Neck circumference and clustered cardiovascular risk factors in children and adolescents: cross-sectional study

Abstract

ObjectiveEarly detection of cardiovascular disease (CVD) risk factors, such as obesity, is crucial to prevent adverse long-term effects on individuals’ health. Therefore, the aims were: (1) to explore the robustness of neck circumference (NC) as a predictor of CVD and examine its association with numerous anthropometric and body composition indices and (2) to release sex and age-specific NC cut-off values to classify youths as overweight/obese.DesignCross-sectional study.Setting23 primary schools and 17 secondary schools from Spain.Participants2198 students (1060 girls), grades 1–4 and 7–10.MeasuresPubertal development, anthropometric and body composition indices, systolic and diastolic blood pressure (SBP and DBP, respectively), cardiorespiratory fitness, blood sampling triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), glucose and inflammatory markers. Homoeostasis model assessment (HOMA-IR) and cluster of CVD risk factors were calculated.ResultsNC was positively correlated with all anthropometric and body composition indices. NC was negatively associated with maximum oxygen consumption (R2=0.231, p<0.001 for boys; R2=0.018, p<0.001 for girls) and positively associated with SBP, DBP, TC/HDL-c, TG, HOMA, complement factors C-3 and C-4, leptin, adiponectin and clustered CVD risk factor in both sexes (R2 from 0.035 to 0.353, p<0.01 for boys; R2 from 0.024 to 0.215, p<0.001 for girls). Moreover, NC was positively associated with serum C reactive protein, LDL-c and visfatin only in boys (R2 from 0.013 to 0.107, p<0.05).ConclusionNC is a simple, low-cost and practical screening tool of excess of upper body obesity and CVD risk factors in children and adolescents. Paediatricians can easily use it as a screening tool for overweight/obesity in children and adolescents. For this purpose, sex and age-specific thresholds to classify children and adolescents as normal weight or overweight/obese are provided.

Association between Neck Circumference and Glycemia in Adolescents

“…A positive correlation was also found between NC and fasting glycemia and HOMA1-IR in the study by Gomez-Arbelaez et al [30] in a study performed with 669 Colombian children and adolescents, aged 8 to 14 years. Castro-Piñero et al [11] found a positive correlation between the measurement of NC with insulin resistance through HOMA1-IR in 2198 Spanish children and adolescents.…”

“…The neck circumference (NC) is an anthropometric measure that has been used to evaluate the overweight and accumulation of subcutaneous fat in the upper body, regardless of age. It is also a useful tool to predict insulin resistance and other risk factors [10] [11].…”

Evaluation of neck circumference as a predictor of elevated cardiometabolic risk outcomes in 5–8-year-old Brazilian children

“…Of the relatively few studies which have measured NC and cardiometabolic outcomes in children, several have documented the positive associations we observed for NC with BMI, SBP, and HOMA. However, others have also identified positive relationships between NC, DBP and triglycerides, and a negative relationship between NC and HDL cholesterol (Formisano et al 2016;Castro-Piñero et al 2017;Kurtoglu et al 2012;Androutsos et al 2012). Differences in methodology, sample size, and population characteristics are likely to contribute to variation in results.…”

“…As a relatively simple anthropometric measurement, NC, like WC, was proposed as an easy-to-employ proxy for metabolically harmful FM deposited in the upper body (Tchernof and Després 2013). Studies have shown that NC and WC associate with one another (Hatipoglu et al 2010;Nafiu et al 2010;Katz et al 2014;Hassan et al 2015;Taheri et al 2016;Castro-Piñero et al 2017), and that their degree of association with outcomes such as overweight/obesity, HOMA, and SBP is similar (Hatipoglu et al 2010;Androutsos et al 2012). At the same time, some have argued that NC is preferable to WC, as the former does not demonstrate pre-versus postprandial variation, depend on the consistency of measurements taken at the end of an expired breath, or necessitate the removal of clothing (Hatipoglu et al 2010;Nafiu et al 2010;Taheri et al 2016).…”

“…There is good evidence that measures including waist circumference (WC), waist-tohip ratio (WHR), and waist-to-height ratio (WHtR) fulfill these criteria in both adults (Yusuf et al 2005) and children (Savva et al 2000), although see Sardinha et al (2016) and Li et al (2020). Neck circumference (NC) has also received wide interest as a proxy for upper body FM depots, with studies conducted in children, adolescents, and adults in a range of populations (Nafiu et al 2010;Stabe et al 2013;Katz et al 2014;Formisano et al 2016;Castro-Piñero et al 2017;Alzeidan et al 2019;Mastroeni et al 2019). Across these studies, NC correlated with other anthropometric parameters (e.g.…”