Protective Role of Calf Circumference against Prediabetes and Prehypertension among Workers in Kano State, Nigeria

Calf circumference is an easy, cheap, and noninvasive method of assessing peripheral muscle and fat mass.It has been associated with cardiometabolic disease.This study aims to test the null hypothesis that, compared to the highest quartile/tertile, the lower quartiles/tertiles of calf circumference were not associated with a higher risk of prediabetes and prehypertension.In this cross-sectional study of students of the School of Continuing Education of Bayero University Kano, 58 prediabetic and 200 prehypertensive subjects were age-matched with an equal number of controls.Subjects were selected using a multi-stage sampling technique.Body height was measured using a portable stadiometer (Seca, Germany), and circumferences (waist, hip and calf) were measured using an inelastic measuring tape (MEDLINE, USA).Prediabetes was determined by measuring glycosylated haemoglobin levels using a fluorescence immunoassay system (Finecaretm, China) and blood pressure using a mercury sphygmomanometer (Accoson, England).Bayesian multilevel models of prediabetes and prehypertension odds ratios were fitted using the brms R package with calf circumference tertiles/quartiles as predictors, controlling for body mass index and waist-to-hip ratio.For the adjusted model, the odds ratios of prediabetes for the first and 3rd quartiles of calf circumference compared to the 4th were respectively found to be 1.15 [95% CrI: 0.35-3.91,Pnull = 0.4, evidence ratio in favor of alternative hypothesis = 1.5 ] and 1.48 [95% CrI: 0.52-4.05,Pnull = 0.23, evidence ratio in favour of alternative hypothesis = 3.4].The odds ratios of prediabetes for the 2nd quartile of calf circumference compared to the fourth were 0.89 [95% CI: 0.36, 2.22, Pnull = 0.61, evidence ratio in favour of alternative hypothesis = 0.6].The odds ratios of prehypertension for the 1st tertile of calf circumference compared to the 3rd were 1.76 [95% CI: 0.55, 5.87, Pnull = 0.18, evidence ratio in favour of alternative hypothesis = 4].The odds ratios of prehypertension for the 2nd tertile of calf circumference compared to the fourth were 0.58 [95% CI: 0.2, 1.61, Pnull = 0.86, evidence ratio in favour of alternative hypothesis = 0.6].In conclusion, calf circumference can be used as a cheap, easy, noninvasive prediabetes and prehypertension screening method.However, the non-linear relationship between calf circumference and the risk of prediabetes and prehypertension suggests a need for future studies to determine upper and lower cut-off values for calf circumference.