The Potential use of Anthropometric Parameters to Predict the Anemia Status of Adolescent Girls
Article Sidebar
Issue
Vol. 18 No. 3 (2023)
Accepted
26 July 2023
Published
30 November 2023
Keywords:
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adolescent girls' anemia, anthropometry, Hb, ROC, WHtR
Abstract
The study assesses the potential use of anthropometric parameters and their optimal cut-off value for predicting the anemia status of adolescent girls. This cross-sectional study analyzed data from 2,184 adolescent girls aged 15‒19 years from West Bandung and Sumedang districts of Indonesia who participated in the Better Investment for Stunting Alleviation Program (BISA). Anemia is defined as a Haemoglobin (Hb) level <12 g/dl and was analyzed by HemoCue® 201+. Anthropometric parameters studied were Body Weight (BW), BMI-for-Age z-Score (BAZ), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), and Waist-to-Height Ratio (WHtR) and all were measured according to WHO procedure. Receiver Operating Characteristics (ROC) was used to analyze the potential of anthropometric parameter to predict anemia status. Based on multivariate analysis, a significant correlation was found between age (OR=0.88; 95% CI:0.79‒0.97) and WHtR (OR=0.12; 95% CI:0.02‒0.63) with anemia status. The ROC analysis revealed that the WHtR parameter had the highest Area Under the Curve (AUC) for predicting anemia, although with a very low accuracy (AUC=0.529). The optimal cut-off with value of WHtR for adolescent girls was ≤0.44. This study suggests that WHtR is a potential parameter for early detection of anemia status among adolescent girls and needs to be confirmed with further studies.
References
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Mulyasari I, Pontang GS. 2018. Waist circumference and waist-to-height ratio as indicators for excess adiposity in Indonesian Adolescents. J Gizi Pangan 13(3):131‒136. https://doi.org/10.25182/jgp.2018.13.3.131-136
Qin Y, Melse-Boonstra A, Pan X, Yuan B, Dai Y, Zhao J, Zimmermann MB, Kok FJ, Zhou M, Shi Z. 2013. Anemia in relation to body mass index and waist circumference among chinese women. Nutr J 12(10):1‒3. https://doi.org/10.1186/1475-2891-12-10
Sari P, Herawati DMD, Dhamayanti M, Hilmanto D. 2022. Anemia among adolescent girls in West Java, Indonesia: Related factors and consequences on the quality of life. Nutrients 14(18):3777. https://doi.org/10.3390/nu14183777
Shaka MF, Wondimagegne YA. 2018. Anemia, a moderate public health concern among adolescents in South Ethiopia. Plos One 13(7):e0191467. https://doi.org/10.1371/journal.pone.0191467
Swainson MG, Batterham AM, Tsakirides C, Rutherford ZH, Hind K. 2017. Prediction of whole-body fat percentage and visceral adipose tissue mass from five anthropometric variables. Plos One 12(5):e0177175. https://doi.org/10.1371/journal.pone.0177175
Teji K, Dessie Y, Assebe T, Abdo M. 2016. Anaemia and nutritional status of adolescent girls in Babile District, Eastern Ethiopia. Pan Afr Med J 24(1):1‒10. https://doi.org/10.11604/pamj.2016.24.62.6949
[WHO] World Health Organization. 1995. Physical status: The use and interpretation of anthropometry. WHO technical Report Series 854. https://apps.who.int/iris/bitstream/handle/10665/37003/WHO_TRS_854.pdf?sequence=1&isAllowed=y [Accessed 1st March 2023].
[WHO] World Health Organization. 2010. Nutrition Landscape Information System (NLIS) Country Profile Indicator-Interpretation Guide. Geneva (CH): WHO.
[WHO] World Health Organization. 2011a. Prevention of iron deficiency anaemia in adolescents. https://apps.who.int/iris/bitstream/handle/10665/205656/B4770.pdf?sequence=1&isAllowed=y [Accessed 1st March 2023].
[WHO] World Health Organization. 2011b. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. https://apps.who.int/iris/bitstream/handle/10665/85839/WHO_NMH_NHD_MNM_11.1_eng.pdf?sequence=22&isAllowed=y [Accessed 1st March 2023].
[WHO] World Health Organization. 2020. Global anaemia reduction efforts among women of reproductive age: Impact, achievement of targets and the way forward for optimizing efforts. https://apps.who.int/iris/handle/10665/336559 [Accessed 1st March 2023].
[WHO] World Health Organization. 2021. WHO global anemia estimates 2021 edition. https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children [Accessed 1st March 2023].
Yan W, Bingxian H, Hua Y, Jianghong D, Jun C, Dongliang G, Yujian Z, Ling, L, Yanying G, Kaiti X et al. 2007. Waist-to-height ratio is an accurate and easier index for evaluating obesity in children and adolescents. Obesity 15(3):748‒752. https://doi.org/10.1038/oby.2007.601
Zhang YX, Chen J, Liu XH. 2021. Profiles of anemia among school-aged children categorized by body mass index and waist circumference in Shandong, China. Pediatr Neonatol 62(2):165‒171. https://doi.org/10.1016/j.pedneo.2020.11.002
Akobeng AK. 2007. Understanding diagnostic test 3: Receiver operating characteristic curves. Acta Paediatr 96(5):644‒647. https://doi.org/10.1111/j.1651-2227.2006.00178.x
Ashwell M, Gunn P, Gibson S. 2012. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: Systematic review and meta-analysis. Obes Rev 13(3):275‒286. https://doi.org/10.1111/j.1467-789X.2011.00952.x
Bacopoulou F, Efthymiou V, Landis G, Rentoumis A, Chrousos GP. 2015. Waist circumference, waist-to-hip ratio and waist-to-height ratio reference percentiles for abdominal obesity among Greek adolescents. BMC Pediatrics 15(1):1‒9. https://doi.org/10.1186/s12887-015-0366-z
Bojanic D, Ljubojevic M, Krivokapic D, Gontarev S. 2020. Waist circumference, waist-to-hip ratio, and waist-to-height ratio reference percentiles for abdominal obesity among Macedonian adolescents. Nutr Hosp 37(4):786‒793. https://doi.org/10.20960/nh.03006
Browning LM, Hsieh SD, Ashwell M. 2010. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0•5 could be a suitable global boundary value. Nutr Res Rev 23(2): 247‒269. https://doi.org/10.1017/S0954422410000144
Choma SS, Alberts M, Modjadji SEP. 2015. Conflicting effects of BMI and waist circumference on iron status. J Trace Elem Med Biol 32:73‒78. https://doi.org/10.1016/j.jtemb.2015.06.003
Crivelli M, Wyss K, Grize L, Matthys B, Aebi T, Zemp E. 2018. Are overweight and obesity in children risk factors for anemia in early childhood? Results from a national nutrition survey in Tajikistan. Int J Public Health 63:491‒499. https://doi.org/10.1007/s00038-018-1088-4
Dutta S, Karkada IR, Sengupta P, Chinni SV. 2021. Anthropometric markers with specific cut-offs can predict anemia occurrence among Malaysian young adults. Front Physiol 12:731416. https://doi.org/10.3389/fphys.2021.731416
Gligoroska JP, Gontarev S, Dejanova B, Todorovska L, Stojmanova DS, Manchevska S. 2019. Red blood cell variables in children and adolescents regarding the age and sex. Iran J Public Health 48(4):704‒712. PMID: 31110981
Gokhale M, Agarwal P, Biswas DA. 2022. Does fat distribution play a role in obesity-associated iron deficiency anemia? An anthropometry-based analysis in young women. Int J Sci Res Dent Med Sci 4(3):119‒126. https://doi.org/10.30485/ ijsrdms.2022.351785.1335
Huang YF, Tok TS, Lu CL, Ko HC, Chen MY, Chen SCC. 2015. Relationship between being overweight and iron deficiency in adolescents. Pediatr Neonatol 56(6):386‒392. https://doi.org/10.1016/j.pedneo.2015.02.003
Jeong J, Cho Y, Cho I-Y, Ahn J. 2022 Association between obesity and anemia in a nationally representative sample of South Korean adolescents: A crosssectional study. Healthcare 10(6):1055. https://doi.org/10.3390/healthcare10061055
Jorgensen JM, Crespo-Bellido M, Dewey KG. 2019. Variation in hemoglobin across the life cycle and between males and females. Ann N Y Acad Sci 1450(1):105‒125. https://doi.org/10.1111/nyas.14096
Kallner A. 2018. Laboratory Statistics: Methods in Chemistry and Health Science 2nd Edition. Cambridge (US): Elsevier.
Krishnan V, Zaki RA, Nahar AM, Jalaludin MY, Majid HA. 2021. The longitudinal relationship between nutritional status and anaemia among Malaysian adolescents. Lancet Reg Health-West Pac 15:100228. https://doi.org/10.1016/j.lanwpc.2021.100228
Lee BJ, Kim JY. 2016. Identification of hemoglobin levels based on anthropometric indices in elderly Koreans. Plos One 11(11):e0165622. https://doi.org/10.1371/journal.pone.0165622
[MoH RI] Ministry of Health Republic of Indonesia. 2013. Riset Kesehatan Dasar 2013. Jakarta (ID): MoH RI.
[MoH RI] Ministry of Health Republic of Indonesia. 2018. Riset Kesehatan Dasar 2018. Jakarta (ID): MoH RI.
Martin-Calvo N, Moreno-Galarraga L, Martinez-Gonzalez MA. 2016. Association between body mass index, waist-to-height ratio and adiposity in children: A systematic review and meta-analysis. Nutrients 8(8):512. https://doi.org/10.3390/nu8080512
Mehdad S, Benaich S, Hamdouchi AE, Bouhaddou N, Azlaf M, Menchawy IE, Belghiti H, Benkirane H, Lahmam H, Barkat A, Kari KE, Mzibri ME, Aguenaou H. 2022. Association between overweight and anemia in Moroccan adolescents: A cross-sectional study. Pan Afr Med J 41(1):1‒12. https://doi.org/10.11604/pamj.2022.41.156.20927
Mulyasari I, Pontang GS. 2018. Waist circumference and waist-to-height ratio as indicators for excess adiposity in Indonesian Adolescents. J Gizi Pangan 13(3):131‒136. https://doi.org/10.25182/jgp.2018.13.3.131-136
Qin Y, Melse-Boonstra A, Pan X, Yuan B, Dai Y, Zhao J, Zimmermann MB, Kok FJ, Zhou M, Shi Z. 2013. Anemia in relation to body mass index and waist circumference among chinese women. Nutr J 12(10):1‒3. https://doi.org/10.1186/1475-2891-12-10
Sari P, Herawati DMD, Dhamayanti M, Hilmanto D. 2022. Anemia among adolescent girls in West Java, Indonesia: Related factors and consequences on the quality of life. Nutrients 14(18):3777. https://doi.org/10.3390/nu14183777
Shaka MF, Wondimagegne YA. 2018. Anemia, a moderate public health concern among adolescents in South Ethiopia. Plos One 13(7):e0191467. https://doi.org/10.1371/journal.pone.0191467
Swainson MG, Batterham AM, Tsakirides C, Rutherford ZH, Hind K. 2017. Prediction of whole-body fat percentage and visceral adipose tissue mass from five anthropometric variables. Plos One 12(5):e0177175. https://doi.org/10.1371/journal.pone.0177175
Teji K, Dessie Y, Assebe T, Abdo M. 2016. Anaemia and nutritional status of adolescent girls in Babile District, Eastern Ethiopia. Pan Afr Med J 24(1):1‒10. https://doi.org/10.11604/pamj.2016.24.62.6949
[WHO] World Health Organization. 1995. Physical status: The use and interpretation of anthropometry. WHO technical Report Series 854. https://apps.who.int/iris/bitstream/handle/10665/37003/WHO_TRS_854.pdf?sequence=1&isAllowed=y [Accessed 1st March 2023].
[WHO] World Health Organization. 2010. Nutrition Landscape Information System (NLIS) Country Profile Indicator-Interpretation Guide. Geneva (CH): WHO.
[WHO] World Health Organization. 2011a. Prevention of iron deficiency anaemia in adolescents. https://apps.who.int/iris/bitstream/handle/10665/205656/B4770.pdf?sequence=1&isAllowed=y [Accessed 1st March 2023].
[WHO] World Health Organization. 2011b. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. https://apps.who.int/iris/bitstream/handle/10665/85839/WHO_NMH_NHD_MNM_11.1_eng.pdf?sequence=22&isAllowed=y [Accessed 1st March 2023].
[WHO] World Health Organization. 2020. Global anaemia reduction efforts among women of reproductive age: Impact, achievement of targets and the way forward for optimizing efforts. https://apps.who.int/iris/handle/10665/336559 [Accessed 1st March 2023].
[WHO] World Health Organization. 2021. WHO global anemia estimates 2021 edition. https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children [Accessed 1st March 2023].
Yan W, Bingxian H, Hua Y, Jianghong D, Jun C, Dongliang G, Yujian Z, Ling, L, Yanying G, Kaiti X et al. 2007. Waist-to-height ratio is an accurate and easier index for evaluating obesity in children and adolescents. Obesity 15(3):748‒752. https://doi.org/10.1038/oby.2007.601
Zhang YX, Chen J, Liu XH. 2021. Profiles of anemia among school-aged children categorized by body mass index and waist circumference in Shandong, China. Pediatr Neonatol 62(2):165‒171. https://doi.org/10.1016/j.pedneo.2020.11.002
Authors
OktavianaM., DwirianiC. M., & DewiM. (2023). The Potential use of Anthropometric Parameters to Predict the Anemia Status of Adolescent Girls . Jurnal Gizi Dan Pangan, 18(3), 137-146. https://doi.org/10.25182/jgp.2023.18.3.137-146
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