Mid-upper arm circumference cut-offs for screening thinness and severe thinness in Indian adolescent girls aged 10–19 years in field settings

Objective: (i) To assess diagnostic accuracy of mid-upper arm circumference (MUAC) for screening thinness and severe thinness in Indian adolescent girls aged 10–14 and 15–19 years compared with BMI-for-age Z -score (BAZ) Design: Cross-sectional, conducted October 2016–April 2017. Setting: Four tribal blocks of two eastern India states, Chhattisgarh and Odisha. Participants: Girls ( n 4628) aged 10–19 years. Measurements included height, weight and MUAC to calculate BAZ. Standard diagnostic accuracy tests, receiver–operating characteristic curves and Youden index helped arrive at MUAC cut-offs at BAZ Results: Mean MUAC and BMI correlation was positive (0·78, P = 0·001 and r 2 = 0·61). Among 10–14 years, MUAC cut-off corresponding to BAZ v . 10–14 years. State-wise variations existed. MUAC cut-offs ranged from 17·7 cm (10 years) to 22·5 cm (19 years) for BAZ Conclusions: Study provides a case for use of year-wise and sex-wise context-specific MUAC-cut-offs for screening thinness/severe thinness in adolescents, rather than one MUAC cut-off across 10–19 years, depending on purpose and logistic constraints.