Is there an affiliation between waist-calf circumference ratio and all-cause and cause-specific mortality?

In a community-based cohort examine revealed in BMC Public Well being, researchers studied how anthropometric measures just like the waist-calf circumference ratio (WCR), waist circumference (WC), calf circumference (CC), and physique mass index (BMI) are related to cause-specific and all-cause mortality in aged adults.

They discovered {that a} decrease CC and better WCR are related to an elevated danger of heart problems (CVD), all-cause, and other-cause mortality.

Additional, whereas BMI was related to an elevated danger of respiratory illness and all-cause mortality, WC might assist predict most cancers mortality.

Study: Association of waist-calf circumference ratio, waist circumference, calf circumference, and body mass index with all-cause and cause-specific mortality in older adults: a cohort study. Image Credit: Zdenka Darula/Shutterstock.comExamine: Affiliation of waist-calf circumference ratio, waist circumference, calf circumference, and physique mass index with all-cause and cause-specific mortality in older adults: a cohort examine. Picture Credit score: Zdenka Darula/


Weight problems and central weight problems are each identified to be related to varied continual illnesses. Though BMI is a standard measure of weight problems used to foretell mortality, it doesn’t distinguish between fats and muscle mass and fails to account for physique fats distribution.

Whereas WC is strongly linked to CVD and mortality, it might not mirror physique composition precisely in older adults by itself.

Then again, CC, a marker of muscle mass, is reported to be related to a decrease mortality danger. Of those anthropometric measures, WCR has emerged as a promising metric of physique composition that evaluates central weight problems in addition to muscle mass. It’s a superior predictor of well being outcomes than different weight problems measures alone.

Nonetheless, there’s an absence of research investigating the hyperlink between WCR and mortality danger in older folks. This examine examined the affiliation between cause-specific and all-cause mortality and WCR amongst older adults.

Concerning the examine

On this examine, knowledge from 4,627 contributors above 65 years of age have been included from the continued Chinese language longitudinal wholesome longevity survey (2014) carried out in 22 provinces of China.

Over 52% of the contributors have been feminine, and the imply (±SD) age was 84.7 (±10.2) years. Parameters equivalent to their WC (centimeters), CC (centimeters), top (meters), and weight (kilograms) have been measured.

Whereas WCR was calculated because the ratio of WC and CC, BMI was calculated because the ratio of weight and squared top.

As the first final result, all causes and particular causes of mortality have been assessed, together with CVD, respiratory ailments, most cancers, and different causes, primarily based on the Worldwide Statistical Classification of Illnesses, tenth revision (ICD-10).

Covariates have been obtained through a structured questionnaire. R-based statistical analyses included utilizing a number of imputations by chained equations technique, Cox proportional hazards fashions to estimate hazard ratios (HRs), 95% confidence intervals (CIs) for mortality, and Kaplan–Meier survival evaluation. Sensitivity analyses have been carried out to validate the work.

Outcomes and dialogue

A complete of 1,671 deaths occurred within the median follow-up interval of three.5 years, amongst which 22.9% deaths have been from CVD, 5.3% from most cancers, 10.4% from respiratory ailments, and 61.5% from different causes.

It was noticed that WCR was larger in older, single, feminine, and single contributors, particularly those that didn’t train commonly and consumed fewer greens of their food regimen. The bottom survival possibilities have been present in contributors with the very best quartile of WCR or the bottom quartile of CC, WC, and BMI.

A number of mechanisms might doubtlessly clarify this affiliation of excessive WCR with mortality, together with central adiposity, resulting in insulin resistance, oxidative stress, dyslipidemia, and irritation.

All-cause, CVD, and other-cause mortality dangers have been larger within the third and fourth quartiles of WCR than within the second. Quite the opposite, the very best CC quartile was discovered to be related to a decreased danger of all-cause (HR 1.42), other-cause (1.37), and CVD (HR 1.88) mortality, as in comparison with the second, corroborating with present literature.

Whereas WC confirmed no vital affiliation with all-cause mortality, these contributors in its first and fourth quartiles confirmed larger HRs for most cancers mortality.

Moreover, people within the first quartile of BMI and CC had a better danger of all-cause mortality. The bottom BMI quartile confirmed a better danger for all-cause and respiratory illness mortality.

Moreover, the potential affiliation of CC with CVD and all-cause mortality was stronger in adults above 80 years in comparison with youthful (p < 0.05). Sensitivity analyses present that the outcomes remained constant even when contributors with preexisting circumstances and lacking covariate values have been excluded.

Though this investigation has a number of strengths, together with the simplicity of WCR as a measure, a potential design, and a big pattern dimension, additional analysis with an extended follow-up interval and evaluation of temporal modifications in physique composition could be helpful for doubtlessly confirming these findings.


These findings counsel that WCR and CC could also be higher predictors for all-cause and other-cause mortality than WC and BMI in older adults.

The alarming rise within the world prevalence of weight problems and its menace to public well being requires the continued identification and employment of strategies for predicting mortality danger and doubtlessly aiding remedy.

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