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This study aimed to synthesize the existing evidence on the performance of Mid-Upper Arm Circumference (MUAC) to identify children and adolescents with overweight and obesity.
Systematic review and meta-analysis.
We searched PubMed, EMBASE, SCOPUS, Cochrane Library, Web of Science, CINAHL, and Google scholar databases from their inception to December 10, 2021, for relevant studies. There were no restrictions regarding the language of publication. Studies reporting measures for the diagnostic performance of MUAC compared to a reference standard for diagnosing overweight and obesity in children and adolescents aged 2 to 19 years were included.
A total of 54,381 children and adolescents from twenty-one studies were reviewed; 10 studies contributed to meta-analyses.
In Boys, MUAC showed a pooled Area Under the Curve (AUC) of 0.92 (95% CI 0.89 - 0.94), sensitivity of 84.4 (95% CI 84.6-.90.8), and a specificity of 86.0 (95% CI 79.2-90.8), when compared against BMI z-score, defined overweight and obesity. As for girls, MUAC showed a pooled AUC of 0.93 (95% CI 0.90 - 0.95) sensitivity of 86.4 (95% CI 79.8- 91.0), specificity of 86.6 (95% CI 82.2-90.1) when compared against overweight and obesity defined using BMI z-scores.
In comparison with BMI, MUAC has an excellent performance to identify overweight and obesity in children and adolescents. However, no sufficient evidence on the performance of MUAC compared to gold standard measures of adiposity. Future research should compare performance of MUAC to the “golden standard” measure of excess adiposity.
To evaluate the performance of mid-upper arm circumference (MUAC) to identify thinness in the late adolescence period (aged 15–19 years) in Ethiopia.
We conducted a school-based cross-sectional study. The receiver operating characteristics curve was used to examine the validity of MUAC compared with BMI Z-score to identify adolescents with thinness (BMI Z-score <−2 sd).
Fifteen high schools (grade 9–12) located in Addis Ababa, Ethiopia.
A total of 851 adolescent (456 males and 395 females) were included in the study.
The prevalence of thinness and severe thinness among high-school adolescents in Addis Ababa was 9·5 % (95 % CI 7·7, 11·7 %). The overall AUC for MUAC against BMI Z-score <−2 SD was 0·91 (95 % CI 0·88, 0·93). The optimal MUAC cut-offs to identify thinness were 23·3 cm for males and 22·6 cm for females. These cut-off points give high sensitivity and specificity for both males (a sensitivity of 87·9 % and a specificity of 75·9 %) and females (a sensitivity of 100 % and a specificity 88·2 %).
MUAC has a comparable level of accuracy with BMI Z-score to identify thinness in adolescents aged 15–19 years. Hence, MUAC could be used as an alternative tool for surveillance and screening of thinness among adolescents aged 15–19 years. The optimum cut-off proposed by this study may incorrectly include a large number of adolescents when used in a relatively well-nourished population. In this situation, it would be necessary to choose a cut-off with greater positive predictive value.
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