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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Evaluation of mid-upper arm circumference in pre-school children: comparison between NCHS/CDC-2000 and WHO-2006
Viviane G Nascimento1, Thais Costa Machado, Ciro João Bertoli
1Departamento de Saúde Materno-Infantil, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
Insights
Arm circumference (AC) classification in preschoolers differs significantly between World Health Organization (WHO-2006) and National Center for Health Statistics (NCHS/CDC-2000) references. The WHO reference is more sensitive for overweight children but less specific for lean children compared to NCHS/CDC.
Area of Science:
- Pediatric Nutrition
- Anthropometry
- Growth Monitoring
Background:
- Accurate anthropometric measurements are crucial for assessing child growth and nutritional status.
- Arm circumference (AC) is a key indicator, but its classification can vary based on reference standards.
- Existing references like NCHS/CDC-2000 and WHO-2006 may yield different classifications for AC in preschool children.
Purpose of the Study:
- To evaluate and compare the classification of arm circumference (AC) in preschool children using two prominent growth references: NCHS/CDC-2000 and WHO-2006.
- To determine how different BMI Z-score groups are classified by AC using these references.
- To assess the correlation between AC differences and BMI Z-scores.
Main Methods:
- A cross-sectional study involving 205 preschool children.
- Measurements included weight, height, and arm circumference (AC). Body mass index (BMI) was calculated.
- BMI was classified using WHO Z-scores. AC was classified using both NCHS/CDC-2000 and WHO-2006 references, with comparisons made across BMI Z-score tertiles.
Main Results:
- The WHO-2006 reference classified AC into higher Z-scores compared to the NCHS/CDC-2000 reference.
- WHO-2006 demonstrated higher sensitivity but lower specificity for lean children, while NCHS/CDC-2000 showed the opposite for overweight children.
- Significant differences in AC classification were observed based on the reference standard used.
Conclusions:
- The choice of reference standard (WHO-2006 vs. NCHS/CDC-2000) significantly impacts the classification of arm circumference in preschool children.
- Healthcare providers should be aware of these differences when assessing nutritional status using AC.
- Further research may be needed to determine the optimal reference for specific populations or clinical contexts.
Abstract:
We aimed to evaluate the classification of arm circumference (AC) in pre-school children by using National Center for Health Statistics (NCHS/CDC-2000) and World Health Organization (WHO-2006) references. We evaluated 205 children: weight, height and AC were assessed and the body mass index (BMI) was calculated. The BMI values were classified into Z-scores by the WHO referential. The AC was classified into Z-cores by two references, comparing the whole-sample value and among groups (tercis) of BMI Z-score. The correlation was also evaluated between differences of AC with BMI Z-score. The WHO referential classified the AC in Z-scores greater than the NCHS/CDC, which is more specific and less sensitive than the NCHS/CDC for lean children and at the same time more sensitive and less specific for children with overweight. In conclusion, a significant difference in the AC classification occurs according to the referential used.
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