A prospective study of arm circumference and risk of death in Bangladesh

Yu Chen, Wenzhen Ge, Faruque Parvez, Sripal Bangalore, Mahbub Eunus, Alauddin Ahmed, Tariqul Islam, Muhammad Rakibuz-Zaman, Rabiul Hasan, Maria Argos, Diane Levy, Golam Sarwar, Habibul Ahsan

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Abstract

Background: Epidemiological studies have observed protective effects of mid-upper arm circumference (MUAC) against all-cause mortality mostly in Western populations. However, evidence on cause-specific mortality is limited. Methods: The sample included 19 575 adults from a population-based cohort study in rural Bangladesh, who were followed up for an average of 7.9 years for mortality. Cox proportional hazards regression was used to evaluate the effect of MUAC, as well as the joint effect of body mass index (BMI) and MUAC, on the risk of death from any cause, cancer and cardiovascular disease (CVD). Results: During 154 664 person-years of follow-up, 744 deaths including 312 deaths due to CVD and 125 deaths due to cancer were observed. There was a linear inverse relationship of MUAC with total and CVD mortality. Each 1-cm increase in MUAC was associated a reduced risk of death from any cause [hazard ratio (HR)=0.85; 95% confidence interval (C), 0.81-0.89) and CVD (HR=0.87; 95% CI, 0.80-0.94), after controlling for potential confounders. No apparent relationship between MUAC and the risk of death from cancer was observed. Among individuals with a low BMI (<18.5 kg/m2), a MUAC less than 24 cm was associated with increased risk for all-cause (HR=1.81; 95% CI, 1.52-2.17) and CVD mortality (HR=1.45; 95% CI, 1.11-1.91). Conclusions: MUAC may play a critical role on all-cause and CVD mortality in lean Asians.

Original languageEnglish (US)
Article numberdyu082
Pages (from-to)1187-1196
Number of pages10
JournalInternational Journal of Epidemiology
Volume43
Issue number4
DOIs
StatePublished - Aug 2014

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Keywords

  • Cardiovascular diseases
  • Cohort study
  • Epidemiology
  • Mid-upper arm circumference (MUAC)
  • Mortality

ASJC Scopus subject areas

  • Epidemiology

Cite this

Chen, Y., Ge, W., Parvez, F., Bangalore, S., Eunus, M., Ahmed, A., Islam, T., Rakibuz-Zaman, M., Hasan, R., Argos, M., Levy, D., Sarwar, G., & Ahsan, H. (2014). A prospective study of arm circumference and risk of death in Bangladesh. International Journal of Epidemiology, 43(4), 1187-1196. [dyu082]. https://doi.org/10.1093/ije/dyu082