Mid-upper-arm Circumference and Arm-to-height Ratio in Evaluation of Overweight and Obesity in Han Children

Abstract

The purposes of this study were: (1) to analyze whether mid-upper-arm circumference (MUAC) could be used to determine overweight and obese children and to propose the optimal cutoffs of MUAC in Han children aged 7-12 years; and (2) to evaluate the feasibility and accuracy of the arm-to-height ratio (AHtR) and propose the optimal cutoffs of AHtR for identifying overweight and obesity. In 2011, anthropometric measurements were assessed in a cross-sectional, population-based study of 2847 Han children aged 7-12 years. Overweight and obesity were defined according to the 2004 Group of China Obesity Task Force definition. The AHtR was calculated as arm circumference/height. Receiver operating characteristic curve analyses were performed to assess the accuracy of MUAC and AHtR as diagnostic tests for elevated body mass index (BMI; defined as BMI≥85(th) percentiles). The accuracy levels of MUAC for identifying elevated BMI [as assessed by area underthe curve (AUC)] were over 0.85 (AUC: approximately 0.934-0.975) in both gendersand across all age groups. The MUAC cutoff values for elevated BMI were calculated to be approximately 18.9-23.4cm in boys and girls. The accuracy levels of AHtR for identifyingelevated BMI (as assessed by AUC) were also over 0.85 (AUC: 0.956 in boys and 0.935 in girls). The AHtR cutoff values for elevated BMI were calculated to be 0.15 in boys and girls. This study demonstrates that MUAC and AHtR are simple, inexpensive, and accurate measurements that may be used to identify overweight and obese Han children. Compared with MUAC, AHtR is a nonage-dependent index with higher applicability to screen for overweight and obese children.