Consistent accuracy of mid arm circumference and calf circumference as birth weight surrogates during first few days

Measurement within 24 hours and then daily for 10 days after birth was made of mid arm, calf, and thigh circumference, and birth weight among infants delivered by the Dayanand Medical College and Hospital in Ludhiana, Punjab State, India. The results of the correlation procedures was that mid arm an calf circumference were highly correlated with birth weights: r = .60 and r = .76 respectively. Thigh circumference data was discarded, due to technical errors. Analysis of variance found that there were not significant differences between the values of arm and calf circumference and birth weight. This information was found useful for determining birth weight with colored strips during the first 10 days after birth. The criteria of health workers in field conditions to assess birth weight with surrogate measures were satisfied: high correlation, easy measurement, and consistently accuracy over the first few days of life. Health workers do not always see new borns in the first few days. The significance of measuring birth weight is in the determination of low birth weight and the need for special care or monitoring as a means of enhancing child survival.     

Evaluation of arm and thigh circumference in screening low birth weight newborns

The present cross-sectional study collected data regarding birth weight along with arm and thigh circumference of 174 consecutive newborns delivered at Maternity Hospital, Tasgaon during 2003. To compare & evaluate utility of arm & thigh circumferences for the detection of LBW newborns. Assessment of the best suitable measurement for identification of low birth weight newborns was made by comparison of Coefficient of Determinants (R(2)), Sensitivity and Specificity values and Kappa Statistics. The estimated cut off points of arm and thigh circumference for given value of birth weight 2.5 kg. were 9.1 cm and 14.2 cm. respectively. Although both measurements are highly sensitive, present study established supiriority of arm circumference over thigh circumference in predicting low birth weight newborns. Thigh circumference is more reliable. Advantages of these measurements are their simplicity & low cost.     

Measuring malnutrition in famines: are weight-for-height and arm circumference interchangeable?

Data from two surveys in Sudan have been used to examine whether weight-for-height (WFH) and mid-upper arm circumference (MUAC) can be used interchangeably at a population level to define the proportion of children aged one to four years that are malnourished, whether they identify the same individual children as malnourished, and whether the relationship between WFH and MUAC varies with age. A MUAC cut-off of 13.0 cm consistently defined approximately the same proportion of children malnourished as 80% WFH in all seven groups of children examined, even though the proportion of children with less than 80% WFH varied between 8.6% and 30.7%. However, sensitivity/specificity analysis showed that many of the children identified as malnourished by the two indices were not the same individuals. Both the MUAC cut-off defining the same proportion malnourished as 80% WFH, and the sensitivity/specificity values, varied substantially with age. Studies of other populations have revealed both different MUAC cut-offs defining the same proportion of children malnourished as 80% WFH, and different sensitivities and specificities of MUAC relative to WFH. We do not recommend the direct comparison of data from surveys using WFH and those using MUAC.     

Cross-sectional reference values for mid-upper arm circumference,triceps skinfold thickness and arm fat area of Turkish children and adolescents

The aim of the study was to establish cross-sectional reference values for the mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF) and arm fat area (AFA) of Turkish children and adolescents. In total 5,553 students aged between 6 and 17 years were selected by a multistage sampling method from schools representing city centre, rural and urban areas of Kayseri, Central Anatolia. The MUAC and TSF were measured, and the arm muscle area, arm area, AFA and fat percentage (%) were calculated. The LMS method was employed to calculate the MUAC, TSF and AFA curve parameters. The MUAC, TSF, AFA and fat percentage in each age group were significantly higher in girls than in boys. In boys, the TSF 50th percentile ranged from 7.6 mm at 17 years to 9.0 mm at 11 years; whereas in girls this ranged from 9.4 mm at 6 years to 14.6 mm at 17 years. The MUAC 50th percentile ranged from 17.0 to 23.6 cm in boys, and from 15.6 cm to 20.9 cm in girls. The AFA 50th percentile measurements ranged from 4.5 cm at 6 years to 5.8 cm at 12–14 years in boys; and ranged from 7.2 cm at 6 years to 14.8 cm at 17 years in girls. The percentile distribution was more disperse towards higher TSF and AFA values in boys than in girls.     

Cross-sectional reference values for mid-upper arm circumference, triceps skinfold thickness and arm fat area of Turkish children and adolescents

The aim of the study was to establish cross-sectional reference values for the mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF) and arm fat area (AFA) of Turkish children and adolescents. In total 5,553 students aged between 6 and 17 years were selected by a multistage sampling method from schools representing city centre, rural and urban areas of Kayseri, Central Anatolia. The MUAC and TSF were measured, and the arm muscle area, arm area, AFA and fat percentage (%) were calculated. The LMS method was employed to calculate the MUAC, TSF and AFA curve parameters. The MUAC, TSF, AFA and fat percentage in each age group were significantly higher in girls than in boys. In boys, the TSF 50th percentile ranged from 7.6 mm at 17 years to 9.0 mm at 11 years; whereas in girls this ranged from 9.4 mm at 6 years to 14.6 mm at 17 years. The MUAC 50th percentile ranged from 17.0 to 23.6 cm in boys, and from 15.6 cm to 20.9 cm in girls. The AFA 50th percentile measurements ranged from 4.5 cm at 6 years to 5.8 cm at 12-14 years in boys; and ranged from 7.2 cm at 6 years to 14.8 cm at 17 years in girls. The percentile distribution was more disperse towards higher TSF and AFA values in boys than in girls.     

The importance of the measurement of the circumference of arm,arm muscle area and skinfold thickness during puberty

Several methods are available to study lean and adipose tissue component of the upper arm, but the use of a specific technique is mostly determined by time and financial expense. Besides, anthropometric techniques (arm muscle area, mid-arm circumference and the triceps skinfold thickness), which are the most practical, simple, inexpensive and noninvasive, x-ray, ultrasound scanning, computed tomography (CT), or magnetic resonance images (MRI) are also used to determine separate measures of muscles, adipose tissue, and bone area. These radiographic methods are expensive and suitable only for research studies. This short review will try to stress the importance of the measurement of the circumference of arm, arm muscle area and skinfold thickness during puberty and adolescence.     

Agreement between body mass index,calf circumference,arm circumference,habitual energy intake and the MNA in hospitalized elderly

Objectives  

This study aimed to assess the agreement between body mass index, calf circumference, arm circumference, habitual energy intake and the mini nutritional assessment (MNA) and then assess the accuracy of these parameters in relation to the MNA.     

上臂围值在评价学龄前儿童营养状况中的作用

利用１９８５～１９８９年我国７省９个县的２６１７１名及１９９０年２７省１０１个县的６８８７６名１～５岁儿童体重和上臂围数据，对国际上采用的诊断１～５岁儿童营养不良的上臂围界限值（＜１２．５ｃｍ为重度营养不良，１２．５～１３．５ｃｍ为中度营养不良）进行分析。结果表明１～５岁儿童用同一上臂围界限值灵敏度随年龄增长而下降，而特异度则随年龄的上升而上升，提示随年龄的增长漏检率越来越高。经判别分析提出各年龄组的上臂围界限值，但其漏检率和误判率也在３０％左右，本研究结果说明上臂围不是评价学龄前儿童营养不良的理想指标。     

Maternal mid-upper arm circumference is associated with birth weight among HIV-infected Malawians

The authors examined the relationship of maternal anthropometry to fetal growth and birth weight among 1005 human immunodeficiency virus (HIV)-infected women in Lilongwe, Malawi, who consented to enrollment in the Breastfeeding, Antiretrovirals, and Nutrition Study (www.thebanstudy.org). Anthropometric assessments of mid-upper arm circumference (MUAC), arm muscle area (AMA), and arm fat area (AFA) were collected at the baseline visit between 12 and 30 weeks' gestation and in up to 4 follow-up prenatal visits. In longitudinal analysis, fundal height increased monotonically at an estimated rate of 0.92 cm/wk and was positively and negatively associated with AMA and AFA, respectively. These latter relationships varied over weeks of follow-up. Baseline MUAC, AMA, and AFA were positively associated with birth weight (MUAC: 31.84 g/cm(2), 95% confidence interval [CI], 22.18-41.49 [P < .01]; AMA: 6.88 g/cm(2), 95% CI, 2.51-11.26 [P < .01]; AFA: 6.97 g/cm(2), 95% CI, 3.53-10.41 [P < .01]). In addition, MUAC and AMA were both associated with decreased odds for low birth weight (LBW; <2500 g) (MUAC: odds ratio [OR] = 0.85, 95% CI, 0.77-0.94 [P < .01]; AMA: OR = 0.95, 95% CI, 0.91-0.99 [P < .05]). These findings support the use of MUAC as an efficient, cost-effective screening tool for LBW in HIV-infected women, as in HIV-uninfected women.     

Association of grip strength,upper arm circumference,and waist circumference with dementia in older adults of the wise study: A cross-sectional analysis

Objective

We examined the associations of handgrip strength, upper arm circumference, and waist circumference with dementia among Singapore older adults.

Design

Cross-sectional epidemiological study.

Setting

Residential homes, day care centres, nursing homes and institutions.

Participants

2,565 men and women aged 60 years and above who participated in the Well-being of the Singapore Elderly (WiSE) study in 2013.

Measurements

Socio-demographic correlates, dietary habits, health behaviours, grip strength, upper arm circumference, and waist circumference were collected. Grip strength was measured using a hand dynamometer with the dominant hand. Upper arm circumference was measured using a measuring tape around the thickest part of the upper arm while waist circumference measured in centimetres was measured at the narrowest part of the body between the chest and hips for women, and measured at the level of the umbilicus for men. Dementia was diagnosed using the 10/66 dementia diagnostic criteria.

Results

Mean grip strength was 13.07 kg (SE=0.60) for people with dementia and 21.98 kg (SE=0.26) for people without dementia. After adjusting for all factors, grip strength remained significantly associated with dementia (p <0.0001). Upper arm circumference was associated with dementia (p <0.0001) but this association was only significant in the univariate analysis. Waist circumference was not significantly associated with dementia.

Conclusions

Lower grip strength was independently associated with dementia in the older adult population in Singapore. Further research needs to be done to ascertain whether this association exists for specific types of dementia and look into the relationship of other anthropometric measurements with dementia in Singapore.

     

北京市大兴区婴儿皮褶厚度发育现状及与体重、胸围、上臂围相关性分析

目的 了解大兴地区0~12月龄婴儿皮褶厚度发育现状,探讨皮褶厚度与体重、胸围、上臂围的相关性,为婴幼儿保健提供参考依据。方法 选择2017年1月-2018年8月在儿童保健门诊就诊的465例婴儿,按照年龄分为5组,测量体重、头围、胸围、上臂围以及四个部位的皮褶厚度,分别是肱二头肌、肱三头肌、肩胛下角、髂前上棘。结果 各年龄组体重、上臂围及各肱二头肌、肩胛下角皮褶厚度均值全部明显高于WHO2006年推荐儿童体格生长发育标准同性别同年龄组,胸围在各年龄组增长均大于头围,0~12月龄内上臂围增长迅速,9月龄到达峰值。男性、女性婴儿皮褶厚度发育趋势一致,12月龄组不同性别肱三头肌皮褶厚度差异具有统计学意义(P<0.05),其余同年龄不同性别婴幼儿皮褶厚度差异无统计学意义。四个部位皮褶厚度对男性婴儿体重及胸围均有显著影响;髂前上棘、肱三头肌和肩胛下角对男性上臂围有显著影响。髂前上棘、肱三头肌和肩胛下角对女性婴儿体重和胸围有显著影响,肱三头肌对女性上臂围有显著影响。结论 0~12月龄婴幼儿皮褶厚度均高于WHO推荐参考指标,胸围、上臂围发育迅速,其中胸围与头围交叉时间提前明显,提示婴儿营养水平良好或存在营养过剩可能,需要积极寻找影响因素进行干预,改善生命早期营养状况。     

Mid-arm circumference and mid-arm circumference: head circumference ratio for assessing longitudinal growth in hospitalized preterm infants.

In order to study the usefulness of upper mid-arm circumference (MAC) and mid-arm circumference:head circumference ratio (MAC:HC) measurements in assessing longitudinal growth in hospitalized preterm infants, we prospectively measured weights, lengths, occipitofrontal head circumferences (OFC), MACs, MAC:HCs, weight/length for age, nutritional intakes, and serum transthyretin and albumin levels in 50 preterm, low-birth-weight, appropriate for gestational age newborn infants during their first 4 postnatal weeks and at hospital discharge. At some time during hospitalization, weight measurements were abnormal (greater than or equal to 2SD from the gestational age mean) in 48% of the infants as compared with 24% with abnormal MAC measurements (p = 0.002). Abnormal MAC:HCs occurred in 25% of the infants as compared with 68% with abnormal weight/length for age values (p less than 0.001). During weeks 2-4, when nutritional intakes were adequate and serum transthyretin and albumin levels were normal, mean weight gain velocity was less than intrauterine rates and was significantly slower than MAC velocities, which were at or greater than intrauterine rates (p less than 0.001). At discharge, when all infants were gaining weight at intrauterine rates, weight measurements were still abnormal in 28% of the infants as compared with 10% of infants who had abnormal MACs (p = 0.005). Similarly, only 12% of infants had abnormal MAC:HCs as compared with 25% of infants with abnormal weight/length for age values at discharge (p = 0.05). The MAC and MAC:HC are useful for assessing longitudinal growth in preterm infants since they do not overestimate the prevalence of malnourishment during periods of apparent protein-calorie sufficiency.     

Efficacy of mid-upper arm circumference in identification,follow-up and discharge of malnourished children during nutrition rehabilitation

BACKGROUND/OBJECTIVES

Although it is crucial to identify those children likely to be treated in an appropriate nutrition rehabilitation programme and discharge them at the appropriate time, there is no golden standard for such identification. The current study examined the appropriateness of using Mid-Upper Arm Circumference for the identification, follow-up and discharge of malnourished children. We also assessed its discrepancy with the Weight-for-Height based diagnosis, the rate of recovery, and the discharge criteria of the children during nutrition rehabilitation.

SUBJECTS/METHODS

The study present findings from 156 children (aged 6-59 months) attending a supplementary feeding programme at Makadara and Jericho Health Centres, Eastern District of Nairobi, Kenya. Records of age, weight, height and mid-upper arm circumference were selected at three stages of nutrition rehabilitation: admission, follow-up and discharge. The values obtained were then used to calculate z-scores as defined by WHO Anthro while estimating different diagnostic indices.

RESULTS

Mid-upper arm circumference single cut-off (< 12.5 cm) was found to exhibit high values of sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio at both admission and discharge. Besides, children recorded higher rate of recovery at 86 days, an average increment of 0.98 cm at the rate of 0.14mm/day, and a weight gain of 13.49gm/day, albeit higher in female than their male counterparts. Nevertheless, children admitted on basis of low MUAC had a significantly higher MUAC gain than WH at 0.19mm/day and 0.13mm/day respectively.

CONCLUSIONS

Mid-upper arm circumference can be an appropriate tool for identifying malnourished children for admission to nutrition rehabilitation programs. Our results confirm the appropriateness of this tool for monitoring recovery trends and discharging the children thereafter. In principle the tool has potential to minimize nutrition rehabilitation costs, particularly in community therapeutic centres in developing countries.     

Performance status of male and female advanced cancer patients is independently predicted by mid-upper arm circumference measurement

In the advanced cancer patient, performance status has considerable prognostic power. Karnofsky performance status, together with variables reported to influence its score, was measured in advanced gastrointestinal cancer patients (n = 148). For male and female patients, age, body mass index, weight loss, triceps skinfold thickness, mid-upper arm circumference, albumin, C-reactive protein, and tumor type and stage were regressed against Karnofsky performance status. On multiple regression analysis, only mid-upper arm circumference and log10 C-reactive protein in men (r2 = 0.462, P < 0.0001) and only mid-upper arm circumference and weight loss in women (r2 = 0.485, P < 0.01) were independent predictors of Karnofsky performance status. There was a significant partial correlation, with gender as a covariable, between log10 C-reactive protein and albumin (r = -0.530, P < 0.0001) and mid-upper arm circumference (r = -0.269, P = 0.035) and weight loss (r = 0.286, P = 0.024). The results of the present study indicate that mid-upper arm circumference is a major factor that influences performance status in male and female patients with advanced gastrointestinal cancer.     

Risk factors for pre-eclampsia among Zimbabwean women: maternal arm circumference and other anthropometric measures of obesity

Maternal pre-pregnancy obesity is a risk factor for pre-eclampsia (proteinuric hypertension in pregnancy) among North American and European women. We studied the relationship between maternal obesity and risk of pre-eclampsia among Zimbabwean women. A case-control study was conducted at Harare Maternity Hospital, Harare, Zimbabwe, between June 1995 and April 1996. Study participants were 144 women with pre-eclampsia and 194 normotensive women serving as controls. Maternal weight, height and mid-arm circumference were measured and recorded during study participants' postpartum hospital admission. Maternal mid-arm circumference, considered to be relatively stable during pregnancy among women of developing countries, was used as the primary indicator of maternal pre-pregnancy obesity. Logistic regression procedures were used to estimate odds ratios and 95% confidence intervals. There were linear trends in risk of pre-eclampsia with increasing mid-arm circumference, increasing weight and increasing body mass index. After adjusting for potential confounding factors, women in the highest quintile for mid-arm circumference (28–39 cm) were 4.4 times more likely to have had their pregnancy complicated by pre-eclampsia than women in the lowest quintile (21–23 cm). Odds ratios of similar magnitude were observed for the other anthropometric measures. To our knowledge, this is the first study to demonstrate a positive association between maternal obesity and pre-eclampsia risk in a black African population. Biological mechanisms thought to explain this relatively consistent epidemiological finding include endothelial cell injury, possibly resulting from hyperlipidaemia.     

Seasonal variations and trends in weight and arm circumference of non-pregnant rural Senegalese women, 1990-1997

Objective:To describe levels, monthly variations and trends in weight and arm circumference of non-pregnant lactating women living in the Sahel, characterized by one short yearly rainy season (July-October).Methods:A mixed unbalanced cross-sectional longitudinal observational study conducted at 3, 5, 7 and 10 months postpartum among 3869 women living in the Sine area in central Senegal who had brought their infants into dispensaries for immunization from January 1990 to February 1997, and 1-5 consecutive children per woman (26 106 visits).Results:Mean weight was 55.7 kg (s.d.: 7.1), but it varied by 2.5-3.9 kg each year, from high means during the dry season (March-May) to low means at the end of the rainy season (September-November). The prevalence of underweight, overweight and obesity (body mass index (BMI)<18.5, 25-29.9 and >30 kg/m(2), respectively) was 7.6% (95% confidence interval: 7.3, 7.9), 6.4% (6.1, 6.7) and 0.4% (0.3, 0.4), but varied strongly by season (P<0.0001 for all). Unlike weight, mean arm increased during the early rains, a peak season of agricultural work (+0.10 cm/month (s.d.: 0.6) from June to August vs -0.35 kg/month (s.d.: 1.1) for weight). BMI and arm circumference were positively associated with age (mean: 20.8 vs 22.2 kg/m(2) and 25.3 vs 27.4 cm, at 20-24 and 40-49 years, respectively, P<0.0001 for both).Conclusions:Season was a major determinant of the anthropometric status of rural African women. Negative energy balance reduced body weight from the onset of agricultural labour, while arm circumference increased during early rains, probably due to high physical activity.European Journal of Clinical Nutrition (2008) 62, 997-1004; doi:10.1038/sj.ejcn.1602807; published online 30 May 2007.