Is neck circumference an appropriate tool to predict cardiovascular risk in clinical practice? A cross-sectional study in Chilean population.
ABSTRACT: OBJECTIVES:Neck circumference has emerged as a predictor of obesity and metabolic syndrome, but its clinical usefulness for different groups of population is not clearly defined. The aim is to evaluate the predictive capacity of neck circumference in order to detect cardiovascular risks (CVRs) on the Chilean population and to compare it with waist circumference performance. DESIGN:Cross-sectional study. SETTING:General Chilean population. PARTICIPANTS:Data of 4607 adults aged 18 and over from the Chilean National Health Survey 2009-2010 were analysed. PRIMARY AND SECONDARY OUTCOME MEASURES:Anthropometrics measures included neck and waist circumference, height and weight. CVR was identified according to the Framingham tables adapted for the Chilean population. Receiver operating characteristics curves and logistic regression models were made to evaluate the performance of neck circumference to predict a moderate/high CVR, comparing it to waist circumference. RESULTS:Almost 10% of the sample had a moderate or high CVR. The probability of having a moderate/high cardiovascular risk increase with cervical obesity (OR 1.95, 95% CI 1.04 to 3.68) and central obesity (OR 4.5, 95% CI 2.47 to 8.22). The area under the curves were high for cervical obesity (AUC 81.4%, 95% CI 78.8% to 84.0%) and central obesity (AUC 82.2%, 95% CI 79.7% to 84.7%) and not statistically different (p=0.152). CONCLUSIONS:Neck obesity has a high capacity to predict moderate/high CVR in the Chilean population. Its good performance appears as an opportunity to use it in clinical practice when waist circumference measurement is difficult to measure and eventually replace the waist circumference measurement as the technique is easier.
Project description:Measurement of waist circumference has substantial variability and some limitations, while neck circumference is a simple and reliable anthropometric measure. This study aimed to assess the association between neck circumference and waist circumference and to identify the best cutoff of neck circumference that could predict central obesity in prediabetic patients. This cross-sectional study included adult patients with prediabetes, defined as having fasting plasma glucose levels ranging from 100 to 125?mg/dL or HbA1c ranging from 5.7 to 6.49%, who visited the outpatient clinic of Family Medicine Department, Ramathibodi Hospital, Thailand, during October 2014 and March 2016. Neck circumference was measured from the level just below the laryngeal prominence perpendicular to the long axis of the neck. Central obesity was defined as having waist circumference measurements greater than 90 and 80?cm for males and females, respectively. The correlation between neck circumference and waist circumference was explored by applying pairwise correlation coefficient. Receiver operating characteristic (ROC) curve analysis was performed and Youden index equal to "sensitivity - (1-specificity)" was calculated. Neck circumference that yielded the maximum Youden index was determined as the optimal cutoff point for prediction of central obesity. There were 1,534 patients eligible for this study. After adjusting for covariables, neck circumference was found to be significantly associated with waist circumference in both females and males, with ?-coefficients of 1.01 (95% CI: 0.83, 1.20) and 0.65 (95% CI: 0.46, 0.85), respectively. After applying the ROC analysis, neck circumferences ? 32?cm in females and ? 38?cm in males were determined as the best cutoff values to predict central obesity. Neck circumference is strongly correlated with waist circumference in prediabetics and should be considered as an alternative to the waist circumference measurement in screening for central obesity.
Project description:BACKGROUND AND AIM:Previous studies have indicated that neck circumference is a valuable predictor for obesity and metabolic syndrome, but little evidence is available for fatty liver disease. We examined the association of neck circumference with fatty liver disease and evaluated its predictive value in Chinese adults. METHODS:This cross-sectional study comprised 4053 participants (1617 women and 2436 men, aged 20-88) recruited from the Health Examination Center in Guangzhou, China between May 2009 and April 2010. Anthropometric measurements were taken, abdominal ultrasonography was conducted and blood biochemical parameters were measured. Covariance, logistic regression and receiver operating characteristic curve analyses were employed. RESULTS:The mean neck circumference was greater in subjects with fatty liver disease than those without the disease in both women and men after adjusting for age (P<0.001). Logistic regression analysis showed that the age-adjusted ORs (95% CI) of fatty liver disease for quartile 4 (vs. quartile 1) of neck circumference were 7.70 (4.95-11.99) for women and 12.42 (9.22-16.74) for men. After further adjusting for other anthropometric indices, both individually and combined, the corresponding ORs remained significant (all P-trends<0.05) but were attenuated to 1.94-2.53 for women and 1.45-2.08 for men. An additive interaction existed between neck circumference and the other anthropometric measures (all P<0.05). A high neck circumference value was associated with a much greater prevalence of fatty liver disease in participants with both high and normal BMI, waist circumference and waist-to-hip ratio values. CONCLUSIONS:Neck circumference was an independent predictor for fatty liver disease and provided an additional contribution when applied with other anthropometric measures.
Project description:Studies based on Body Mass Index (BMI) and waist circumference (WC) are generally used to examine the prevalence and tendency of overweight and obesity. These studies help determine the socioeconomic development of a country and improve public health policies. Therefore, the goal of this research was to determine the trend of change in abdominal obesity of Chilean university students according to the Body Mass Index (BMI) measured in intervals of three and six years.For this study, a total of 1598 students of both sexes ranging in age from 18 to 26 from a Chilean university were evaluated. Students were assessed commencing in 2007 (372 males and 315 females), 2010 (250 males and 330 females), and ending in 2013 (153 males and 178 females). During the three transversal assessments, weight, height, and waist circumference were evaluated. BMI was calculated for both sexes.No significant differences were found in age and BMI during the three years evaluated (2007, 2010, and 2013). In 2013, waist circumference (WC) increased significantly (p < 0.001 for both sexes). Moreover, in 2013, in all the percentiles evaluated, high values of WC were compared in relation to previous years. Furthermore, in 2013, in all four BMI categories (underweight, normal, overweight, and obese), the university students showed significant increases in WC (Females: p = 0.004; Males: p = 0.035) whereas in 2007 and 2010, the values remained relatively stable.BMI remained constant during 2007, 2010, and 2013. However, the university students of both sexes showed greater risk of abdominal obesity as a result of increased WC in 2013.
Project description:Adipokines, such as leptin, may affect cancer through its link with inflammation and obesity. We investigated the association between leptin, C-reactive protein, and risk of cancer death while accounting general and abdominal obesity. From the Third National Health and Examination Survey (NHANES III), we selected 5957 adult men and women with baseline measurements of serum leptin and CRP. Multivariable Cox regression was used to assess leptin and CRP levels (low, moderate, high) in relation to risk of cancer death. Stratification analyses were performed for obesity as defined by body mass index (BMI) and waist circumference. Fine and Gray regression was performed to account for death from cardiovascular disease and other causes as competing events. A total of 385 participants died of cancer during a mean follow-up of 18 years. After adjusting for BMI and waist circumference, an inverse association with log-transformed leptin was found for women, with a hazard ratio (HR) of 0.81 (95% confidence interval [CI]: 0.51-1.30) and 0.40 (95% CI: 0.24-0.68) for moderate and high compared to low levels of leptin, respectively; P(trend) = 0.0007). No association for leptin was observed in men, but higher CRP corresponded to increased risk of dying from cancer (HR: 2.98; 95% CI: 1.57-5.64 for the highest vs. lowest categories of CRP). Similar associations were observed with competing risk analysis also adjusted for BMI and waist circumference. Contrasting associations of serum leptin and CRP with cancer mortality may indicate sex-specific biological or environmental pathways linking obesity and cancer in men and women which warrant mechanistic investigations.
Project description:PURPOSE:The aim of this study was to determine the association between active transportation and obesity indicators in adults from eight Latin American countries. METHODS:Data from the ELANS study, an observational multi-country study (n: 8336; 18-65 years), were used. Active transportation (walking and cycling) and leisure time physical activity was assessed using the International Physical Activity Questionnaire (long version). The obesity indicators considered were: body mass index, and waist and neck circumference. RESULTS:In the total sample, the average time dedicated to active transportation was 24.3 min/day, with the highest amount of active transportation being Costa Rica (33.5 min/day), and the lowest being Venezuela (15.7 min/day). The countries with the highest proportion of active transportation were Ecuador (71.9%), and the lowest was Venezuela (40.5%). Results from linear regression analyses suggest that active transportation was significantly and independently associated with a lower body mass index (?: -0.033; 95% CI: -0.064; -0.002), but not with waist circumference (?: -0.037; 95% CI: -1.126; 0.390 and neck circumference (?: -0.007; 95% CI: -0.269; 0.130). CONCLUSIONS:Active transportation is significantly associated with a lower body mass index. Governments should incentivize this type of transportation as it could help to reduce the obesity pandemic in Latin America.
Project description:Gluteofemoral obesity (determined by measurement of subcutaneous fat in the hip and thigh regions) could reduce risks of cardiovascular and diabetic disorders associated with abdominal obesity. We evaluated whether gluteofemoral obesity also reduces the risk of Barrett's esophagus (BE), a premalignant lesion associated with abdominal obesity.We collected data from non-Hispanic white participants in 8 studies in the Barrett's and Esophageal Adenocarcinoma Consortium. We compared measures of hip circumference (as a proxy for gluteofemoral obesity) from cases of BE (n = 1559) separately with 2 control groups: 2557 population-based controls and 2064 individuals with gastroesophageal reflux disease (GERD controls). Study-specific odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated using individual participant data and multivariable logistic regression and combined using a random-effects meta-analysis.We found an inverse relationship between hip circumference and BE (OR per 5-cm increase, 0.88; 95% CI, 0.81-0.96), compared with population-based controls in a multivariable model that included waist circumference. This association was not observed in models that did not include waist circumference. Similar results were observed in analyses stratified by frequency of GERD symptoms. The inverse association with hip circumference was statistically significant only among men (vs population-based controls: OR, 0.85; 95% CI, 0.76-0.96 for men; OR, 0.93; 95% CI, 0.74-1.16 for women). For men, within each category of waist circumference, a larger hip circumference was associated with a decreased risk of BE. Increasing waist circumference was associated with an increased risk of BE in the mutually adjusted population-based and GERD control models.Although abdominal obesity is associated with an increased risk of BE, there is an inverse association between gluteofemoral obesity and BE, particularly among men.
Project description:Background: Waist circumference has been correlated with the risk of hyperuricemia. Whether neck circumference is also associated with hyperuricemia has not been assessed. This study aimed to investigate whether neck circumference is associated with hyperuricemia. Methods: This study population from Beijing is part of the larger China-wide Risk Evaluation of Cancers in Chinese Diabetic Individuals: a lONgitudinal (REACTION) study. For this Beijing sub-center cross-sectional study, a total of 8971 subjects were recruited. Gender-specific multivariable-adjusted regression analyses were conducted to analyze the association of neck circumference and waist circumference with hyperuricemia and the association of neck circumference with serum uric acid levels in the non-hyperuricemia population. Results: After adjusting for confounding variables, regression analyses showed that neck circumference was positively associated with hyperuricemia [OR, 2.61 (1.86-3.67) for males and 3.27 (2.53-4.22) for females] in both genders; further, neck circumference was also positively associated with serum uric acid levels in non-hyperuricemia subjects [b, 2.58 (1.76-3.39) for males and 4.27 (3.70-4.84) for females] in both genders. Additionally, we demonstrated that neck circumference was similar to waist circumference in terms of the strength of association (OR, 3.03 for waist circumference vs. 2.61 for neck circumference in males, and 3.50 vs. 3.27 for females) with hyperuricemia and the ability to predict hyperuricemia (AUC, 0.63 for waist circumference vs. 0.61 for neck circumference in males, and 0.66 vs. 0.66 in females). Conclusion: Neck circumference is positively and independently associated with hyperuricemia in both genders and is also associated with serum uric acid levels in the non-hyperuricemia population.
Project description:METHODS:Data from women (n = 305, aged 43 [34; 53] years-old, BMI 44.2 [40.8; 48.2] kg/m2) included in the Severe Obesity Outcome Network (SOON) cohort were analyzed (i) to evaluate collinearity between the different anthropometric markers, (ii) to compare the association of markers with hypertension, type 2 diabetes, obstructive sleep apnea syndrome (OSAS) and other cardiometabolic risks. RESULTS:Hip, waist and neck circumferences correlated with BMI with respectively less collinearity (r = 0.70, r = 0.59 and r = 0.37, respectively, p<0.001) whereas waist-to-hip ratio was not correlated (r = 0.11, p = 0.072). Waist and neck circumferences were significantly associated with hypertension, type 2 diabetes and OSAS in univariate logistic regressions, waist-to-hip ratio with hypertension and type 2 diabetes. Hip circumference was inversely correlated with type 2 diabetes (OR 0.970 (95CI: 0.948; 0.991) p = 0.006). BMI was only linked to OSAS (OR 1.092 (95CI: 1.043; 1.143) p<0.001). Neck circumference was the only marker significantly associated with all cardiometabolic risk markers (HOMA-IR, apnea-hypopnea index, Log Triglycerides/HDL-c, alanin-aminotransferase, aspartate-aminotransferase, gammaglutamyl transpeptidase). CONCLUSIONS:Neck circumference appears the most appropriate anthropometric marker to identify the fat distribution associated with high cardiometabolic risk in women with severe obesity.
Project description:OBJECTIVES:To describe the prevalence of general (body mass index (BMI) ?30?kg/m2) and abdominal (waist circumference women >88?cm, men >102?cm) obesity in Tromsø 7 (2015-2016), and the secular change from Tromsø 6 (2007-2008). Furthermore, to study longitudinal changes in body weight and waist circumference from Tromsø 6 to Tromsø 7. SETTING:A population study in Tromsø, Norway. PARTICIPANTS:The cross-sectional analyses included 20?855 participants in Tromsø 7 (aged ?40 years) and 12?868 in Tromsø 6 (aged ?30 years). The longitudinal analyses included 8592 participants with repeated measurements, aged 35-79 in Tromsø 6. OUTCOME MEASURES:Mean age-specific and sex-specific BMI, waist circumference, prevalence of general and abdominal overweight and obesity, as well as longitudinal changes in body weight and waist circumference according to sex and birth cohort. RESULTS:Over 8?years, the age-adjusted prevalence of general obesity increased (p<0.0001) from 20.1% to 23.0% in women and from 20.7% to 25.2% in men. The age-adjusted prevalence of abdominal obesity did not increase in women (from 54.7% to 53.4%), and the increase in men was modest (from 36.8% to 38.6%, p=0.003). Longitudinal analyses showed an increase in body weight, by 1.1 kg (95%?CI 0.9 to 1.2) in women and 0.7 kg (95%?CI 0.6 to 0.9) in men, and also waist circumference, by 1.3?cm (95%?CI 1.0 to 1.5) in women and 1.4?cm (95%?CI 1.2 to 1.6) in men. There were inverse relationships (p<0.001) between age at baseline and change in weight and waist circumference. CONCLUSIONS:Repeated cross-sectional analyses showed that the prevalence of general obesity increased, whereas the increase in abdominal obesity was less marked. Longitudinal analyses showed increases in both body weight and waist circumference. The youngest age groups have the largest increase.
Project description:BACKGROUND:The association of thyrotropin (TSH) with overall (body mass index, BMI), visceral (waist circumference and steatosis), and upper subcutaneous (neck circumference, NC) adiposity markers is still controversial, and the aim of this study is to assess these associations in the baseline data of a large cohort from ELSA-Brasil. METHODS AND FINDINGS:This cross-sectional study included 11,224 participants with normal thyroid function (normal TSH levels). BMI, waist circumference, NC and steatosis, defined by hepatic attenuation (mild or moderate/severe) were the explicative variables. TSH levels were log transformed (logTSH), and multivariate linear regression models were generated to estimate the associations between logTSH and BMI (continuous and categorized), waist circumference, NC, and steatosis after adjusting for sociodemographic characteristics, health behaviors, and comorbidities. The mean age was 51.5±8.9 years, 5,793 (51.6%) participants were women, 21.8% (n = 2,444) were obese, and 15.1% of the sample was TPOAb positive. The TSH levels were significantly higher in the obese group than in the reference group (<25.0 kg/m2). In the multivariable linear regression models, significant associations of logTSH with BMI and obesity were found. LogTSH was associated with waist circumference only among women. NC and steatosis were not related to TSH levels. CONCLUSIONS:TSH levels were associated with overall adiposity and obesity. Further studies may elucidate reference levels of TSH according to BMI status.