The Association of Subscapular Skinfold with All-Cause, Cardiovascular and Cerebrovascular Mortality
Received 12 May 2020
Accepted for publication 16 July 2020
Published 30 July 2020 Volume 2020:13 Pages 955—963
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Marco Carotenuto
Xiao-Cong Liu, 1 Lin Liu, 1 Yu-Ling Yu, 1 Jia-Yi Huang, 1 Chao-Lei Chen, 1 Kenneth Lo, 2 Yu-Qing Huang, 1 Ying-Qing Feng 1
1Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, People’s Republic of China; 2Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, RI, USA
Correspondence: Yu-Qing Huang; Ying-Qing Feng
Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, People’s Republic of China
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Purpose: Previous studies suggested inconsistent relationship between subscapular skinfold and all-cause, cardiovascular, and cerebrovascular mortality. Therefore, the present study aimed to investigate the associations between subscapular skinfold with all-cause, cardiovascular, and cerebrovascular mortality.
Patients and Methods: Data were collected from the National Health and Nutrition Examination Survey (NHANES, 1999– 2006) with follow-up data through 31 December 2015. Participants were categorized by subscapular skinfold quartiles. The hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated using the multivariate Cox regression model and subgroup analysis. Kaplan–Meier curves were used to present cause-specific mortalities and used Cox cubic regression splines to examine the association of subscapular skinfold with cause-specific mortalities.
Results: A total of 16,402 subjects (49.61% male) were involved in our study. After a mean follow-up of 141.73 months, there were 3078 (18.77%), 392 (2.39%), and 128 (0.78%) cases of all-cause, cardiovascular, and cerebrovascular mortality, respectively. Participants in the highest quartile of subscapular skinfold (≥ 24.80mm) versus the lowest (< 13.20mm) had lower risk for all-cause mortality (HR, 0.71; 95% CI, 0.57– 0.89; P for trend = 0.007) and cardiovascular mortality (HR, 0.44; 95% CI, 0.23– 0.83; P for trend = 0.023) in the fully adjusted model. In the age-stratified analysis, subscapular skinfold was only inversely associated with all-cause and cardiovascular disease mortality in people ≥ 65 years of age (all P-interaction < 0.001). No significant difference was found between subscapular skinfold and cerebrovascular mortality (all P > 0.05).
Conclusion: Subscapular skinfold showed an inverse association with all-cause and cardiovascular disease mortality in people aged ≥ 65 years.
Keywords: all-cause mortality, cardiovascular disease, cerebrovascular disease, NHANES, subscapular skinfold
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