The Correlation of Neck Circumference and Insulin Resistance in Nafld Patients

Abstract

BACKGROUND: Insulin resistance, especially that induced by obesity, plays a central role in the development of non-alcoholic fatty liver disease. Although the evaluation of overweight patients is important, the nutritional assessment tools used in clinical practice have limitations. Neck circumference (NC), from this, becomes a viable and low-cost alternative, which seems to be related to the accumulation of fat in the hepatic tissue. OBJECTIVE: To evaluate the association between NC and metabolic alterations in patients with non- alcoholic fatty liver disease. METHODS: A cross-sectional study performed in 82 patients, of whom 76 underwent liver biopsy. We performed weight, height, abdominal circumference and NC measures. Values of NC ≥42 cm and ≥36 cm were considered as altered for men and women, respectively. Laboratory tests and liver biopsy result were collected in the participants’ charts. We evaluated fasting blood glucose levels, insulin, glycosylated hemoglobin, triglycerides, total cholesterol, high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), ferritin, alkaline phosphatase, gamma glutamyltransferase, albumin, total bilirubin, direct bilirubin, glutamic-oxalacetic transaminase, glutamic-pyruvic transaminase and the HOMA-IR index. RESULTS: We evaluated eighty-two patients. Patients with altered NC had increased body mass index (P=0.043), abdominal circumference (P=0.007), insulin (P=0.003) and HOMA-IR (P=0.029) when compared to those with adequate NC. NC was significantly correlated with reduced levels of high-density cholesterol (HDL-C) in men (r= -042, P<0.05), increased insulin levels in men and female (rs=0.47; P<0.05 and rs=0.51; P<0.01, respectively), as well as higher HOMA-IR index both males (rs=0.49; P<0.01) and female (rs=0.30; P<0.05). There was no significant association between NC and liver outcomes (r=0.145; P=0.36). CONCLUSION: NC is associated with the HOMA-IR index in patients with non-alcoholic fatty liver disease. NC can be used in the screening of insulin resistance in these patients, considering that insulin resistance plays a key role in the progression of the disease.

<p>Association of Metabolic Syndrome and Hyperferritinemia in Patients at Cardiovascular Risk</p>

“…The authors of this trial also found a positive correlation with triglycerides, insulin, and homeostatic model assessment, but not with BMI and WC. 19 Boemeck et al 20 found increased levels of ferritin (>322 ng/mL) in 80% of men and 8.7% of women in a study of patients with nonalcoholic fatty liver disease (NAFLD) but did not find significant differences between ferritin levels and adequate or inadequate NC. Neck circumference is a rapid and low-cost evaluation and may work as an anthropometric indicator that is not influenced by variations in some conditions, such as abdominal distension.…”

Association between neck circumference and non-alcoholic fatty liver disease: cross-sectional analysis from ELSA-Brasil

“…11 In contrast, NC shows advantages because it is simple, easy and low-cost, has no intraindividual variation and is also considered to be a proxy measurement of upper body subcutaneous fat, since it is the only fat compartment that is separated and individualized without interference from other adipose tissues, and may be more easily measured. 13,16,30,31 In addition, several studies have shown that NC measurements have positive associations with different cardiometabolic outcomes, such as type 2 diabetes, [32][33][34] chronic kidney disease 35 and metabolic syndrome. 36 There is still a scarcity of data in the literature but, in agreement with our findings, three recent cross-sectional studies investigated the association between NC and NAFLD among Chinese adults with or without excess weight and suggested that NC measurement formed a marker for NAFLD.…”

“…One of these limitations is that the different anatomical parameters used for WC measurement (smallest circumference, umbilical scar, iliac crest, midpoint between the last rib and the iliac crest, among others) may significantly influence the measurement. 30 Another is the variation that can occur in the abdominal region during the day, through with food intake, such that measurements are influenced by the time of day at which they are made. 30 Moreover, it is not as practical and rapid to perform WC measurements in large population-based epidemiological studies.…”

“…19 Some studies in other countries have demonstrated use of NC measurements as a predictor of NAFLD among obese and non-obese adult individuals, independent of other anthropometric indexes. [14][15][16]19,30…”

Neck circumference – a marker of insulin resistance in the normal-weight Polish

“…A recent meta-analysis indicates that neck circumference is also positively correlated with glycaemic parameters, including serum fasting insulin level and HOMA-IR (Saneei et al, 2019). The association of neck circumference (NC) with IR has been confirmed among NAFLD patients, women with polycystic ovarian syndrome (PCOS) and in older people (Boemeke et al, 2019;Chen et al, 2021;Saad et al, 2017). Most of the studies included only overweight and obese subjects.…”