title: Mid-arm muscle circumference as a significant predictor of all-cause mortality in male individuals.
abstract: BACKGROUND
  Emerging evidences indicate that mid-arm muscle circumference (MAMC) is one of the anthropometric indicators that reflect health and nutritional status, but its correlative effectiveness in all-cause mortality prediction of United States individuals remains uncertain.
  We investigated the joint association between MAMC and all-cause mortality in the US general population. A population-based longitudinal study of 6,769 participants aged 40 to 90 years in the third National Health and Nutrition Examination Survey (NHANES III) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. All participants were divided into two groups based on the gender: male and female group; each group was then divided into three subgroups depending on their MAMC level. The tertiles were as follows: T1 (18<27.3), T2 (27.3<29.6), T3 (29.6≤40.0) cm in the male group and T1 (15<22.3), T2 (22.3<24.6), T3 (24.6≤44.0) cm in the female group. Multivariable Cox regression analyses and Kaplan-Meier survival probabilities were utilized to jointly relate all-cause mortality risk to different MAMC level. For all-cause mortality in male participants, multivariable adjusted hazard ratios (HRs) were 0.83 (95% confidence interval (CI): 0.69-0.98; p = 0.033) for MAMC of 27.3-29.6 cm compared with 18-27.3 cm, and 0.76 (95% CI: 0.61-0.95; p = 0.018) for MAMC of 29.6-40 cm compared with 18-27.3 cm. For all-cause mortality in female participants, multivariable adjusted hazard ratios (HRs) were 0.84 (95% confidence interval (CI): 0.69-1.02; p = 0.075) for MAMC of 22.3-24.6 cm compared with 15-22.3 cm, and 0.94 (95% CI: 0.75-1.17; p = 0.583) for MAMC of 24.6-44 cm compared with 15-22.3 cm.
  
  
  CONCLUSIONS
  Results support a lower MAMC is associated with a higher mortality risk in male individuals.
authors.affiliation: 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.|Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Wu
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.|Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors.forename: Yuan-Yung
authors.initials: YY
authors.lastname: Lin
authors.affiliation: 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.
authors.forename: Tung-Wei
authors.initials: TW
authors.lastname: Kao
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.|Department of Pediatrics, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Lin
authors.affiliation: 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.|Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors.forename: Fang-Yih
authors.initials: FY
authors.lastname: Liaw
authors.affiliation: 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.
authors.forename: Chung-Ching
authors.initials: CC
authors.lastname: Wang
authors.affiliation: 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.
authors.forename: Tao-Chun
authors.initials: TC
authors.lastname: Peng
authors.affiliation: 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.|Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors.forename: Wei-Liang
authors.initials: WL
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry / Q000379:methods; D001132:Arm / Q000033:anatomy & histology*; D015992:Body Mass Index; D002423:Cause of Death; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000033:anatomy & histology*; D009749:Nutrition Surveys / Q000706:statistics & numerical data; D009752:Nutritional Status; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012885:Skinfold Thickness