The Association of Subscapular Skinfold with All-Cause, Cardiovascular and Cerebrovascular Mortality

Abstract

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

Data Sharing Statement

The datasets analyzed during the current study are publicly available at https://www.cdc.gov/nchs/nhanes/index.htm.

Ethics Approval and Informed Consent

The survey protocol was approved by the Institutional Review Board of the Centers for Disease Control and Prevention (Protocol #98-12, Protocol #2005-06, Continuation of Protocol #2005-06, Protocol #2011-17). Written informed consent was obtained from all subjects.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by the Science and Technology Program of Guangzhou (No.201604020143 and No.201803040012), and the National Key Research and Development Program of China (No.2017YFC1307603, No.2016YFC1301305), and the Key Area R&D Program of Guangdong Province (No.2019B020227005).