上臂中部周长作为孟加拉国成年人体重过轻、超重和肥胖指标的有效性。

The validity of mid-upper arm circumference as an indicator of underweight, overweight and obesity adults in Bangladesh.

作者信息

Rahman Sheikh Arafat, Kabir Md Humayan, Rahman Shaikh Shahinur, Kamruzzaman Md

机构信息

Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh.

出版信息

PLoS One. 2025 Jul 28;20(7):e0327499. doi: 10.1371/journal.pone.0327499. eCollection 2025.

DOI:10.1371/journal.pone.0327499

PMID:40720437

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12303288/

Abstract

BACKGROUND

Mid-upper-arm circumference (MUAC), as a simple measurement, is an effective alternative to body mass index (BMI) for resource-limited countries such as Bangladesh. The present study aimed to investigate the age- and sex-specific MUAC cut-off points as screening tools for underweight, overweight and obesity in Bangladesh.

SUBJECT AND METHODS

A nationally representative dataset (BDHS-2017/18) comprising of 12,962 adults individuals (females: 56.5%, mean age: 39.5±16.0 Years, BMI: 22.4±4.1 kg/m2 and MUAC: 27.4±3.1 cm) was analyzed. BMI was categorized as underweight (BMI <18.5 kg/m2), overweight (BMI: 23 kg/m2), or obese (BMI: ≥27.5 kg/m2). A receiver operating characteristic curve analysis was conducted to determine the optimal MUAC cut-off, based on Youden Index, for underweight, overweight, and obese individuals. Multiple linear regression analysis was performed, adjusting for age and sex, to explore age and sex-specific changes in the association between MUAC and BMI. Restricted cubic spline and binary logistic regression analyses were performed to evaluate the risk of underweight, overweight and obesity among different MUAC quartiles.

RESULTS

For males, MUAC cut-offs were ≤26.5 cm for underweight (AUC: 82.1%, sensitivity: 71.1%, specificity: 77.8%), ≥ 28.5 cm for overweight (AUC: 84.8%, sensitivity: 77.6%, specificity: 76.9%), and ≥29.5 cm for obesity (AUC: 89.4%, sensitivity: 87.8%, specificity: 76.6%) in younger and middle-aged individuals; older males had cut-offs of ≤25.5 cm, ≥ 27.5 cm, and ≥29.5 cm respectively. For females, the cut-offs were lower: ≤ 25.5 cm for underweight in younger and middle-aged, and ≤24.5 cm in older; ≥ 27.5 cm for overweight in younger, and ≥26.5 cm in middle-aged and older; and ≥28.5 cm for obesity in younger and middle-aged, and ≥27.5 cm in older. The MUAC-BMI correlation was strong (R = 0.69, P < 0.001), stronger in males (R = 0.75) than females (R = 0.69). The MUAC cut-off for underweight, overweight, and obesity slightly decreased with age in both sexes.

CONCLUSION

Age- and sex-specific MUAC cut-offs are effective for screening underweight, overweight and obesity in Bangladesh.

摘要

背景

上臂中部周长（MUAC）作为一种简单的测量方法，对于孟加拉国等资源有限的国家来说，是体重指数（BMI）的有效替代指标。本研究旨在调查特定年龄和性别的MUAC切点，作为孟加拉国体重过轻、超重和肥胖的筛查工具。

对象与方法

分析了一个具有全国代表性的数据集（BDHS-2017/18），该数据集包含12962名成年人（女性：56.5%，平均年龄：39.5±16.0岁，BMI：22.4±4.1kg/m²，MUAC：27.4±3.1cm）。BMI被分类为体重过轻（BMI<18.5kg/m²）、超重（BMI：23kg/m²）或肥胖（BMI：≥27.5kg/m²）。基于约登指数进行受试者工作特征曲线分析，以确定体重过轻、超重和肥胖个体的最佳MUAC切点。进行多元线性回归分析，对年龄和性别进行调整，以探讨MUAC与BMI之间关联的特定年龄和性别变化。进行受限立方样条和二元逻辑回归分析，以评估不同MUAC四分位数中体重过轻、超重和肥胖的风险。

结果

对于男性，在年轻和中年个体中，体重过轻的MUAC切点≤26.5cm（AUC：82.1%，敏感性：71.1%，特异性：77.8%），超重的MUAC切点≥28.5cm（AUC：84.8%，敏感性：77.6%，特异性：76.9%），肥胖的MUAC切点≥29.5cm（AUC：89.4%，敏感性：87.8%，特异性：76.6%）；老年男性的切点分别为≤25.5cm、≥27.5cm和≥29.5cm。对于女性，切点较低：年轻和中年体重过轻的切点≤25.5cm，老年≤24.5cm；年轻超重的切点≥27.5cm，中年和老年≥26.5cm；年轻和中年肥胖的切点≥28.5cm，老年≥27.5cm。MUAC与BMI的相关性很强（R=0.69，P<0.001），男性（R=0.75）比女性（R=0.69）更强。体重过轻、超重和肥胖的MUAC切点在两性中均随年龄略有下降。