Excellent intra and inter-observer reproducibility of wrist circumference measurements in obese children and adolescents

In a previous study, we found that wrist circumference, in particular its bone component,was associated with insulin resistance in a population of overweight/obese children. Theaim of the present study was to evaluate the intra- and inter-operator variability in wrist cir-cumference measurement in a population of obese children and adolescents. One hundredand two (54 male and 48 female) obese children and adolescents were consecutivelyenrolled. In all subjects wrist circumferences were measured by two different operators twotimes to assess intra- and inter-operator variability. Statistical analysis was performed usingSAS v.9.4 and JMP v.12. Measurements of wrist circumference showed excellent inter-operator reliability with Intra class Correlation Coefficients (ICC) of 0.96 and ICC of 0.97 forthe first and the second measurement, respectively. The intra-operator reliability was, also,very strong with a Concordance Correlation Coefficient (CCC) of 0.98 for both operators.The high reproducibility demonstrated in our results suggests that wrist circumference mea-surement, being safe, non-invasive and repeatable can be easily used in out-patient set-tings to identify youths with increased risk of insulin-resistance. This can avoid testing theentire population of overweight/obese children for insulin resistance parameters