Diagnostic Performance and Appropriate Cut-Offs of Different Anthropometric Indicators for Detecting Children with Overweight and Obesity.

Muhammad Asif,Muhammad Qasim,Justyna Wyszyńska,Muhammad Younis,Khurram Afzal,Manzar Ali,Muhammad Hassham Hassan Bin Asad,Muhammad Aslam,Asad Abbas,Kalim Ullah,Sami Ullah,Maria Irene Bellini

doi:10.1155/2021/1608760

Abstract

In the clinical settings, different anthropometric indicators like neck circumference (NC), waist circumference (WC), midupper arm circumference (MUAC), waist-to-height ratio (WHtR), and arm-to-height ratio (AHtR) have been suggested for evaluating overweight and obesity in children. The comparative ability of these indicators in Pakistan is yet unknown. This study is aimed at examining the validity of different anthropometric indicators of overweight and obesity simultaneously and at determining their superlative cut-off values that would correctly detect overweight and obesity in children. For this purpose, the dataset of anthropometric measurements height, weight, WC, MUAC, and NC of 5,964 Pakistani children, aged 5-12 years collected in a cross-sectional multiethnic anthropometric survey (MEAS), was used. Receiver operating characteristic (ROC) curve analysis was performed to assess the validity of different anthropometric indicators. The most sensitive and specific cut-off points, positive and negative predictive values of each indicator were also calculated. The results of the ROC curve indicated that all the studied indicators had a good performance but the indicators AHtR and WHtR had the highest value of the area under the curve (AUC) for the screening of children with overweight and obesity (AUC > 0.80). In the overall sample, AHtR, WHtR, MUAC, WC, and NC cut-off points indicative of overweight, in both boys and girls, were 0.14, 0.46, 18.41 cm, 62.86 cm, and 26.36 cm and 0.14, 0.47, 18.16 cm, 64.39 cm, and 26.54 cm, respectively; the corresponding values for obesity were 0.14, 0.47, 18.67 cm, 62.10 cm, and 26.36 cm and 0.14, 0.48, 20.19 cm, 64.39 cm, and 25.27 cm. We concluded that the sex-specific cut-off points for AHtR, WHtR, MUAC, WC, and NC can be used to diagnose overweight and obesity in Pakistani children.

Highlights

Childhood obesity has become a grave public health issue, and its prevalence over the past years has risen dramatically worldwide [1]
Anthropometry, whose concerned with the measurement of physical sizes, was considered as an internationally acceptable method that can be applied to a large population
The classification of nutritional status using World Health Organization (WHO) Body mass index (BMI) reference values showed that 11.7% of children were overweight and 4.7% were obese

Summary

Introduction

Childhood obesity has become a grave public health issue, and its prevalence over the past years has risen dramatically worldwide [1]. A cross-sectional study with the Pakistani children has shown that the prevalence of overweight and obesity in Pakistani primary school children was about 17% and 7.5%, respectively [3]. These results were a four-time increase in overweight school-aged children in the past five years. Few investigators in recent years evaluated the diagnostic performance of midupper arm circumference (MUAC) and arm-to-height ratio (AHtR) and proposed that both of these indicators are simple, inexpensive, and accurate measures for obesity screening in children [14,15,16,17]

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Discussion

Conclusion