Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2024; 12(15): 2568-2577
Published online May 26, 2024. doi: 10.12998/wjcc.v12.i15.2568
Triceps skinfold thickness trajectories and the risk of all-cause mortality: A prospective cohort study
Na Yang, Li-Yun He, Zi-Yi Li, Yu-Cheng Yang, Fan Ping, Ling-Ling Xu, Wei Li, Hua-Bing Zhang, Yu-Xiu Li
Na Yang, Li-Yun He, Zi-Yi Li, Yu-Cheng Yang, Fan Ping, Ling-Ling Xu, Wei Li, Hua-Bing Zhang, Yu-Xiu Li, Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Co-corresponding authors: Hua-Bing Zhang and Yu-Xiu Li.
Author contributions: Zhang HB and Yang N conceived and designed the study; Yang N, He LY, and Yang YC conducted fieldwork, experiments, clinical activities, and data collection and compilation; Yang N, Zhang HB, and Li ZY analyzed and interpreted the data; all authors contributed to drafting the manuscript, revising it, and providing critique; Zhang HB and Li YX managed the overall and/or sectional scientific aspects of the study. As co-corresponding authors, Zhang HB and Li YX have equally contributed to all aspects of this manuscript, including conception, data analysis, drafting, and revision. The joint efforts Zhang HB and Li YX have been instrumental in ensuring the integrity and quality of the research presented.
Supported by National High Level Hospital Clinical Research Funding, No. 2022-PUMCH-B-015; CAMS Innovation Fund for Medical Sciences, No. 2021-1-12M-002; CAMS Innovation Fund for Medical Sciences, No. 2023-I2M-C&T-B-043; and Beijing Municipal Natural Science Foundation, No. M22014.
Institutional review board statement: The study was reviewed and approved by the University of North Carolina at Chapel Hill and the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: All data utilized in this study can be accessed through the official website of the China Health and Nutrition Survey (CHNS) and the website is https://www.cpc.unc.edu/projects/china.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hua-Bing Zhang, MD, Chief Doctor, Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing Street, Beijing 100730, China. huabingzhangchn@163.com
Received: February 5, 2024
Revised: April 2, 2024
Accepted: April 8, 2024
Published online: May 26, 2024
Abstract
BACKGROUND

The measurement of triceps skinfold (TSF) thickness serves as a noninvasive metric for evaluating subcutaneous fat distribution. Despite its clinical utility, the TSF thickness trajectories and their correlation with overall mortality have not been thoroughly investigated.

AIM

To explore TSF thickness trajectories of Chinese adults and to examine their associations with all-cause mortality.

METHODS

This study encompassed a cohort of 14747 adults sourced from the China Health and Nutrition Survey. Latent class trajectory modeling was employed to identify distinct trajectories of TSF thickness. Subjects were classified into subgroups reflective of their respective TSF thickness trajectory. We utilized multivariate Cox regression analyses and mediation examinations to explore the link between TSF thickness trajectory and overall mortality, including contributory factors.

RESULTS

Upon adjustment for multiple confounding factors, we discerned that males in the ‘Class 2: Thin–stable’ and ‘Class 3: Thin–moderate’ TSF thickness trajectories exhibited a markedly reduced risk of mortality from all causes in comparison to the ‘Class 1: Extremely thin’ subgroup. In the mediation analyses, the Geriatric Nutritional Risk Index was found to be a partial intermediary in the relationship between TSF thickness trajectories and mortality. For females, a lower TSF thickness pattern was significantly predictive of elevated all-cause mortality risk exclusively within the non-elderly cohort.

CONCLUSION

In males and non-elderly females, lower TSF thickness trajectories are significantly predictive of heightened mortality risk, independent of single-point TSF thickness, body mass index, and waist circumference.

Keywords: Triceps skinfold thickness, Trajectory, All-cause mortality, Body mass index, Geriatric Nutritional Risk Index

Core Tip: In this prospective cohort study, 14747 adults from the China Health and Nutrition Survey (1993-2015) were included and lower triceps skinfold (TSF) thickness trajectories in males and non-elderly females were significantly associated with an increased risk of all-cause mortality, independent of the one-point TSF thickness, body mass index, and waist circumference. When the TSF thickness in early adulthood was similar, even if the TSF thickness subsequently increased, there was no significant difference in the risk of all-cause mortality.