, Zhongshan Hospital of Xiamen University, Xiamen, China. Tel:
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Hsiang CH, Wu CJ, Kao TW, Chen WL. Calf circumference and risk of cardiovascular disease. Geriatr Gerontol Int 2020; 20:1133-1137. [PMID: 33009856 DOI: 10.1111/ggi.14052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/08/2020] [Accepted: 09/17/2020] [Indexed: 01/06/2023]
Abstract
AIM Calf circumference (CC) is an anthropometric parameter that is easily obtained. Increasingly, research has shown that CC related to cardiovascular events. We aimed to determine the correlation between CC and Framingham risk score (FRS) for the 10-year cardiovascular disease risk assessment in Taiwanese elderly aged ≥65 years. METHODS We included 540 men and 683 women aged ≥65 years. All participants and data were collected from geriatric physical screenings in Tri-Service General Hospital in Taiwan during 2017. The correlation between CC and FRS-coronary heart disease (CHD) were calculated. We used multivariate regression models to investigate the correlation between CC and FRS-CHD. Covariate adjustments were investigated by performing an extended model. RESULTS A significantly negative association was observed between FRS-CHD and CC in both genders in both models (all P < 0.05). Male and female participants were divided into quartiles at the CC level (Q1-Q4) and we compared their baseline characteristics separately. We further explored the association between CC divided in quartiles and the FRS-CHD, which exhibited a significant negative correlation comparing the largest quartiles with the first quartile in a fully adjusted model in both genders (P < 0.05). In addition, the higher quartiles of CC seemed to have a lower FRS-CHD with statistical significance (P for trend <0.05). DISCUSSION CC had a strongly negative correlation with FRS-CHD in both genders. In the future, CC might be an applicable tool in geriatric research in Taiwan for the early detection of developing cardiovascular events. Geriatr Gerontol Int 2020; 20: 1133-1137.
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Affiliation(s)
- Chih-Hsuan Hsiang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan.,Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan
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Chao YP, Kao TW, Chang YW, Peng TC, Chen WL, Wu LW. Utilization of anthropometric parameters as a novel tool for detection of insulin resistance. Clin Nutr 2019; 39:2571-2579. [PMID: 31812468 DOI: 10.1016/j.clnu.2019.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 11/02/2019] [Accepted: 11/10/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Anthropometric parameters have been widely applied in evaluating muscle mass, insulin resistance (IR), and cardiometabolic diseases. Arm circumference (AC) and calf circumference (CC) are used as informative markers for sarcopenia. However, few studies concern the correlation between AC, CC and IR. The aim of the present survey is to investigate the relationship between AC, CC and homeostatic model assessment of insulin resistance (HOMA-IR). METHODS This cross-sectional observational study included 11,527 participants aged 40-85 years from the National Health and Nutrition Examination Survey (NHANES), 1999 to 2006. We divided the participants into male and female groups. Each group was then divided into four subgroups depending on their AC and CC levels. RESULTS After adjustment for multiple covariates, we observed a significant negative correlation between the CC and HOMA-IR. This study showed a significant positive correlation between the AC and HOMA-IR after multiple adjustments. Subjects in the highest CC quartiles tended to have the lowest HOMA-IR in both male and female group (P for trend <0.001 in all models). CONCLUSIONS CC may be a novel tool to guide public health policy and clinical predictor of IR in middle-aged and older people.
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Affiliation(s)
- Yuan-Ping Chao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, 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, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yaw-Wen Chang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, 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, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, 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, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, 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, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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Wu CJ, Kao TW, Chen YY, Yang HF, Chen WL. Peripheral fat distribution versus waist circumference for predicting mortality in metabolic syndrome. Diabetes Metab Res Rev 2019; 35:e3116. [PMID: 30548993 DOI: 10.1002/dmrr.3116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/16/2018] [Accepted: 11/30/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To elucidate whether the peripheral fat (PF)-combined definition of metabolic syndrome (MetS) would show a better predictive ability for cause-specific mortality than the common MetS. METHODS Data were derived from the National Health and Nutrition Examination Survey from 1999 through 2002. We investigated three types of MetS including waist circumference MetS (WCMetS), PFMetS, and PF-combined definition of MetS. The main outcome was to evaluate the predictive ability of the newly defined MetS for time to cause-specific mortality. The secondary outcomes were the relationships between the PF percentage and C-reactive protein (CRP) and homeostasis model assessment of insulin resistance (HOMA-IR) to clarify the gender discrepancy. RESULTS For cardiovascular mortality, the adjusted hazard ratios for WCMetS, PFMetS, and PF-combined definition MetS were 1.867, 1.742, and 2.117, respectively (all P < 0.001). A positive association between PF percentage and CRP in men and a negative correlation between PF percentage and HOMA-IR in women after adjustment for all variates were found. CONCLUSIONS The PF-combined definition of MetS had a stronger predictive ability for all-cause and cardiovascular mortality than general MetS. Notably, the PF might have differential gender-specific health effects on cardiovascular events.
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Affiliation(s)
- Chen-Jung Wu
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Wu CJ, Kao TW, Chen YY, Peng TC, Wang CC, Zhou YC, Yang HF, Chen WL. Examining the association between vestibular function and lower extremity circumference in an aged population. Geriatr Gerontol Int 2019; 19:622-627. [PMID: 31025472 DOI: 10.1111/ggi.13679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/20/2019] [Accepted: 04/03/2019] [Indexed: 01/01/2023]
Abstract
AIM To explore the association between vestibular dysfunction and specific anthropometric parameters. METHODS The results from 2420 participants of the 1999-2004 National Health and Nutrition Examination Survey were included for the evaluation of vestibular dysfunction using the Romberg test of standing balance and anthropometric measurements, including waist circumference, thigh circumference, calf circumference (CC), waist-to-thigh ratio (WTR) and waist-to-calf ratio (WCR). Passing the balance test was defined as participants keeping their balance for 30 s while in the standing position with their eyes closed. Multivariable logistic regression models were the main statistical tools in the present study. RESULTS The mean age of the participants was approximately 65 years, and half of the study participants were men. The full adjusted odds ratio of vestibular dysfunction for the CC, thigh circumference, WCR and WTR was 0.941 (95% confidence interval [CI], 0.894-0.992), 0.948 (95% CI 0.912-0.986), 1.856 (95% CI 1.087-3.170) and 2.516 (95% CI 1.235-5.126), respectively. Higher waist circumference along with lower thigh circumference and CC were observed in the participants in the higher WTR and WCR quartiles. Furthermore, a dose-response relationship between vestibular dysfunction and anthropometric ratios was detected. DISCUSSION The present study showed that individuals with lower CC and thigh circumference or higher WCR and WTR exhibited higher odds of having vestibular dysfunction. Geriatr Gerontol Int 2019; 19: 622-627.
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Affiliation(s)
- Chen-Jung Wu
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chao Zhou
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
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Wu CJ, Kao TW, Chang YW, Peng TC, Wu LW, Yang HF, Chen WL. Does the Additional Component of Calf Circumference Refine Metabolic Syndrome in Correlating With Cardiovascular Risk? J Clin Endocrinol Metab 2018; 103:1151-1160. [PMID: 29346655 DOI: 10.1210/jc.2017-02320] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/10/2018] [Indexed: 01/10/2023]
Abstract
CONTEXT Calf circumference (CC) was a useful anthropometric tool, but there was limited study on the effect of CC on metabolic syndrome (MetS) for cardiovascular risk. OBJECTIVE The objective of our study was to determine whether adding CC as a component of MetS refined correlating MetS with cardiovascular, all-cause, and cancer mortality risks. DESIGN, SETTING, PATIENTS, AND INTERVENTIONS From the National Health and Nutrition Examination Survey data set for 1999 through 2002, we analyzed four types of MetS: (1) increased waist circumference and two or more of four MetS components (WaistMetS); (2) decreased CC and two or more of four MetS components (CalfMetS); (3) increased waist-to-calf ratio and two or more of four MetS components (WCRMetS); and (4) decreased CC and three or more of five MetS components (CC+MetS). PRIMARY OUTCOME MEASURE The cause-specific hazard ratios were measured as categorized by the four types of MetS. RESULTS For cardiovascular mortality, the adjusted hazard ratios for WaistMetS, CalfMetS, WCRMetS, and CC+MetS were 1.867, 1.871, 1.949, and 2.306, respectively (all P < 0.001). Notably, CalfMetS showed the strongest positive correlation with serum C-reactive protein levels, and WCRMetS had the strongest positive relationship with homeostasis model assessment of insulin resistance. CONCLUSIONS Adding CC to the components of MetS correlated with higher cardiovascular and all-cause mortality risk than the traditional definition of MetS.
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Affiliation(s)
- Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- 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, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yaw-Wen Chang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- 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, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- 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, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- 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, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- 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, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- 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, Taipei, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Chen YY, Kao TW, Chou CW, Wu CJ, Yang HF, Lai CH, Wu LW, Chen WL. Exploring the Link between Serum Phosphate Levels and Low Muscle Strength, Dynapenia, and Sarcopenia. Sci Rep 2018; 8:3573. [PMID: 29476104 DOI: 10.1038/s41598-018-21784-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 02/09/2018] [Indexed: 11/09/2022] Open
Abstract
Emerging evidences addressed an association between phosphate and muscle function. Because little attention was focused on this issue, the objective of our study was to explore the relationship of phosphate with muscle strength, dynapenia, and sarcopenia. From the National Health and Nutrition Examination Survey, a total of 7421 participants aged 20 years or older were included in our study with comprehensive examinations included anthropometric parameters, strength of the quadriceps muscle, and appendicular lean masses. Within the normal range of serum phosphate, we used quartile-based analyses to determine the potential relationships of serum phosphate with dynapenia, and sarcopenia through multivariate regression models. After adjusting for the pertinent variables, an inverse association between the serum phosphate quartiles and muscle strength was observed and the linear association was stronger than other anthropometric parameters. Notably, the significant association between phosphate and muscle strength was existed in >65 years old age group, not in 20-65 years old. The higher quartiles of phosphate had higher likelihood for predicting the presence of dynapenia rather than sarcopenia in entire population. Our study highlighted that higher quartiles of phosphate had significant association with lower muscle strength and higher risks for predicting the presence of dynapenia.
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