{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:20:14Z","timestamp":1787750414658,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"25","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6,19]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Mid-upper arm circumference (MUAC) is widely used for screening pediatric malnutrition due to its simplicity and feasibility. Although its relationship with anthropometric indicators including weight-for-height (WFH), body mass index (BMI)-for-age, and height-for-age has been previously examined, the degree of agreement and its clinical implications remain variable. This study aimed to evaluate the agreement and clinical relevance of MUAC in assessing acute, chronic, and concurrent malnutrition. This retrospective cross-sectional study included 473 children (0\u201318 years) evaluated for malnutrition at a tertiary pediatric gastroenterology clinic. Nutritional status was classified using World Health Organization growth standards based on WFH, BMI-for-age, and height-for-age z-scores. MUAC was analyzed as absolute values and MUAC-for-age z-score categories. Acute malnutrition was identified in 72.9% of participants, chronic malnutrition in 18.2%, and concurrent malnutrition in 8.9%. MUAC classified 83.7% of children as malnourished and detected a higher proportion of mild malnutrition than BMI-for-age and WFH classifications. MUAC severity showed a moderate correlation with WFH classifications in children\u2005&lt;5 years (\u03c1\u2005=\u20050.447,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;.001) and a strong correlation with BMI-for-age classifications in those\u2005\u2265\u20055 years (\u03c1\u2005=\u20050.649,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;.001). Agreement between MUAC-based severity categories and anthropometric classifications was fair for WFH (\u03ba\u2005=\u20050.33) and moderate for BMI-for-age (\u03ba\u2005=\u20050.55). Children with concurrent malnutrition were more frequently classified into moderate or severe MUAC categories (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;.01). MUAC showed fair-to-moderate agreement and moderate-to-strong correlations with BMI-for-age and WFH indicators of acute malnutrition, whereas its associations with chronic malnutrition were weaker. It identifies a higher proportion of children with mild malnutrition and reflects the severity of concurrent malnutrition. These findings support the potential complementary role of MUAC in routine anthropometric assessment and suggest that it may contribute to the early identification of pediatric malnutrition.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/md.0000000000049335","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T06:01:03Z","timestamp":1782108063000},"page":"e49335","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Agreement and clinical relevance of mid-upper arm circumference in acute, chronic, and concurrent pediatric malnutrition: A retrospective cross-sectional study"],"prefix":"10.1097","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0107-4699","authenticated-orcid":false,"given":"Melike","family":"Arslan","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology, Department of Pediatrics, Konya City Hospital, Konya, T\u00fcrkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20260820","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.3390\/nu12082413","article-title":"Acute malnutrition in children: pathophysiology, clinical effects and treatment.","volume":"12","author":"Dipasquale","year":"2020","journal-title":"Nutrients"},{"key":"R3-20260820","doi-asserted-by":"crossref","first-page":"e13246","DOI":"10.1111\/mcn.13246","article-title":"The relationship between wasting and stunting in young children: a systematic review.","volume":"18","author":"Thurstans","year":"2022","journal-title":"Matern Child Nutr"},{"key":"R4-20260820","first-page":"1535","article-title":"Assessment of the diagnostic performance of MUAC in malnutrition screening and its correlation with other anthropometric indicators in healthy children and adolescents.","volume":"11","author":"Durukan","year":"2024","journal-title":"Children (Basel)"},{"key":"R5-20260820","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1159\/000367880","article-title":"3.1 Primary and secondary malnutrition.","volume":"113","author":"Shahrin","year":"2015","journal-title":"World Rev Nutr Diet"},{"key":"R6-20260820","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1177\/0884533616671861","article-title":"Diagnosing pediatric malnutrition: paradigm shifts of etiology-related definitions and appraisal of the indicators.","volume":"32","author":"Bouma","year":"2017","journal-title":"Nutr Clin Pract"},{"key":"R7-20260820","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1002\/ncp.11208","article-title":"Measurement of mid-upper arm circumference to screen for childhood malnutrition: general applicability and use in special populations.","volume":"39","author":"Becker","year":"2024","journal-title":"Nutr Clin Pract"},{"key":"R8-20260820","doi-asserted-by":"crossref","first-page":"881","DOI":"10.9745\/GHSP-D-20-00450","article-title":"Accuracy of using mid-upper arm circumference to detect wasting among children aged 6-59 months in Nepal.","volume":"9","author":"Lamsal","year":"2021","journal-title":"Glob Health Sci Pract"},{"key":"R9-20260820","doi-asserted-by":"crossref","first-page":"111918","DOI":"10.1016\/j.nut.2022.111918","article-title":"Sensitivity and specificity of mid-upper arm circumference for assessment of severe acute malnutrition among children ages 6 to 59 months: systematic review and meta-analysis.","volume":"107","author":"Lambebo","year":"2023","journal-title":"Nutrition"},{"key":"R10-20260820","first-page":"e31","article-title":"Mid-upper arm circumference only protocol in Pakistan: missed opportunities for children suffering from severe acute malnutrition? A mixed-methods observational study.","volume":"27","author":"Guesdon","year":"2024","journal-title":"Public Health Nutr"},{"key":"R11-20260820","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1186\/s12887-025-06120-7","article-title":"Validity of mid-upper arm circumference in assessing thinness among older children aged 5-9 years: a cross-sectional study.","volume":"25","author":"Namirembe","year":"2025","journal-title":"BMC Pediatr"},{"key":"R13-20260820","doi-asserted-by":"crossref","first-page":"2333794X19861575","DOI":"10.1177\/2333794X19861575","article-title":"User-informed medical device development: a case study for pediatric malnutrition assessment.","volume":"6","author":"Thaete","year":"2019","journal-title":"Glob Pediatr Health"},{"key":"R17-20260820","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1002\/ncp.11205","article-title":"Utility of mid-upper arm circumference in pediatric malnutrition: an Australasian Society of Parenteral and Enteral Nutrition consensus statement using the Delphi method.","volume":"39","author":"Miles","year":"2024","journal-title":"Nutr Clin Pract"},{"key":"R18-20260820","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1017\/S1368980024002465","article-title":"Acute malnutrition associated with mid-upper arm circumference among under-five children in tribal areas, India: a cross-sectional study.","volume":"28","author":"Patra","year":"2024","journal-title":"Public Health Nutr"},{"key":"R19-20260820","doi-asserted-by":"crossref","first-page":"e13404","DOI":"10.1111\/mcn.13404","article-title":"Does a child\u2019s mid-upper arm circumference-for-age z-score represent another nutritional indicator of childhood malnutrition status?","volume":"18","author":"Haque","year":"2022","journal-title":"Matern Child Nutr"},{"key":"R20-20260820","doi-asserted-by":"crossref","first-page":"e00612","DOI":"10.34172\/jrhs.2024.147","article-title":"Diagnostic accuracy of mid-upper arm circumference for the detection of acute malnutrition among children aged 6-60 months: a diagnostic accuracy study.","volume":"24","author":"Jasani","year":"2024","journal-title":"J Res Health Sci"},{"key":"R21-20260820","doi-asserted-by":"crossref","first-page":"8830494","DOI":"10.1155\/2021\/8830494","article-title":"Comparison of mid-upper-arm circumference and weight-for-height z-score in identifying severe acute malnutrition among children aged 6-59 months in South Gondar Zone, Ethiopia.","volume":"2021","author":"Abitew","year":"2021","journal-title":"J Nutr Metab"},{"key":"R22-20260820","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1186\/s12889-025-21301-w","article-title":"The performance of upper arm circumference for age in diagnosing severe acute malnutrition in children aged 6 to 59 months in South Kivu, Eastern Democratic Republic of Congo: Lwiro Cohort.","volume":"25","author":"Ngaboyeka","year":"2025","journal-title":"BMC Public Health"},{"key":"R23-20260820","doi-asserted-by":"crossref","first-page":"896","DOI":"10.3945\/ajcn.112.047639","article-title":"The effect of multiple anthropometric deficits on child mortality: meta-analysis of individual data in 10 prospective studies from developing countries.","volume":"97","author":"McDonald","year":"2013","journal-title":"Am J Clin Nutr"},{"key":"R24-20260820","doi-asserted-by":"crossref","first-page":"e12516","DOI":"10.1111\/mcn.12516","article-title":"Children concurrently wasted and stunted: a meta-analysis of prevalence data of children 6-59 months from 84 countries.","volume":"14","author":"Khara","year":"2018","journal-title":"Matern Child Nutr"},{"key":"R25-20260820","doi-asserted-by":"crossref","first-page":"e13000","DOI":"10.1111\/mcn.13000","article-title":"Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda: prevalence and case detection.","volume":"16","author":"Odei Obeng-Amoako","year":"2020","journal-title":"Matern Child Nutr"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000049335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:33:15Z","timestamp":1787747595000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000049335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,19]]},"references-count":20,"journal-issue":{"issue":"25","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000049335","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,19]]},"assertion":[{"value":"2026-03-09","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-31","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}