Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Neck circumference may be a valuable tool for screening individuals with obesity: findings from a young Chinese population and a meta-analysis

Authors: Xiaoting Pei, Li Liu, Mustapha Umar Imam, Ming Lu, Yanzi Chen, Panpan Sun, Yaxin Guo, Yiping Xu, Zhiguang Ping, Xiaoli Fu

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

Central obesity and overweight/obesity can result in various chronic non-communicable diseases, such as cardiovascular disease, metabolic syndrome, and diabetes mellitus. Waist circumference (WC) and body mass index (BMI) are widely used to measure obesity despite their limitations. For example, WC and BMI cannot be measured in pregnant women and subjects with abdominal ascites or masses. Therefore, this study aims to determine the efficacy of neck circumference (NC) as a tool for screening central obesity and overweight/obesity.

Methods

A total of 1169 undergraduates aged 18–25 years were studied by a cross-sectional survey in China, 2016. Questionnaires and physical examinations were used to collect data. Receiver operator characteristic (ROC) curve was performed to determine the best threshold of NC for screening central obesity and overweight/obesity. Meanwhile, a meta-analysis was conducted to estimate the efficacy of NC for screening central obesity and overweight/obesity synthetically.

Results

NC was moderately correlated with WC and BMI. The ROC analysis showed that 37.1 cm for male and 32.6 cm for female were the best thresholds for central obesity, and 37.4 cm and 32.2 cm for overweight/obesity, respectively. The sensitivity, specificity, area under receiver operating curve (AUC) of central obesity and overweight/obesity were higher. In the meta-analysis, the pooled sensitivity, specificity, AUC and their 95%CI of NC for screening central obesity were 0.72 (0.68~ 0.75), 0.87 (0.74~ 0.94), 0.77 (0.73~ 0.80) for male and 0.73 (0.65~ 0.80), 0.80 (0.71~ 0.86), 0.82 (0.79~ 0.86) for female. For overweight/obesity, the pooled sensitivity, specificity, AUC and corresponding 95%CI were 0.83 (0.70~ 0.91), 0.77 (0.66~ 0.85), 0.86 (0.83~ 0.89) for male and 0.82 (0.71~ 0.90), 0.84 (0.61~ 0.95), 0.89 (0.86~ 0.92) for female.

Conclusion

NC may not be a good tool for screening individuals with central obesity. But it may be a simple and valuable tool for screening individuals with overweight/obesity, especially in females.
Literature
1.
Davis CR, Dearing E, Usher N, Trifiletti S, Zaichenko L, Ollen E, Brinkoetter MT, Crowell-Doom C, Joung K, Park KH, et al. Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender, race, adult psychosocial risk and health behaviors. Metab Clin Exp. 2014;63(2):199–206.CrossRefPubMed
2.
Liu X, Kris-Etherton PM, West SG, Lamarche B, Jenkins DJ, Fleming JA, McCrea CE, Pu S, couture P, Connelly PW, et al. effects of canola and high-oleic-acid canola oils on abdominal fat mass in individuals with central obesity. Obesity (Silver Spring, Md). 2016;24(11):2261–8.CrossRef
3.
Tian XY, Zhao GM, Li Y, Wang L, Shi Y. Overweight and obesity difference of Chinese population between different urbanization levels. J Rural Health. 2014;30(1):101–12.CrossRefPubMed
4.
Liu XR, Zhou YR, Wang JJ, Liu X, Yang CW, Li JJ, Chen SH, Wu SL. effect of central obesity on the events of new-onset cerebral infarction among type 2 diabetes mellitus patients. Chin J Epidemiol. 2014;35(4):390–2.
5.
Nikooyeh B, Abdollahi Z, Salehi F, Nourisaeidlou S, Hajifaraji M, Zahedirad M, Shariatzadeh N, Kalayi A, Balderlou FB, Salmasi JG: Prevalence of Obesity and Overweight and Its Associated Factors in Urban Adults from West Azerbaijan, Iran: The National Food and Nutritional Surveillance Program (NFNSP). 2016.
6.
Shan G, Wei D, Wang C, Zhang J, Wang B, Ma M, Pan L, Yu T, Xue F, Wu Z. trends of overweight and obesity in Yi people between 1996 and 2007: an Yi migrant study. Biomed Environ Sci. 2011;24(5):467–74.PubMed
7.
Hua SY, Liu GS, Sun LH, Lian GY. The effect of overweight and obesity on the medical expenses of patients with hypertension. Health Economics Research. 2017;10:27–9.
8.
Qing LI, Cai L, You DY. Economic burden caused by diabetes and attributable to obesity in rural residents of Dayao County of Yunnan Province. Chinese General Practice. 2016;
9.
Wakabayashi I. Necessity of both waist circumference and waist-to-height ratio for better evaluation of central obesity. Metab Syndr Relat Disord. 2013;11(3):189–94.CrossRefPubMed
10.
Luo YQ, Ma XJ, Shen Y, Xu YT, Xiong Q, Zhang XL, Xiao Y, Bao Y, Jia W. Neck circumference as an effective measure for identifying cardio-metabolic syndrome: a comparison with waist circumference. Endocrine. 2016:1–9.
11.
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. 2013;78(6):874–81.CrossRef
12.
Kondolot M, Horoz D, Poyrazoglu S, Borlu A, Ozturk A, Kurtoglu S, Mazicioglu MM. Neck circumference to assess obesity in preschool children as a predictor. J Clin Res Pediatr Endocrinol. 2016;
13.
Lou D-H, Yin F-Z, Wang R, Ma C-M, Liu X-L, Lu Q. neck circumference is an accurate and simple index for evaluating overweight and obesity in Han children. Ann Hum Biol. 2012;39(2):161–5.CrossRefPubMed
14.
Onat A, Hergenç G, Yüksel H, Can G, Ayhan E, Kaya Z, Dursunoğlu 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(1):46–51.CrossRefPubMed
15.
Nafiu OO, Burke C, Lee J, Voepel-Lewis T, Malviya S, Tremper KK. Neck circumference as a screening measure for identifying children with high body mass index. Pediatrics. 2010;126(2):e306–10.CrossRefPubMed
16.
Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, Zhang JD, Du XP, Li YL, Ji Y, et al. 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(11):2465–7.CrossRefPubMedPubMedCentral
17.
Arnold TJ, Schweitzer A, Hoffman HJ, Onyewu C, Hurtado ME, Hoffman EP, Klein CJ. Neck and waist circumference biomarkers of cardiovascular risk in a cohort of predominantly African-American college students: a preliminary study. J Acad Nutr Diet. 2014;114(1):107–16.CrossRefPubMed
18.
Zou Y, Zhang R, Zhou B, Huang L, Chen J, Gu F, Zhang H, Fang Y, Ding G. A comparison study on the prevalence of obesity and its associated factors among city, township and rural area adults in China. BMJ Open. 2015;5(7):e008417.CrossRefPubMedPubMedCentral
19.
Assyov Y, Gateva A, Tsakova A, Kamenov Z. A comparison of the clinical usefulness of neck circumference and waist circumference in individuals with severe obesity. Endocr Res. 2016:1–9.
20.
Hatipoglu N, Dogan S, Mazicioglu MM, Kurtoglu S. Relationship between neck circumference and non-alcoholic fatty liver disease in childhood obesity. J Clin Res Pediatr Endocrinol. 2016;8(1):32–9.CrossRefPubMedPubMedCentral
21.
Wang XH, Zhang N, Yu CG, Ji ZL. evaluation of neck circumference as a predictor of central obesity and insulin resistance in Chinese adults. Int J Clin Exp Med. 2015;8(10):19107–13.PubMedPubMedCentral
22.
Skov Ettrup LS, Eliasen M, Ekholm O, Gronbaek M, Tolstrup JS. Binge drinking, drinking frequency, and risk of ischaemic heart disease: a population-based cohort study. Scand J Public Health. 2011;39(8):880–7.CrossRefPubMed
23.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–e34.CrossRefPubMed
24.
Bohning D, Bohning W, Holling H. Revisiting Youden's index as a useful measure of the misclassification error in meta-analysis of diagnostic studies. Stat Methods Med Res. 2008;17(6):543–54.CrossRefPubMed
25.
Rutter CM, Gatsonis CA. A hierarchical regression approach to meta-analysis of diagnostic test accuracy evaluations. Stat Med. 2001;20(19):2865–84.CrossRefPubMed
26.
Tatone EH, Gordon JL, Hubbs J, LeBlanc SJ, DeVries TJ, Duffield TF. A systematic review and meta-analysis of the diagnostic accuracy of point-of-care tests for the detection of hyperketonemia in dairy cows. Prev Vet Med. 2016;130:18–32.CrossRefPubMed
27.
Zhang YL, Huo YN, Xu FH, Liu JD, Cheng LH, Lin AH, Wang CX. the relationship between neck circumference and central obesity in middle-aged and elderly community people of Nanchang. Chin J Intern Med. 2015;54(8):725–6.
28.
Ang NS, Raboca JC. Neck circumference as a screening measure for abdominal obesity and its association with metabolic syndrome among high risk Filipino patients in Makati medical center - a pilot study. Pennsylvania. Legacies. 2014;26(2):150–8.
29.
Aswa J, Garg S, Kutty K, Shankar V. Utility of neck circumference, a simple and novel measure as anthropometric marker of obesity in adults. World Journal of Pharmacy and Pharmaceutical Sciences. 2014;3(3):1618–29.
30.
Wang JX, Ma SS, He WS, Xu C, li YL, Huang CY, yin WY. the correlation of neck circumference and obesity in Chinese old people. Chin J Gerontol. 2017;37(03):708–9.
31.
Lin S, Hu L, li XF, Zeng LY. role of neck circumference for diagnosis of central obesity in community subjects aged over 50. The Journal of Practical Medicine. 2017;33(18):3127–30.
32.
Ben-Noun L, Sohar E, Laor A. Neck circumference as a simple screening measure for identifying overweight and obese patients. Obes Res. 2001;9(8):470–7.CrossRefPubMed
33.
Yan Q, Sun DM, Li X, Zheng QH, Li L, Gu CH, Feng B. Neck circumference is a valuable tool for identifying metabolic syndrome and obesity in Chinese elder subjects: a community-based study. Diabetes Metab Res Rev. 2014;30(1):69–76.CrossRefPubMed
34.
Júnior CH, Sampaio RA, Gonçalvez IO, Aguiar SD, Palmeira R, Oliveira JF, Asano RY, Sampaio PY, Uchida MC. Cutoffs and cardiovascular risk factors associated with neck circumference among community-dwelling elderly adults: a cross-sectional study. Sao Paulo Med J. 2016;134(6):519–27.CrossRef
35.
Kumar S, Gupta A, Jain S. Neck circumference as a predictor of obesity and overweight in rural Central India. International Journal of Medicine & Public Health. 2012;
36.
Song Y, Ma J, Wang H-J, Wang Z, Hu P, Zhang B, Agard a. secular trends of obesity prevalence in Chinese children from 1985 to 2010: urban-rural disparity. Obesity. 2015;23(2):448–53.CrossRefPubMed
37.
Huang BX, Zhu MF, Wu T, Zhou JY, Liu Y, Chen XL, Zhou RF, Wang LJ, Chen YM, Zhu HL. Neck circumference, along with other anthropometric indices, has an independent and additional contribution in predicting fatty liver disease. PLoS One. 2015;10(2):e0118071.CrossRefPubMedPubMedCentral
38.
Hetemaki N, Savolainen-Peltonen H, Tikkanen MJ, Wang F, Paatela H, Hamalainen E, Turpeinen U, Haanpaa M, Vihma V, Mikkola TS. Estrogen metabolism in abdominal subcutaneous and visceral adipose tissue in postmenopausal women. J Clin Endocrinol Metab. 2017;
39.
Zhou XL, Zhao JJ. Obesity and sexhormones. Chinese Journal of Practical Internal Medicine. 2011;31(4):257–9.
40.
Li H-X, Zhang F, Zhao D, Xin Z, Guo S-Q, Wang S-M, Zhang J-J, Wang J, Li Y, Yang G-R, et al. Neck circumference as a measure of neck fat and abdominal visceral fat in Chinese adults. BMC Public Health. 2014;14
41.
Browning LM, Mugridge O, Chatfield M, Dixon A, Aitken S, Joubert I, Prentice AM, Jebb SA. Validity of a new abdominal bioelectrical impedance device to measure abdominal and visceral fat: comparison with MRI. Obesity (Silver Spring). 2010;18(12):2385–91.CrossRef
42.
Nafiu OO, Burke C, Lee J, Voepellewis T, Malviya S, Tremper KK. Neck circumference as a screening measure for identifying children with high body mass index. Pediatrics. 2010;126(2):e306-e310.CrossRef
Metadata
Title
Neck circumference may be a valuable tool for screening individuals with obesity: findings from a young Chinese population and a meta-analysis
Authors
Xiaoting Pei
Li Liu
Mustapha Umar Imam
Ming Lu
Yanzi Chen
Panpan Sun
Yaxin Guo
Yiping Xu
Zhiguang Ping
Xiaoli Fu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5448-z

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue

Research article

Is waist-to-height ratio the best predictive indicator of hypertension incidence? A cohort study

Research article

Breast cancer risk in a screening cohort of Asian and white British/Irish women from Manchester UK

Research article

The usefulness of small-area-based socioeconomic characteristics in assessing the treatment outcomes of type 2 diabetes patients: a register-based mixed-effect study

Research article

Development and convergent validity of new self-administered questionnaires of active transportation in three African countries: Kenya, Mozambique and Nigeria

Study protocol

MINDMAP: establishing an integrated database infrastructure for research in ageing, mental well-being, and the urban environment

Research article

Exploring the small-scale spatial distribution of hypertension and its association to area deprivation based on health insurance claims in Northeastern Germany