The performance of mid-upper arm circumference for identifying children and adolescents with overweight and obesity: a systematic review and meta-analysis

Abstract

Objective: 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. Design: Systematic review and meta-analysis. Setting: 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. Participants: A total of 54,381 children and adolescents from twenty-one studies were reviewed; 10 studies contributed to meta-analyses. Results: 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. Conclusion: 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.

Performance of mid‐upper arm circumference to identify adolescents with obesity and metabolic syndrome: NHANES 2011–2018 analysis

“…MUAC can serve as a valuable screening and surveillance tool in situations where measuring weight is considered inappropriate due to concerns about body image issues 10 . Studies have proposed that MUAC can be used as an alternative tool for identifying children and adolescents with overweight and obesity at both clinical and community levels 9,11 …”

“…10 Studies have proposed that MUAC can be used as an alternative tool for identifying children and adolescents with overweight and obesity at both clinical and community levels. 9,11 A recent systematic review and meta-analysis has demonstrated that MUAC performs excellently in identifying adolescents with obesity, as defined by BMI Z-score. 11 The review also highlights studies that have compared the performance of MUAC with BMI Z-score and bioelectrical impedance.…”

“…9,11 A recent systematic review and meta-analysis has demonstrated that MUAC performs excellently in identifying adolescents with obesity, as defined by BMI Z-score. 11 The review also highlights studies that have compared the performance of MUAC with BMI Z-score and bioelectrical impedance. 11 However, it is important to note that bioelectrical impedance is known to have relatively inferior performance in measuring body fat and identifying adolescents with obesity.…”

“…11 The review also highlights studies that have compared the performance of MUAC with BMI Z-score and bioelectrical impedance. 11 However, it is important to note that bioelectrical impedance is known to have relatively inferior performance in measuring body fat and identifying adolescents with obesity. 12 As a result, there is a lack of evidence on the performance of MUAC to identify adolescents with obesity compared to obesity as defied by accurate measures of total body fat such as dual-energy X-ray absorptiometry (DEXA).…”

Relationship between body composition and physical fitness of primary school learners from a predominantly rural province in South Africa

“…4,5,6,7 However, this has not been the case in middle-income countries, where there is scanty literature related to the phenomenon under study. In South Africa, although there has been a high prevalence of overweight and obesity amongst children, 8,9,10,11 there are few research studies regarding the relationship between physical fitness and body composition amongst primary school learners.…”