Hayes Julia, Quiring Michael, Kerac Marko, Smythe Tracey, Tann Cally J, Groce Nora, Gultie Zerihun, Nyesigomwe Lydia, DeLacey Emily
Nutrition and Health Services, Holt International, Eugene, Oregon, USA.
Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London, UK.
Nutr Health. 2023 Jun 20:2601060231181607. doi: 10.1177/02601060231181607.
Anthropometric measurements, including mid-upper arm circumference (MUAC), are used for monitoring and evaluating children's nutritional status. Evidence is limited on optimal nutritional assessment for children with disabilities, who are at high risk for malnutrition. This study describes MUAC use among children with disabilities. Four databases (Embase, Global Health, Medline, and CINHAL) were searched from January 1990 through September 2021 using a predefined search strategy. Of the 305 publications screened, 32 papers were included. Data included children 6 months to 18 years old with disabilities. Data including general study characteristics, methods for MUAC measurement, terminology, and measurement references were extracted into Excel. Due to heterogeneity of the data, a narrative synthesis was used. Studies from 24 countries indicate that MUAC is being used as part of nutritional assessment, but MUAC measurement methods, references, and cutoffs were inconsistent. Sixteen (50%) reported MUAC as a mean ± standard deviation (SD), 11 (34%) reported ranges or percentiles, 6 (19%) reported z-scores, and 4 (13%) used other methods. Fourteen (45%) studies included both MUAC and weight-for-height but nonstandard reporting limited comparability of the indicators for identifying those at risk of malnutrition. Although its speed, simplicity, and ease of use afford MUAC great potential for assessing children with disabilities, more research is needed to understand its appropriateness, and how it performs at identifying nutritionally high-risk children in comparison to other measures. Without validated inclusive measures to identify malnutrition and monitor growth and health, millions of children could have severe consequences for their development.
人体测量指标，包括上臂中部周长（MUAC），用于监测和评估儿童的营养状况。关于残疾儿童最佳营养评估的证据有限，而残疾儿童面临营养不良的高风险。本研究描述了MUAC在残疾儿童中的应用情况。使用预定义的检索策略，检索了1990年1月至2021年9月期间的四个数据库（Embase、全球健康、Medline和CINHAL）。在筛选的305篇出版物中，纳入了32篇论文。数据包括6个月至18岁的残疾儿童。将包括一般研究特征、MUAC测量方法、术语和测量参考值的数据提取到Excel中。由于数据的异质性，采用了叙述性综合分析。来自24个国家的研究表明，MUAC正被用作营养评估的一部分，但MUAC的测量方法、参考值和临界值并不一致。16项研究（50%）报告MUAC为均值±标准差（SD），11项研究（34%）报告范围或百分位数，6项研究（19%）报告z分数，4项研究（13%）使用其他方法。14项研究（45%）同时纳入了MUAC和身高别体重，但非标准报告限制了识别营养不良风险儿童指标的可比性。尽管MUAC的速度、简便性和易用性使其在评估残疾儿童方面具有很大潜力，但仍需要更多研究来了解其适用性，以及与其他测量方法相比，它在识别营养高风险儿童方面的表现如何。如果没有经过验证的包容性措施来识别营养不良以及监测生长和健康状况，数百万儿童的发育可能会受到严重影响。
