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Updated: Jun 9, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Role of Skinfold Thickness and MUAC in Predicting Insulin Resistance: ROC And Regression Analysis
Neslihan Gürcan Kaya1, Yasemin Kinali Çetin2
1Depatmament of Pediatric Gastroenterology, Ankara Training and Research Hospital, Ankara, Turkey.
Insights
Standardized skinfold thickness and mid-upper arm circumference measurements effectively predict insulin resistance in obese children. These non-invasive markers, particularly skinfold thickness SDS, offer superior early detection of metabolic risk compared to raw values.
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Anthropometry
Background:
- Early detection of insulin resistance (IR) in children is crucial for preventing long-term metabolic complications.
- While anthropometric measures like mid-upper arm circumference (MUAC) and skinfold thickness are used, their predictive value, especially when age-standardized, requires further evaluation.
- This study addresses the need for reliable, non-invasive markers for IR in pediatric obesity.
Purpose of the Study:
- To evaluate the predictive performance of raw, SDS, and percentile measurements of MUAC and skinfold thickness for insulin resistance in pediatric patients with obesity.
- To compare the effectiveness of standardized versus raw anthropometric measurements in identifying IR.
- To identify optimal cutoffs for standardized measures for early IR detection.
Main Methods:
- A cross-sectional study involving 171 obese children and adolescents (aged 6-18 years).
- Collection of anthropometric measurements (MUAC, skinfold thickness) and conversion to SDS and percentile values.
- Assessment of insulin resistance using HOMA-IR with pubertal-stage-adjusted cutoffs, analyzed via logistic regression and ROC analysis.
Main Results:
- Insulin resistance was prevalent in 56.1% of the study cohort.
- Standardized measures (SDS, percentiles) showed significantly stronger prediction of IR than raw measurements.
- Skinfold thickness SDS (OR=12.04) and MUAC SDS (OR=7.28) were strong independent predictors of IR, with excellent discriminatory power (AUC=0.82 for skinfold SDS).
Conclusions:
- Skinfold thickness SDS and MUAC SDS are effective, practical, and non-invasive predictors of insulin resistance in obese pediatric patients.
- Standardized anthropometric measurements significantly outperform raw values for IR prediction.
- Integrating skinfold thickness SDS and MUAC SDS into routine clinical assessments can enhance early detection of metabolic risk in children.
Introduction:
Early detection of insulin resistance (IR) in children is essential to prevent long-term metabolic complications. Simple anthropometric measures-mid-upper arm circumference (MUAC) and skinfold thickness-are widely used, but their predictive value, especially when age-standardized, remains unclear. This study aimed to evaluate the performance of raw, SDS, and percentile MUAC and skinfold measurements in predicting IR in patients with obesity and adolescents.
Methods:
A cross-sectional study was conducted with 171 participants with obesity aged 6-18 years. Anthropometric measurements were recorded and converted to SDS and percentile values. Insulin resistance was evaluated using HOMA-IR with pubertal-stage-adjusted cutoffs. Logistic regression and ROC analyses were applied.
Results:
Insulin resistance was present in 56.1% of participants. Both MUAC and skinfold thickness showed significant positive associations with IR; however, standardized measures (SDS and percentiles) demonstrated markedly stronger predictive value than raw measurements. Skinfold thickness SDS emerged as the strongest independent predictor of IR (OR = 12.04, p < 0.001), followed by MUAC SDS (OR = 7.28, p < 0.001). ROC analysis showed excellent discriminatory power for skinfold SDS (AUC = 0.82), with an optimal cutoff of 1.48 (76% sensitivity, 80% specificity). MUAC SDS also performed well (AUC = 0.76; cutoff = 1.10).
Conclusion:
Skinfold thickness SDS and MUAC SDS are strong, practical, and non-invasive markers for predicting insulin resistance in paediatric patients with obesity. Standardized measurements clearly outperform raw values and should be integrated into routine clinical assessment to enhance early detection of metabolic risk.
