Mid-Arm Circumference and All-Cause, Cardiovascular, and Cancer Mortality among Obese and Non-Obese US Adults: the National Health and Nutrition Examination Survey III

Epidemiological studies have shown that mid-arm circumference (MAC) can be used to predict death risk and malnutrition. We performed a retrospective observational study involving 11,958 US participants aged 20-90 years from the National Health and Nutrition Examination Survey III, 1988-1994, to determine the correlation between MAC and all-cause, cardiovascular, and cancer mortality risk in the obese and non-obese population. Death certificate data were obtained up to 2006. The participants were divided into three groups on the basis of body mass index: 19 <= BMI < 25 kg/m2 (normal weight group), 25 <= BMI < 30 kg/m(2) (overweight group) and BMI >= 30 kg/m(2) (obesity group); each group was then divided into three subgroups depending on their MAC level. In the nonobese population, MAC was inversely associated with all-cause mortality; specifically, in the normal weight group, the multivariate-adjusted hazard ratio of the T3 (29.6-42.0) cm subgroup was 0.72 (95% confidence interval: 0.58-0.90) when compared with the T1 (18.0-27.2) cm, while the multivariateadjusted hazard ratio of the T2 (27.3-29.5) cm subgroup was 0.76 (95% confidence interval: 0.64-0.91) when compared with the T1 (18.0-27.2) cm subgroup. The results indicate that MAC is inversely associated with all-cause mortality in non-obese individuals in the United States.