Relationship between Mid-Upper Arm Circumference and Body Mass Index in Inpatients

Abstract

Nutritional screening is a fundamental aspect of the initial evaluation of the hospitalised patient. Body Mass Index (BMI) in association with other parameters is a good marker of malnutrition (<18.5 kg/m2), but it presents the handicap that the great majority of patients cannot be weighed andmeasured. Forthis reason it is necessary to find other indicators that can be measuredin these patients. Objectives 1) Analyse the relationship between BMI and Mid-Upper Arm Circumference (MUAC); 2) establish a cut-off point of MUAC equivalent to BMI <18.5 kg/m2. Materials and Methods Theanthropometric data of patients hospitalised over the period 2004–2013 were retrospectively revised. The following variables were collected: weight, height, BMI, MUAC, sex and age. Results 1373patients were evaluated, who presented a mean weight of: 65.04±15.51 kg; height: 1.66±0.09 m; BMI: 23.48±5.03 kg/m2; MUAC: 26.95±4.50 cm; age: 56.24±16.77. MUAC correlates suitably to BMI by means of the following equation (simple linear regression): BMI=−0.042+0.873xMUAC(cm)(R2=0.609),withaPearsonrvalueof0.78(p<0.001). Thearea under the curve of MUACforthediagnosis of malnutrition was 0.92 (95% CI: 0.90–0.94; p<0.001). The MUAC value 22.5 cmpresented asensitivity of 67.7%, specificity of 94.5%, and a correct classification of 90%. No significant statistical differences were found in the cut-off point of MUAC for the diagnosis of malnutrition based on sex (p = 0.115) and age(p=0.694). Conclusions 1) MUACcorrelates positively and significantly with BMI. 2) MUAC 22.5 cm correlates properly with a BMI of <18.5 kg/m2, independent of the age or sex of the patient, although there are other alternatives. MUAC constitutes a useful tool as a marker of malnutrition, fundamentally in patients for whom weight and height cannot be determined.