Each 1 cm increase in arm circumference was linked to an 8% higher prevalence of gallstone disease, according to a recent study.
In the study, published in Frontiers in Medicine, investigators conducted a retrospective analysis to examine the association between arm circumference (AC) and gallstone disease (GS) prevalence in U.S. adults. They utilized data from the 2017 to 2020 National Health and Nutrition Examination Survey (NHANES) cycle. A total of 8,081 participants were included, with 849 reporting a history of GS based on self-reported medical history. AC, measured following standardized protocols, was analyzed as the primary exposure variable. Multivariable logistic regression models were employed to assess the association between AC and GS prevalence, adjusting for demographic characteristics, metabolic factors, and comorbidities. Dose-response relationships were evaluated using generalized additive models with smooth curve fitting, while subgroup analyses were conducted to explore effect modification by age, sex, race, body mass index, hypertension, and diabetes.
The analysis demonstrated a positive and linear relationship between AC and GS prevalence. Each 1 cm increase in AC was associated with an 8% increase in GS prevalence (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 1.07–1.10). When categorized into tertiles, participants in the highest AC tertile exhibited a 2.43-fold greater prevalence of GS compared with those in the lowest tertile (OR = 2.43, 95% CI = 1.91–3.10). Subgroup analyses revealed that the association was more pronounced in younger participants aged 20 to 39 years (OR = 1.11, 95% CI = 1.08–1.14) compared with those aged 60 to 80 years (OR = 1.05, 95% CI = 1.03–1.08; P for interaction = .006). The association was also stronger in women (OR = 1.10, 95% CI = 1.08–1.11) compared with in men (OR = 1.06, 95% CI = 1.02–1.09; P for interaction = .001). Racial subgroup analysis showed the highest odds of GS in non-Hispanic White participants (OR = 1.08, 95% CI = 1.06–1.11). The association remained significant regardless of diabetes or hypertension status, although it was slightly stronger in participants without diabetes (OR = 1.09, 95% CI = 1.07–1.11).
Because of the cross-sectional nature of the study, the investigators could not determine whether arm circumference directly influenced gallstone disease risk. Additionally, reliance on self-reported gallstone history may have introduced recall bias, arm circumference was measured only once, and residual confounding couldn't be ruled out despite statistical adjustments.
While the study’s cross-sectional design precluded causal inference, the findings suggested an association between AC and GS prevalence. Further research is needed to determine its clinical relevance in metabolic health assessment and disease risk stratification. Additionally, because NHANES data rely on self-reported GS history, recall bias may have been present.
Full disclosures can be found in the published study.
