Skip to main content
Top
Published in: Cardiovascular Diabetology 1/2013

Open Access 01-12-2013 | Original investigation

Neck circumference as an independent predictive contributor to cardio-metabolic syndrome

Authors: Jing-ya Zhou, Hui Ge, Ming-fan Zhu, Li-jun Wang, Li Chen, Yao-zong Tan, Yu-ming Chen, Hui-lian Zhu

Published in: Cardiovascular Diabetology | Issue 1/2013

Login to get access

Abstract

Background

The predictive potentials of neck circumference (NC) for cardio-metabolic risks remain uncertain. The aim of this study was to investigate whether NC independently contributes to the prediction of cardio-metabolic risks beyond body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHpR) in a large Chinese population.

Methods

A total of 4201 participants (2508 men and 1693 women) aged 20-85 were recruited from the Health Examination Centre between May 2009 and April 2010, anthropometric indices, biochemical and clinical parameters were measured. Receiver operating characteristic, partial correlation and logistic regression analyses were employed to evaluate the association of the anthropometric indices to cardio-metabolic risks separately by gender.

Results

Neck circumference was positively correlated with SBP and DBP (r=0.250 and 0.261), fasting blood glucose (FBP) (r=0.177), TG (r=0.240), TC (r=0.143) and LDL-C (r=0.088) and negatively correlated with HDL-C (r=-0.202) in males (all P<0.01). Similar results were found in females with the exception of TC. The AUCs of NC for metabolic abnormalities ranged from 0.558 (Increased LDL-C) to 0.683 (MS-rf) in men and 0.596 (Increased LDL-C) to 0.703 (MS-rf) in women (P<0.01). The NC of ≥37 cm for men and ≥33 cm for women were the best cut-off points for metabolic syndrome. The adjusted ORs (95% CIs) of NC in men and women respectively were 1.29 (1.12-1.48) and 1.44 (1.20-1.72) for metabolic syndrome risk factors (MS-rf), 1.15 (1.01-1.32) and 1.22 (1.03-1.46) for high BP, 1.16 (1.02-1.33) and 1.42 (1.18-1.71) for increased TG, and 1.26 (1.06-1.50) and 1.32 (1.06-1.65) for increased FBP; the adjusted OR of NC in women for decreased HDL-C was 1.29 (1.10-1.51).

Conclusions

Neck circumference was significantly associated with cardio-metabolic risk factors and independently contributed to the prediction of cardio-metabolic risks beyond the classical anthropometric indices in adults of China.
Appendix
Available only for authorised users
Literature
1.
go back to reference Alberti KGMM, Zimmet P, Shaw J: Metabolic syndrome–a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006, 23: 469-480.CrossRefPubMed Alberti KGMM, Zimmet P, Shaw J: Metabolic syndrome–a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006, 23: 469-480.CrossRefPubMed
2.
go back to reference Vague J: The degree of masculine differentiation of obesities: A factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr. 1956, 4: 20-34.PubMed Vague J: The degree of masculine differentiation of obesities: A factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr. 1956, 4: 20-34.PubMed
3.
go back to reference Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, Adams PW: Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab. 1982, 54: 254-260. 10.1210/jcem-54-2-254.CrossRefPubMed Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, Adams PW: Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab. 1982, 54: 254-260. 10.1210/jcem-54-2-254.CrossRefPubMed
4.
go back to reference Peiris AN, Struve MF, Mueller RA, Lee MB, Kissebath AH: Glucose metabolism in obesity: Influence of body fat distribution. J Clin Endocrinol Metab. 1988, 67: 760-767. 10.1210/jcem-67-4-760.CrossRefPubMed Peiris AN, Struve MF, Mueller RA, Lee MB, Kissebath AH: Glucose metabolism in obesity: Influence of body fat distribution. J Clin Endocrinol Metab. 1988, 67: 760-767. 10.1210/jcem-67-4-760.CrossRefPubMed
5.
go back to reference Ben-Noun L, Sohar E, Laor A: Neck circumference as a simple screening measure for identifying overweight and obese patients. Obes Res. 2001, 9: 470-477. 10.1038/oby.2001.61.CrossRefPubMed Ben-Noun L, Sohar E, Laor A: Neck circumference as a simple screening measure for identifying overweight and obese patients. Obes Res. 2001, 9: 470-477. 10.1038/oby.2001.61.CrossRefPubMed
6.
go back to reference Wing RR, Jeffery RW, Burton LR, Thorson C, Kuller LH, Folsom AR: Change in waist-hip ratio with weight loss and its association with change in cardiovascular risk factors. Am J Clin Nutr. 1992, 55: 1086-1092.PubMed Wing RR, Jeffery RW, Burton LR, Thorson C, Kuller LH, Folsom AR: Change in waist-hip ratio with weight loss and its association with change in cardiovascular risk factors. Am J Clin Nutr. 1992, 55: 1086-1092.PubMed
7.
go back to reference Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ: Waist circumference and abdominal sagittal diameter: Best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994, 73: 460-468. 10.1016/0002-9149(94)90676-9.CrossRefPubMed Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ: Waist circumference and abdominal sagittal diameter: Best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994, 73: 460-468. 10.1016/0002-9149(94)90676-9.CrossRefPubMed
8.
go back to reference Ben-Noun LL, Laor A: Relationship of neck circumference to cardiovascular risk factors. Obes Res. 2003, 11: 226-231. 10.1038/oby.2003.35.CrossRefPubMed Ben-Noun LL, Laor A: Relationship of neck circumference to cardiovascular risk factors. Obes Res. 2003, 11: 226-231. 10.1038/oby.2003.35.CrossRefPubMed
9.
go back to reference Kurtoglu S, Hatipoglu N, Mazicioglu MM, Kondolot M: Neck circumference as a novel parameter to determine metabolic risk factors in obese children. Eur J Clin Invest. 2012, 42: 623-630. 10.1111/j.1365-2362.2011.02627.x.CrossRefPubMed Kurtoglu S, Hatipoglu N, Mazicioglu MM, Kondolot M: Neck circumference as a novel parameter to determine metabolic risk factors in obese children. Eur J Clin Invest. 2012, 42: 623-630. 10.1111/j.1365-2362.2011.02627.x.CrossRefPubMed
10.
go back to reference Onat A, Hergenc G, Yuksel H, Can G, Ayhan E, Kaya Z, Dursunoqlu D: Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr. 2009, 28: 46-51. 10.1016/j.clnu.2008.10.006.CrossRefPubMed Onat A, Hergenc G, Yuksel H, Can G, Ayhan E, Kaya Z, Dursunoqlu D: Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr. 2009, 28: 46-51. 10.1016/j.clnu.2008.10.006.CrossRefPubMed
11.
go back to reference Preis SR, Pencina MJ, D’Aqostino RB, Meiqs JB, Vasan RS, Fox CS: Neck circumference and the development of cardiovascular disease risk factors in the Framingham heart study. Diabetes Care. 2013, 36: e3.PubMedCentralCrossRefPubMed Preis SR, Pencina MJ, D’Aqostino RB, Meiqs JB, Vasan RS, Fox CS: Neck circumference and the development of cardiovascular disease risk factors in the Framingham heart study. Diabetes Care. 2013, 36: e3.PubMedCentralCrossRefPubMed
12.
go back to reference WHO expert consultation: Appropriate body-mass index for Asian population and its implications for policy and intervention strategies. Lancet. 2004, 363: 157-163.CrossRef WHO expert consultation: Appropriate body-mass index for Asian population and its implications for policy and intervention strategies. Lancet. 2004, 363: 157-163.CrossRef
13.
go back to reference Ashwell M, Gunn P, Gibson S: Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obesity Rev. 2012, 13: 275-286. 10.1111/j.1467-789X.2011.00952.x.CrossRef Ashwell M, Gunn P, Gibson S: Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obesity Rev. 2012, 13: 275-286. 10.1111/j.1467-789X.2011.00952.x.CrossRef
14.
go back to reference Guidelines for prevention and treatment of adult dyslipidemia China designated Jiont Committee: Guide to China Adult dyslipidemia prevention. Chin J Geriatr Heart Brain Vessel Dis. 2008, 10: 390-409. Guidelines for prevention and treatment of adult dyslipidemia China designated Jiont Committee: Guide to China Adult dyslipidemia prevention. Chin J Geriatr Heart Brain Vessel Dis. 2008, 10: 390-409.
15.
go back to reference Nikolopoulou A, Kadoqlou NP: Obesity and metabolic syndrome as related to cardiovascular disease. Expert Rev Cardiovasc Ther. 2012, 10: 933-939. 10.1586/erc.12.74.CrossRefPubMed Nikolopoulou A, Kadoqlou NP: Obesity and metabolic syndrome as related to cardiovascular disease. Expert Rev Cardiovasc Ther. 2012, 10: 933-939. 10.1586/erc.12.74.CrossRefPubMed
16.
go back to reference Al-Odat AZ, Ahmad MN, Haddad FH: References of anthropometric indices of central obesity and metabolic syndrome in Jordanian men women. Diabetes Metab Syndr. 2012, 6: 15-21. 10.1016/j.dsx.2012.05.012.CrossRefPubMed Al-Odat AZ, Ahmad MN, Haddad FH: References of anthropometric indices of central obesity and metabolic syndrome in Jordanian men women. Diabetes Metab Syndr. 2012, 6: 15-21. 10.1016/j.dsx.2012.05.012.CrossRefPubMed
17.
go back to reference Gharipour M, Sarrafzadegan N, Sadeqhi M, Andalib E, Talaie M, Shafie D, Aqhababaie E: Predictors of metabolic syndrome in the Iranian population: waist circumference, body mass index, or waist to hip ratio?. Cholesterol. 2013, 201: 1-6.CrossRef Gharipour M, Sarrafzadegan N, Sadeqhi M, Andalib E, Talaie M, Shafie D, Aqhababaie E: Predictors of metabolic syndrome in the Iranian population: waist circumference, body mass index, or waist to hip ratio?. Cholesterol. 2013, 201: 1-6.CrossRef
18.
go back to reference LaBerge RC, Vaccani JP, Gow RM, Gaboury I, Hoey L, Katz SL: Inter- and intra-rater reliability of neck circumference measurements in children. Pediatr Pulmonol. 2009, 44: 64-69. 10.1002/ppul.20944.CrossRefPubMed LaBerge RC, Vaccani JP, Gow RM, Gaboury I, Hoey L, Katz SL: Inter- and intra-rater reliability of neck circumference measurements in children. Pediatr Pulmonol. 2009, 44: 64-69. 10.1002/ppul.20944.CrossRefPubMed
19.
go back to reference Preis SR, Massaro JM, Hoffmann U, D’Aqostino RB, Levy D, Robins SJ, Meiqs JB, Vasan RS, O’Donnell CJ, Fox CS: Neck circumference as a novel measure of cardiometaboolic risk: the Framingham Heart study. J Clin Endocirnol Metab. 2010, 95: 3701-3710. 10.1210/jc.2009-1779.CrossRef Preis SR, Massaro JM, Hoffmann U, D’Aqostino RB, Levy D, Robins SJ, Meiqs JB, Vasan RS, O’Donnell CJ, Fox CS: Neck circumference as a novel measure of cardiometaboolic risk: the Framingham Heart study. J Clin Endocirnol Metab. 2010, 95: 3701-3710. 10.1210/jc.2009-1779.CrossRef
20.
go back to reference Ben-Noun LL, Laor A: Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardiol. 2006, 11: 14-20.PubMed Ben-Noun LL, Laor A: Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardiol. 2006, 11: 14-20.PubMed
21.
go back to reference Stabe C, Vasques AC, Lima MM, Tambascia MA, Pareja JC, Yamanaka A, Geloneze B: Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian Metabolic Syndrome Study. Clin Endocrinol (Oxf). 2013, 78: 874-881. 10.1111/j.1365-2265.2012.04487.x.CrossRef Stabe C, Vasques AC, Lima MM, Tambascia MA, Pareja JC, Yamanaka A, Geloneze B: Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian Metabolic Syndrome Study. Clin Endocrinol (Oxf). 2013, 78: 874-881. 10.1111/j.1365-2265.2012.04487.x.CrossRef
22.
go back to reference Ferrannini E, Sironi AM, Iozzo P, Gastaldelli A: Intra-abdominal adiposity,abdominal obesity, and cardiometabolic risk. Eur Heart J Suppl. 2008, 10: B4-10. 10.1093/eurheartj/sum042.CrossRef Ferrannini E, Sironi AM, Iozzo P, Gastaldelli A: Intra-abdominal adiposity,abdominal obesity, and cardiometabolic risk. Eur Heart J Suppl. 2008, 10: B4-10. 10.1093/eurheartj/sum042.CrossRef
23.
go back to reference Yanq L, Samarasinqhe YP, Kane P, Amiel SA, Aylwin SJ: Visceral adiposity is closely correlated with neck circumference and represents a significant indicator if insulin resistance in WHO grade III obesity. Clin Endocrinol (Oxf). 2010, 73: 197-200. Yanq L, Samarasinqhe YP, Kane P, Amiel SA, Aylwin SJ: Visceral adiposity is closely correlated with neck circumference and represents a significant indicator if insulin resistance in WHO grade III obesity. Clin Endocrinol (Oxf). 2010, 73: 197-200.
24.
go back to reference Dahlen EM, Bjarnegard N, Lanne T, Nystrom FH, Ostgren CJ: Sagittal abdominal diameter is a more independent measure compared with waist circumference to predict arterial stiffness in subjects with type 2 diabetes - a prospective observational cohort study. Cardiovasc Diabetol. 2013, 12: 55-62. 10.1186/1475-2840-12-55.PubMedCentralCrossRefPubMed Dahlen EM, Bjarnegard N, Lanne T, Nystrom FH, Ostgren CJ: Sagittal abdominal diameter is a more independent measure compared with waist circumference to predict arterial stiffness in subjects with type 2 diabetes - a prospective observational cohort study. Cardiovasc Diabetol. 2013, 12: 55-62. 10.1186/1475-2840-12-55.PubMedCentralCrossRefPubMed
25.
go back to reference Seo JA, Kim BG, Cho H, Kim HS, Park J, Baik SH, Choi DS, Park MH, Jo SA, Koh YH, Han C, Kim NH: The cutoff values of visceral fat area and waist circumference for identifying subjects at risk for metabolic syndrome in elderly Korean: Ansan Geriatric (AGE) cohort study. BMC Public Health. 2009, 9: 443-451. 10.1186/1471-2458-9-443.PubMedCentralCrossRefPubMed Seo JA, Kim BG, Cho H, Kim HS, Park J, Baik SH, Choi DS, Park MH, Jo SA, Koh YH, Han C, Kim NH: The cutoff values of visceral fat area and waist circumference for identifying subjects at risk for metabolic syndrome in elderly Korean: Ansan Geriatric (AGE) cohort study. BMC Public Health. 2009, 9: 443-451. 10.1186/1471-2458-9-443.PubMedCentralCrossRefPubMed
26.
go back to reference Lee IT, Chiu YF, Hwu CM, He CT, Chianq FT, Lin YC, Assimes T, Curb JD, Sheu WH: Central obesity is important but not essential component of the metabolic syndrome for predicting diabetes mellitus in a hypertensive family-based cohort. Results from the Stanford Asia-pacific program for hypertension and insulin resistance (SAPPHIRe) Taiwan follow-up study. Cardiovasc Diabetol. 2012, 11: 43-50. 10.1186/1475-2840-11-43.PubMedCentralCrossRefPubMed Lee IT, Chiu YF, Hwu CM, He CT, Chianq FT, Lin YC, Assimes T, Curb JD, Sheu WH: Central obesity is important but not essential component of the metabolic syndrome for predicting diabetes mellitus in a hypertensive family-based cohort. Results from the Stanford Asia-pacific program for hypertension and insulin resistance (SAPPHIRe) Taiwan follow-up study. Cardiovasc Diabetol. 2012, 11: 43-50. 10.1186/1475-2840-11-43.PubMedCentralCrossRefPubMed
27.
go back to reference Mohammadreza B, Farzad H, Davoud K, Fereidoun Prof AF: Prognostic significance of the complex "Visceral Adiposity Index" vs. simple anthropometric measures: Tehran lipid and glucose study. Cardiovasc Diabetol. 2012, 11: 20-29. 10.1186/1475-2840-11-20.PubMedCentralCrossRefPubMed Mohammadreza B, Farzad H, Davoud K, Fereidoun Prof AF: Prognostic significance of the complex "Visceral Adiposity Index" vs. simple anthropometric measures: Tehran lipid and glucose study. Cardiovasc Diabetol. 2012, 11: 20-29. 10.1186/1475-2840-11-20.PubMedCentralCrossRefPubMed
28.
go back to reference Vasheqhani Farahani A, Majidzadeh AK, Masoudkabir F, Karbalai S, Koleini M, Aiatollahzade-Esfahani F, Pashanq M, Hakki E: Sagittal abdominal diameter to triceps skinfold thickness ratio: A novel anthropometric index to predict premature coronary atherosclerosis. Atherosclerosis. 2013, 227: 329-333. 10.1016/j.atherosclerosis.2013.01.033.CrossRef Vasheqhani Farahani A, Majidzadeh AK, Masoudkabir F, Karbalai S, Koleini M, Aiatollahzade-Esfahani F, Pashanq M, Hakki E: Sagittal abdominal diameter to triceps skinfold thickness ratio: A novel anthropometric index to predict premature coronary atherosclerosis. Atherosclerosis. 2013, 227: 329-333. 10.1016/j.atherosclerosis.2013.01.033.CrossRef
29.
go back to reference Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, Zhang JD, Du XP, Li YL, Ji Y, Gu XN, Li Y: Beijing Community Diabetes Study Group: Neck circumference positively related with central obesity, overweight and metabolic syndrome in Chinese subjects with type 2 diabetes: Beijing Community Diabetes Study 4. Diabetes Care. 2010, 33: 2464-2467. Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, Zhang JD, Du XP, Li YL, Ji Y, Gu XN, Li Y: Beijing Community Diabetes Study Group: Neck circumference positively related with central obesity, overweight and metabolic syndrome in Chinese subjects with type 2 diabetes: Beijing Community Diabetes Study 4. Diabetes Care. 2010, 33: 2464-2467.
30.
go back to reference Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J: The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005, 12: 295-300. 10.5551/jat.12.295.CrossRefPubMed Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J: The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005, 12: 295-300. 10.5551/jat.12.295.CrossRefPubMed
Metadata
Title
Neck circumference as an independent predictive contributor to cardio-metabolic syndrome
Authors
Jing-ya Zhou
Hui Ge
Ming-fan Zhu
Li-jun Wang
Li Chen
Yao-zong Tan
Yu-ming Chen
Hui-lian Zhu
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2013
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/1475-2840-12-76

Other articles of this Issue 1/2013

Cardiovascular Diabetology 1/2013 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.