{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:55:27Z","timestamp":1787237727332,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Appendicular circumferences (ACs) are critical predictors of skeletal health, cardiovascular disease risk and mortality. Currently, comprehensive reference values and associated factors for thigh (TC), calf (CC), upper arm (UAC) and forearm (FC) circumferences remain unestablished in Chinese adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This community\u2010based cross\u2010sectional study (China National Health Survey, April\u20092023\u2013November 2024) enrolled 8915 adults (\u226520\u2009years) for reference value development and 10\u2009632 for association analysis. ACs were measured via 3D scanning, body composition via bioelectrical impedance analysis and handgrip strength using a Jamar dynamometer. Sex\u2010specific centile curves (P2.5\u2013P97.5) were generated using lambda\u2010mu\u2010sigma methods. Propensity score matching balanced age distributions for sex and menopause subgroup comparisons. Multivariate logistic regression was used to examine factors associated with low appendicular circumference (lowest 5th percentile).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median (25th and 75th) values for men were TC: 59.27\u2009cm (55.09, 64.18), CC: 39.20\u2009cm (37.17, 41.59), UAC: 28.31\u2009cm (26.75, 30.10) and FC: 27.02\u2009cm (25.67, 28.29); for women, TC: 52.45\u2009cm (49.50, 55.74), CC: 35.71\u2009cm (33.95, 37.76), UAC: 27.71\u2009cm (25.74, 30.10) and FC: 24.64\u2009cm (23.33, 26.07). Age trajectories showed sex\u2010specific patterns: TC, CC and UAC peaked at 20\u201329\u2009years with subsequent decline, while FC peaked at 40\u201349\u2009years. BMI\u2010adjusted circumferences exhibited divergent aging trajectories by sex. Postmenopausal women had significantly lower appendicular skeletal muscle mass (ASM), appendicular skeletal muscle mass index (ASMI), handgrip strength and CC than age\u2010matched premenopausal women (all\n                      <jats:italic>p<\/jats:italic>\n                      values &lt;\u20090.05). All ACs strongly correlated with muscle mass, fat mass and muscle strength (all\n                      <jats:italic>p<\/jats:italic>\n                      values &lt;\u20090.001), with UAC and FC showing the strongest ASM and ASMI correlations in men (correlation coefficient: 0.757 and 0.735). Factors associated with low ACs included rural residence, lower education, low BMI, elevated body fat (positively linked to low CC, especially \u2265\u200960\u2009years) and cardiometabolic disorders (diabetes, hypertension, hyperuricemia, dyslipidemia).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study establishes the first age\u2010 and sex\u2010stratified percentile references for ACs in Chinese adults. These results reveal significant sex disparities in absolute and BMI\u2010adjusted measures, providing essential tools for sarcopenia screening, lifestyle intervention evaluation and high\u2010risk population identification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70135","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:42:40Z","timestamp":1763358160000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["3D Body Scanning\u2013Derived Normative Values of Appendicular Circumferences: A Novel Tool for Sarcopenia Screening in Chinese Adults"],"prefix":"10.1002","volume":"16","author":[{"given":"Huijing","family":"He","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Statistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &amp; School of Basic Medicine, Peking Union Medical College  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaolu","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &amp; School of Basic Medicine, Peking Union Medical College  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &amp; School of Basic Medicine, Peking Union Medical College  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaoda","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &amp; School of Basic Medicine, Peking Union Medical College  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiming","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &amp; School of Basic Medicine, Peking Union Medical College  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &amp; School of Basic Medicine, Peking Union Medical College  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &amp; School of Basic Medicine, Peking Union Medical College  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &amp; 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