Dataset Information

Association between mid-upper arm circumference and cardiometabolic risk in Chinese population: a cross-sectional study.

ABSTRACT:

Objectives

Upper body fat has been associated with an unfavourable cardiometabolic risk. We aimed to investigate the associations between mid-upper arm circumference (MUAC), a novel indicator of upper body fat, and a wide spectrum of cardiometabolic risk profiles in Chinese population.

Design and setting

Cross-sectional analyses were performed using data from a well-defined community in 2014, Shanghai, China.

Participants

A total of 6287 Chinese adults (2310 men and 3977 women) aged 40 years or older.

Outcome measures

Multivariable logistic regression model was used to examine the associations of MUAC with cardiometabolic disorders including central obesity, diabetes, hypertension, hypertriglyceridaemia, low high-density lipoprotein (HDL) cholesterol and subclinical atherosclerosis.

Results

In the overall participants, after multivariable adjustment, each 1 SD (3.13?cm) increment in MUAC was positively associated with central obesity (OR 2.05; 95%?CI 1.85 to 2.28), hypertension (OR 1.10; 95%?CI 1.03 to 1.19) and low HDL cholesterol (OR 1.10; 95%?CI 1.01 to 1.22). Multivariable-adjusted ORs for subclinical atherosclerosis were gradually increased across increasing quartiles of MUAC with the lowest quartile as reference (quartile 2: OR 1.31; 95%?CI 1.09 to 1.58; quartile 3: OR 1.33; 95% CI 1.10 to 1.62; quartile 4: OR 1.45; 95% CI 1.16 to 1.80; p for trend=0.005). Similar but more prominent associations were observed among women than men. In addition, MUAC was significantly interacted with diabetes (p for interaction=0.04) and insulin resistance (p for interaction=0.01) on subclinical atherosclerosis.

Conclusion

A greater MUAC was positively associated with higher risks of several cardiometabolic disorders and subclinical atherosclerosis in Chinese adults.

SUBMITTER: Hou Y

PROVIDER: S-EPMC6738736 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Association between mid-upper arm circumference and cardiometabolic risk in Chinese population: a cross-sectional study.

Hou Yanan Y Jia Xu X Xuan Liping L Zhu Wen W Deng Chanjuan C Wang Long L Zhao Zhiyun Z Li Mian M Lu Jieli J Xu Yu Y Chen Yuhong Y Wang Weiqing W Bi Yufang Y Xu Min M Wang Tiange T

BMJ open 20190908 9

<h4>Objectives</h4>Upper body fat has been associated with an unfavourable cardiometabolic risk. We aimed to investigate the associations between mid-upper arm circumference (MUAC), a novel indicator of upper body fat, and a wide spectrum of cardiometabolic risk profiles in Chinese population.<h4>Design and setting</h4>Cross-sectional analyses were performed using data from a well-defined community in 2014, Shanghai, China.<h4>Participants</h4>A total of 6287 Chinese adults (2310 men and 3977 wo ...[more]

PMID: 31501106

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Project description:BACKGROUND/OBJECTIVES:Accurate, early identification of acutely malnourished children has the potential to reduce related child morbidity and mortality. The current World Health Organisation (WHO) guidelines classify non-oedematous acute malnutrition among children under five using Mid-Upper Arm Circumference (MUAC) or Weight-for-Height Z-score (WHZ). However, there is ongoing debate regarding the use of current MUAC cut-offs. This study investigates the diagnostic performance of MUAC to identify children aged 6-24 months with global (GAM) or severe acute malnutrition (SAM). SUBJECTS/METHODS:Cross-sectional, secondary data from a community sample of children aged 6-24 months in Niger were used for this study. Children with complete weight, height and MUAC data and without clinical oedema were included. Using WHO guidelines for GAM (WHZ < -2, MUAC < 12.5 cm) and SAM (WHZ < -3, MUAC < 11.5 cm), the sensitivity (Se), specificity (Sp), predictive values, Youden Index and Receiver Operating Characteristic (ROC) curves were calculated for MUAC when compared with the WHZ reference criterion. RESULTS:Of 1161 children, 23.3% were diagnosed with GAM using WHZ, and 4.4% with SAM. Using current WHO cut-offs, the Se of MUAC to identify GAM was greater than for SAM (79 vs. 57%), yet the Sp was lower (84 vs. 97%). From inspection of the ROC curve and Youden Index, Se and Sp were maximised for MUAC < 12.5 cm to identify GAM (Se 79%, Sp 84%), and MUAC < 12.0 cm to identify SAM (Se 88%, Sp 81%). CONCLUSIONS:The current MUAC cut-off to identify GAM should continue to be used, but when screening for SAM, a higher cut-off could improve case identification. Community screening for SAM could use MUAC < 12.0 cm followed by appropriate treatment based on either MUAC < 11.5 cm or WHZ < -3, as in current practice. While the practicalities of implementation must be considered, the higher SAM MUAC cut-off would maximise early case-finding of high-risk acutely malnourished children.

Project description:BackgroundMid-Upper Arm Circumference (MUAC) is an independent anthropometric measurement used to identify malnutrition in children. While much research has been dedicated to applying fixed estimates of MUAC to identify cases of malnutrition in children under 5?years of age, far less has been done with age-specific MUAC Z-score values across the continuum of age from birth through adolescence.MethodsThe present study examined the effectiveness of a novel MUAC Z-score tape, in the hands of community health volunteers, to identify children over the age of 5 who would benefit from nutritional rehabilitation. In January of 2019, 112 community health volunteers working within Children International in Guatemala were trained to use the MUAC Z-score tape and asked to collect measurements on children or youth in their communities.ResultsOf the 818 MUAC Z-score tape measurements obtained by volunteers, 88.26% (722/818) were concordant with nutritional risk status as predicted by BMI Z-score, and 90.95% (744/818) were concordant with MUAC Z-score tape measurements made by field medical staff. MUAC Z-scores identified 87.10% (27/31) of the severely or moderately undernourished children as determined by the BMI Z-score who would be candidates for the nutrition rehabilitation program (Z-score???-?2) along with an additional six children that would not have been classified as such with BMI Z-score. A qualitative survey distributed to the volunteers showed moderate rates of understanding of nutritional risk using the tape, and 62.50% reported the tape was easy to use.ConclusionsThese quantitative and qualitative findings suggest that with more in-depth training and education the MUAC Z-score tape is a viable, low-cost, low-burden alternative for community-level nutritional status assessment among the population served by Children International in Guatemala.Supplementary informationSupplementary information accompanies this paper at (10.1186/s13690-019-0370-0).

Dataset Information

Association between mid-upper arm circumference and cardiometabolic risk in Chinese population: a cross-sectional study.

Objectives

Design and setting

Participants

Outcome measures

Results

Conclusion

Publications

Association between mid-upper arm circumference and cardiometabolic risk in Chinese population: a cross-sectional study.

Similar Datasets

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