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Determining a global mid-upper arm circumference cut-off to assess underweight in adults (men and non-pregnant women)

Journal Article


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Abstract


  • Objective:

    To determine if a global mid-upper arm circumference (MUAC) cut-off can be established to classify underweight in adults (men and non-pregnant women).

    Design:

    We conducted an individual participant data meta-analysis (IPDMA) to explore the sensitivity (SENS) and specificity (SPEC) of various MUAC cut-offs for identifying underweight among adults (defined as BMI < 18·5 kg/m2). Measures of diagnostic accuracy were determined every 0·5 cm across MUAC values from 19·0 to 26·5 cm. A bivariate random effects model was used to jointly estimate SENS and SPEC while accounting for heterogeneity between studies. Various subgroup analyses were performed.

    Setting:

    Twenty datasets from Africa, South Asia, Southeast Asia, North America and South America were included.

    Participants:

    All eligible participants from the original datasets were included.

    Results:

    The total sample size was 13 835. Mean age was 32·6 years and 65 % of participants were female. Mean MUAC was 25·7 cm, and 28 % of all participants had low BMI (<18·5 kg/m2). The area under the receiver operating characteristic curve for the pooled dataset was 0·91 (range across studies 0·61–0·98). Results showed that MUAC cut-offs in the range of ≤23·5 to ≤25·0 cm could serve as an appropriate screening indicator for underweight.

    Conclusions:

    MUAC is highly discriminatory in its ability to distinguish adults with BMI above and below 18·5 kg/m2. This IPDMA is the first step towards determining a global MUAC cut-off for adults. Validation studies are needed to determine whether the proposed MUAC cut-off of 24 cm is associated with poor functional outcomes.

UOW Authors


  •   Tang, Alice M. (external author)
  •   Chung, Mei (external author)
  •   Dong, Kimberly R. (external author)
  •   Bahwere, Paluku (external author)
  •   Bose, Kaushik (external author)
  •   Chakraborty, Raja (external author)
  •   Charlton, Karen
  •   Das, Priyanka (external author)
  •   Ghosh, Mihir (external author)
  •   Hossain, Md I. (external author)
  •   Nguyen, Phuong (external author)
  •   Patsche, Cecilie B. (external author)
  •   Sultana, Tania (external author)
  •   Deitchler, Megan (external author)
  •   Maalouf-Manasseh, Zeina (external author)

Publication Date


  • 2020

Citation


  • Tang, A. M., Chung, M., Dong, K. R., Bahwere, P., Bose, K., Chakraborty, R., Charlton, K., Das, P., Ghosh, M., Hossain, M. I., Nguyen, P., Patsche, C. B., Sultana, T., Deitchler, M. & Maalouf-Manasseh, Z. (2020). Determining a global mid-upper arm circumference cut-off to assess underweight in adults (men and non-pregnant women). Public Health Nutrition, Online First

Scopus Eid


  • 2-s2.0-85094140373

Ro Full-text Url


  • https://ro.uow.edu.au/context/smhpapers1/article/2705/type/native/viewcontent

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers1/1671

Volume


  • Online First

Place Of Publication


  • United Kingdom

Abstract


  • Objective:

    To determine if a global mid-upper arm circumference (MUAC) cut-off can be established to classify underweight in adults (men and non-pregnant women).

    Design:

    We conducted an individual participant data meta-analysis (IPDMA) to explore the sensitivity (SENS) and specificity (SPEC) of various MUAC cut-offs for identifying underweight among adults (defined as BMI < 18·5 kg/m2). Measures of diagnostic accuracy were determined every 0·5 cm across MUAC values from 19·0 to 26·5 cm. A bivariate random effects model was used to jointly estimate SENS and SPEC while accounting for heterogeneity between studies. Various subgroup analyses were performed.

    Setting:

    Twenty datasets from Africa, South Asia, Southeast Asia, North America and South America were included.

    Participants:

    All eligible participants from the original datasets were included.

    Results:

    The total sample size was 13 835. Mean age was 32·6 years and 65 % of participants were female. Mean MUAC was 25·7 cm, and 28 % of all participants had low BMI (<18·5 kg/m2). The area under the receiver operating characteristic curve for the pooled dataset was 0·91 (range across studies 0·61–0·98). Results showed that MUAC cut-offs in the range of ≤23·5 to ≤25·0 cm could serve as an appropriate screening indicator for underweight.

    Conclusions:

    MUAC is highly discriminatory in its ability to distinguish adults with BMI above and below 18·5 kg/m2. This IPDMA is the first step towards determining a global MUAC cut-off for adults. Validation studies are needed to determine whether the proposed MUAC cut-off of 24 cm is associated with poor functional outcomes.

UOW Authors


  •   Tang, Alice M. (external author)
  •   Chung, Mei (external author)
  •   Dong, Kimberly R. (external author)
  •   Bahwere, Paluku (external author)
  •   Bose, Kaushik (external author)
  •   Chakraborty, Raja (external author)
  •   Charlton, Karen
  •   Das, Priyanka (external author)
  •   Ghosh, Mihir (external author)
  •   Hossain, Md I. (external author)
  •   Nguyen, Phuong (external author)
  •   Patsche, Cecilie B. (external author)
  •   Sultana, Tania (external author)
  •   Deitchler, Megan (external author)
  •   Maalouf-Manasseh, Zeina (external author)

Publication Date


  • 2020

Citation


  • Tang, A. M., Chung, M., Dong, K. R., Bahwere, P., Bose, K., Chakraborty, R., Charlton, K., Das, P., Ghosh, M., Hossain, M. I., Nguyen, P., Patsche, C. B., Sultana, T., Deitchler, M. & Maalouf-Manasseh, Z. (2020). Determining a global mid-upper arm circumference cut-off to assess underweight in adults (men and non-pregnant women). Public Health Nutrition, Online First

Scopus Eid


  • 2-s2.0-85094140373

Ro Full-text Url


  • https://ro.uow.edu.au/context/smhpapers1/article/2705/type/native/viewcontent

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers1/1671

Volume


  • Online First

Place Of Publication


  • United Kingdom