Performance of mid‐upper arm circumference to identify adolescents with obesity and metabolic syndrome: NHANES 2011–2018 analysis

Summary Background Mid‐upper arm circumference (MUAC) was recommended for screening of adolescents with obesity, although its diagnostic performance with respect to high‐precision assessment of body composition remains unknown. Objective To evaluate the diagnostic performance of MUAC in identifying obesity and metabolic syndrome in U.S. adolescents. Methods A cross‐sectional study was conducted using National Health and Nutrition Examination Survey (NHANES) data (2011–2018) of adolescents aged 12–19. We calculated the area under the receiver operating characteristic curve, sensitivity, specificity, positive and negative predictive values and likelihood ratios of MUAC in identifying obesity and metabolic syndrome. Results In our study, data of 5496 adolescents, including 2665 females, were analysed. The prevalence of obesity was higher in boys (14%) than girls (10%), whilst metabolic syndrome was more common in males (2.6%) than females (1.7%). The area under the curve (AUC) of MUAC in identifying obesity was 0.69 in boys and 0.86 in girls, whilst the AUC of MUAC in identifying metabolic syndrome was 0.91 in boys and 0.87 in girls. The optimal MUAC cut‐off for identifying adolescents with obesity was 28.3 cm in boys (sensitivity: 64.8%, specificity: 85.5%) and 30.8 cm in girls (sensitivity: 67.9%, specificity: 90.1%). Conclusions MUAC was a good indicator of both obesity and metabolic syndrome, with higher accuracy in girls.