Combined effects of low calf circumference and vitamin D deficiency on all-cause mortality among community-dwelling older adults
10.3760/cma.j.issn.0254-9026.2023.07.018
- VernacularTitle:小腿围降低和维生素D缺乏对社区老年人全因死亡风险的联合作用
- Author:
Chi ZHANG
1
;
Yiwen HAN
;
Ji SHEN
;
Ruiqi LI
;
Surui YANG
;
Ping ZENG
Author Information
1. 北京医院 国家老年医学中心 国家卫生健康委北京老年医学研究所 国家卫生健康委老年医学重点实验室 中国医学科学院老年医学研究院,北京 100730
- Keywords:
Vitamin D;
Mortality;
Calf circumference
- From:
Chinese Journal of Geriatrics
2023;42(7):848-853
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the individual and combined effects of calf circumference and vitamin D levels on all-cause mortality risk in community-dwelling older adults based on the Chinese Longitudinal Healthy Longevity Survey.Methods:The calf circumference was measured in the baseline survey in 2012 and 2014.Low calf circumference was defined as <34 cm for men or 33 cm for women at screening.Vitamin D deficiency was defined as plasma 25-hydroxyvitamin D[25(OH)D]levels <50 nmol/L.All participants were followed up until 2018, when death outcomes and survival time were collected.Cox proportional hazard regression models were used to analyze the effects of calf circumference and 25(OH)D levels on the risk of all-cause mortality.Results:A total of 3 052 older adults were included in the analysis, of which 1 960(64.22%)had low calf circumference and 2 245(73.56%)had vitamin D deficiency.After 10 559.9 person-years of follow-up period, 1 312 death events were recorded.After adjusting for sociodemographic characteristics, physical activities, cognitive function, and multiple chronic diseases, calf circumference and 25(OH)D levels were negatively associated with the risk of all-cause mortality(both P<0.05). In the combined analysis, compared with the normal group, the risk of death was highest in the participants with both low calf circumference and vitamin D deficiency, which was higher than those with low calf circumference or vitamin D deficiency alone, with a hazard ratios( HR)(95% CI)of 2.51(1.81-3.45), 1.71(1.22-2.42)and 1.53(1.09-2.15), respectively.There was a significant additive interaction between low calf circumference and vitamin D deficiency on mortality(RERI>0). Conclusions:Low calf circumference and vitamin D deficiency are associated with higher mortality.Older adults with combined conditions had a even higher risk of death.Attention should be paid to joint screening and comprehensive intervention for older adults with both low calf circumference and vitamin D deficiency.