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. 2023 Oct 6:10:1200077.
doi: 10.3389/fnut.2023.1200077. eCollection 2023.

Mid-upper arm circumference as a screening tool for identifying underweight adolescents

Imad R Musa  1 , Saeed M Omar  2 , Ashwaq AlEed  3   4 , Abdullah Al-Nafeesah  3 , Ishag Adam  5
Affiliations

Mid-upper arm circumference as a screening tool for identifying underweight adolescents

Imad R Musa et al. Front Nutr. .

Abstract

Background: Mid-upper arm circumference (MUAC) is a potentially credible alternative method for body mass index (BMI) to assess nutritional status. We aimed to assess the correlation between MUAC and BMI- Z-score and to identify a reliable MUAC cut-off point to detect underweight (BMI- Z-score of < -2 standard deviation) Sudanese adolescents.

Methods: A cross-sectional study was conducted in eastern Sudan. After obtaining adolescents' age and sex, their weight, height, and MUAC were measured using the standard procedures. The MUAC (cm) cut-off corresponding to underweight was calculated using receiver operating characteristic (ROC) curve analysis.

Results: In total, 390 adolescents were enrolled in the study and 205 (52.6%) of them were females. The median (interquartile range, IQR) age was 15.1 (14.0-16.3) years. The medians (IQR) of MUAC and BMI- Z-score were 22.0 (20.0-24.0) cm and - 0.62 (-1.5-0.3), respectively. MUAC was positively correlated with BMI Z-score in all participants (r = 0.534, p < 0.001), in females (r = 0.715, p < 0.001), and in males (r = 0.404, p < 0.001). Of the 390 enrolled adolescents, 61(15.6%) were underweight. The MUAC cut-off for underweight was ≤21.2 cm in all participants (Youden's Index, YI = 0.50; sensitivity = 82.0%; specificity = 68.0%, AUROCC = 0.78), in females (YI = 0.66, sensitivity = 86.0%, specificity = 80.0%, AUROCC = 0.87), and in males (YI = 0.32, sensitivity = 80.0%, specificity = 52.0%, AUROCC = 0.69).

Conclusion: MUAC has good accuracy results and can be adopted for community-based screening of underweight adolescents.

Keywords: Z-score; adolescents; body mass index; mid-upper arm circumference; underweight.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Curve estimation for assessing the linear relationship between mid-upper arm circumference and body mass index Z-score in adolescents in eastern Sudan 2021.
Figure 2
Figure 2
Receiver operating curve of mid-upper arm circumference for diagnosing underweight adolescents in eastern Sudan 2021.
See this image and copyright information in PMC

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