上臂中部周长可作为替代身体质量指数评估苏丹东部成年人营养状况的指标。
Mid-upper arm circumference as a substitute for body mass index in the assessment of nutritional status among adults in eastern Sudan.
机构信息
Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Kingdom of Saudi Arabia.
Faculty of Medicine, Gadarif University, Gadarif, Sudan.
出版信息
BMC Public Health. 2022 Nov 10;22(1):2056. doi: 10.1186/s12889-022-14536-4.
BACKGROUND
Body mass index (BMI) remains the most used indicator of nutritional status despite the presence of a potentially credible alternative. Mid-upper arm circumference (MUAC) is an anthropometric measure that requires simple equipment and minimal training. The aim of this study was to compare MUAC with BMI and propose a MUAC cut-off point corresponding to a BMI of < 18.5 kg/m (underweight) and ≥ 30.0 kg/m (obesity) among Sudanese adults.
METHODS
A cross-sectional study using multistage cluster sampling was conducted in New-Halfa, eastern Sudan. Participants' age and sex were recorded and their MUAC, weight and height were measured using the standard procedures. The MUAC (cm) cut-offs corresponding to < 18.5 kg/m and ≥ 30.0 kg/m were calculated and determined using receiver operating characteristic (ROC) curve analysis RESULTS: Five hundreds and fifty-two adults were enrolled in the study. The median (interquartile range, IQR) of the participants age was 31.0 (24.0 ̶ 40.0) years and 331 (60.0%) of them were females. The medians (IQR) of BMI and MUAC were 22.4 (19.1 ̶ 26.3) kg/m and 25.0 (23.0 ̶ 28.0) cm, respectively. There was a significant positive correlation between MUAC and BMI (r = 0.673, p < 0.001). Of the 552 enrolled participants, 104 (18.8%), 282 (51.1%), 89 (16.1%) and 77 (13.9%) were normal weight, underweight, overweight and obese, respectively. Best statistically derived MUAC cut-off corresponding to a BMI < 18.5 kg/m (underweight) was ≤ 25.5 cm in both males and females (Youden's Index, YI = 0.51; sensitivity = 96.0%; specificity = 54.0%), with a good predictive value (AUROCC = 0.82). Best statistically derived MUAC cut-off corresponding to a BMI ≥ 30.0 kg/m (obesity) was ≥ 29.5 cm in both males and females (YI = 0.62, sensitivity = 70.3%, specificity = 92.0%), with a good predictive value (AUROCC = 0.86, 95.0% CI = 0.76 - 0.95).
CONCLUSION
The results suggest that the cut-offs based on MUAC can be used for community-based screening of underweight and obesity.
背景
尽管存在一种潜在可信的替代方法，但体重指数 (BMI) 仍然是最常用的营养状况指标。上臂中部周长 (MUAC) 是一种人体测量指标，仅需使用简单的设备并接受最低限度的培训即可进行测量。本研究旨在比较 MUAC 与 BMI，并提出与 BMI < 18.5 kg/m（消瘦）和 BMI ≥ 30.0 kg/m（肥胖）对应的 MUAC 截断值，适用于苏丹成年人。
方法
本研究采用多阶段聚类抽样方法在苏丹东部的新哈法地区进行了横断面研究。记录参与者的年龄和性别，并使用标准程序测量他们的 MUAC、体重和身高。使用接收者操作特征 (ROC) 曲线分析计算并确定对应于 < 18.5 kg/m 和 ≥ 30.0 kg/m 的 MUAC（cm）截断值。
结果
本研究共纳入了 552 名成年人。参与者的年龄中位数（四分位间距，IQR）为 31.0（24.0 ̶ 40.0）岁，其中 331 名（60.0%）为女性。BMI 和 MUAC 的中位数（IQR）分别为 22.4（19.1 ̶ 26.3）kg/m 和 25.0（23.0 ̶ 28.0）cm。MUAC 与 BMI 呈显著正相关（r = 0.673，p < 0.001）。在 552 名纳入的参与者中，分别有 104 名（18.8%）、282 名（51.1%）、89 名（16.1%）和 77 名（13.9%）为正常体重、消瘦、超重和肥胖。男女最佳统计衍生 MUAC 截断值对应 BMI < 18.5 kg/m（消瘦）分别为 ≤ 25.5 cm（约登指数，YI = 0.51；灵敏度 = 96.0%；特异性 = 54.0%），具有良好的预测值（AUROCC = 0.82）。男女最佳统计衍生 MUAC 截断值对应 BMI ≥ 30.0 kg/m（肥胖）分别为 ≥ 29.5 cm（约登指数，YI = 0.62，灵敏度 = 70.3%，特异性 = 92.0%），具有良好的预测值（AUROCC = 0.86，95.0% CI = 0.76 - 0.95）。
结论
结果表明，基于 MUAC 的截断值可用于社区为基础的消瘦和肥胖筛查。
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