OBJECTIVETo investigate the association between neck circumference and central obesity, overweight, and metabolic syndrome in Chinese individuals with type 2 diabetes.RESEARCH DESIGN AND METHODSA total of 3,182 diabetic subjects (aged 20–80 years) were recruited from 15 community health centers in Beijing using a multistage random sampling approach.RESULTSReceiver operating characteristic analysis showed that the area under the curve for neck circumference and central obesity was 0.77 for men and 0.75 for women (P < 0.001). Furthermore, a neck circumference of ≥38 cm for men and ≥35 cm for women was the best cutoff point for determining overweight subjects. A neck circumference of ≥39 cm for men and ≥35 cm for women was the best cutoff point to determine subjects with metabolic syndrome.CONCLUSIONSIn the present study, neck circumference is positively related with BMI, waist circumference, and metabolic syndrome in Chinese individuals with type 2 diabetes.
Background Neck circumference (NC) was found to be related to the risk factors of cardiovascular disease. However, the effects of NC on cardiovascular disease are still controversial. A prospective study of Chinese patients with type 2 diabetes was performed to evaluate the relationship between NC and cardiovascular disease. Methods A multicenter prospective study with eight-year follow-up was conducted in Beijing communities. Cardiovascular events were defined as myocardial infarction, unstable angina pectoris, hospitalization for heart failure, coronary revascularization, cardiac death, stroke, transient ischemic attack, and cerebral hemorrhage. Results A total of 3,009 diabetic patients were recruited. Following an eight-year follow-up, 211 patients with cardiovascular events (105 in men and 106 in women) were identified. All patients were categorized into two groups according to the upper quartile of NC (43 cm in men and 39 cm in women). The prevalence of cardiovascular events in men with an NC >43 cm (16.48%) was higher than that in the group with an NC <43 cm (8.16%, p=0.007). The prevalence of cardiovascular events in women with the NC >39 cm (10.67%) was higher compared to the group with NC <39 cm (5.31%, p=0.004). The longitudinal prevalence of cardiovascular events in groups with different NC increased with the increasing duration of follow-up (p < 0.001). Cox regression analysis showed that higher NC was associated with the occurrence of cardiovascular events after adjusting for confounding variables (adjusted HR = 2.305 (1.535–3.460)). Conclusions NC was associated with the occurrence of cardiovascular events in type 2 diabetes in Chinese communities, and greater NC may increase the risk of cardiovascular events by about 2.3-fold.
1. Macro- and microvascular diseases are the main chronic complications of diabetes mellitus (DM). 2. It has been shown that DM patients have more severe nailfold microcirculatory disturbances than patients with liver cirrhosis or systemic lupus erythematosus (SLE). 3. It has been shown that the glomerular basement membrane of diabetic rats is significantly thickened compared with that of normal rats (295.5 +/- 45.1 vs 184.8 +/- 33.2 nm). 4. Gastric mucosal blood flow (GMBF) in 41 patients with non-insulin-dependent diabetes mellitus (NIDDM) was determined with a laser Doppler flowmeter. The results showed that average GMBF values at 14 sites in the gastric mucosa were significantly lower in NIDDM patients than in control subjects. 5. The percentage of painless acute myocardial infarction (AMI) among 50 patients with DM was 22.0% and the mortality of AMI was 22.0% (11 cases). Both these values were higher than the corresponding values in patients without DM (9.9 and 11.4%, respectively; P < 0.05). 6. Cerebrovascular disease is more prevalent in diabetic patients than in non-diabetics and the mortality of stroke in DM patients is two-fold higher than that of non-diabetic patients. 7. Diabetes can result in widespread macrovascular atherosclerosis and microcirculatory disorders of multiple organs.
Aims
: Neck circumference (NC) was found to be related to the risk factors for coronary heart disease (CHD). However, the effects of NC on CHD are still controversial. To evaluate the relationship between NC and CHD, a meta-analysis of observational studies was performed.
Method
: Eligible studies on the association between NC and CHD were searched in Medline, Embase, Ovid, and Web of Science databases published in English from January 1980 to December 2016. Moreover, studies published in Chinese in Wanfang and China Hospital Knowledge databases were also searched. Random effects models in the metafor package in statistical analysis software R 3.3.3 were used for the meta-analysis. Heterogeneity was analyzed with
Q
statistics.
Results
: Eight studies were selected for the meta-analysis. A larger NC was associated with a higher prevalence of CHD (OR = 1.18, 95% CI 1.04–1.34,
p
= 0.0108). The eight studies were further divided into three subgroups according to the criteria for diagnosing CHD. In the subgroup of coronary angiography, NC was also found to be associated with the prevalence of CHD with low heterogeneity (OR = 1.17, 95% CI 1.07–1.28,
p
= 0.0007,
I
2
= 17.02%). However, in the subgroup of computed tomography or past history, no association between NC and CHD was found. In addition, subgroup analyses were also conducted according to the regions of the study. No association between NC and CHD was identified in either Chinese studies or Brazil studies (OR = 1.20, 95% CI 0.96–1.49; OR = 1.31, 95% CI 0.82–2.09, respectively).
Conclusion
: Larger NC is associated with increased risk of CHD, especially when coronary angiography was taken to diagnose CHD.
Obesity increases the risk of developing cardiovascular disease and other metabolic diseases. We intended to compare three different anthropometric indicators of obesity, in predicting the incidence of cardiovascular events in Chinese type 2 diabetes. Beijing Community Diabetes Study was a prospective multi-center study conducted in Beijing community health centers. Type 2 diabetes patients from fourteen community health centers were enrolled at baseline. The primary endpoint was cardiovascular events. The upper quartile of neck circumference (NC) was set as greater NC. A total of 3299 diabetes patients were enrolled. In which, 941 (28.52%) had cardiovascular disease at baseline. Logistic analysis showed that central obesity (waist circumference (WC) above 90 cm in men and 85 cm in women) and greater NC were all related to baseline cardiovascular disease (adjusted OR = 1.49, and 1.55). After 10-year follow-up, 340 (10.31%) had cardiovascular events. Compared with patients without cardiovascular events, those having cardiovascular events had higher BMI, larger WC and NC. Cox regression analysis showed that greater WC and NC were all associated with the occurrence of cardiovascular events (adjusted HR = 1.41, and 1.38). A higher NC and WC might increase the risk of cardiovascular events by about 40% in type 2 diabetes patients in Beijing communities.
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