PT43
MUAC Z SCORES IN DIAGNOSING CHILDHOOD MALNUTRITION: A NATIONWIDE MALNUTRITION SCREENING STUDY
B. Unay1, Y. Dogan2, A. Alptekin Sarioglu3,* on behalf of The MUAC Study Group
1Department of Pediatric Neurology, Gulhane Faculty of Medicine, Ankara, 2Department of Pediatric Gastroenterology, Hepatology and Nutrition, Fırat University Faculty of Medicine, Elazig, 3Abbott Nutrition, Abbott Laboratories, Istanbul, Türkiye
Rationale: To determine prevalence of childhood malnutrition and diagnostic role of mid-upper arm circumference (MUAC) z scores with reference to WHO z scores for weight-for-age (WFA) and body mass index (BMI)
Methods: A total of 9107 pediatric outpatients (median (min-max) age 103(2-225) months, 50.9% were girls) were included in this cross-sectional nationwide malnutrition screening study conducted at pediatric centers across Turkey.
Results: MUAC, WFA and BMI z scores revealed malnutrition in 12.5%, 12.0% and 9.0% of patients in the 2-60 months age group; in 16.1%, 12.5% and 13.4% of patients in the 61-120 months age group; and in 21.6%, N/A and 12.7% of patients in the 121-128 months age group, respectively (Fig 1). Eastern Anatolia Region (18.1%) and the Southeastern Anatolia Region (17.4%) were associated with the highest malnutrition prevalence as defined by BMI z scores ≤-2. MUAC z scores were within the range of -2 to -1 in 23.3% of patients and were <-2 in 17.3% of patients. MUAC z scores were positively correlated with WHO z scores for WFA (r=0.684) and BMI (r=0.703) (p<0.001 for each), regardless of gender and age groups. MUAC and BMI z score-based rates of primary malnutrition were 50.8% and 39.3%, respectively. The most common underlying diagnoses for the secondary malnutrition were endocrine-metabolic disorders (20.4%; by MUAC z scores) and chronic kidney disease (20.0%; by BMI z scores).
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Conclusion: MUAC z score assessment is a favorable diagnostic tool in childhood malnutrition, showing significant positive correlations with WHO z scores for WFA, and BMI. Nonetheless, MUAC z scores seem to be a more useful and broadly applicable malnutrition screening tool, particularly in children aged >60 months, in primary malnutrition and in secondary malnutrition related to an underlying neurological, gastroenterological, hemato-oncological or chronic pulmonary disorder.
Disclosure of Interest: B. Unay: None declared, Y. Dogan: None declared, A. Alptekin Sarioglu Other: Aysugul Alptekin Sarioglu, M.D. is an Abbott employee.