Neck Circumference as an Anthropometric Indicator of Central Obesity in Patients with Prediabetes: A Cross-Sectional Study

Abstract

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 β-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.

Obesity Indices to Use for Identifying Metabolic Syndrome among Rural Adults in South Africa

“…However, this results in the insulin resistance of the muscle and the liver caused by reduced insulin production by the pancreatic β-cell [ 42 ] giving rise to metabolic complications. Body mass index in both males and females was not the best indicator of MetS, similar findings were reported by [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. Several studies have indicated that, although BMI is extensively used in a population to assess overall body weight it has limitations that it cannot differentiate between fat mass and fat-free mass [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ,…”

“…The Waist circumference (WC) was measured using a flexible steel tape (Delta surgical SA (PTY) Ltd., Johannesburg, Gauteng, South Africa) to the nearest 0.1 cm, while participants were in light clothing and a standing position [ 23 ]. The measurements were taken at the middle point between the lowest rib and iliac crest at the end of each gentle expiration [ 15 ]. The cut-off points of WC are WC ≥ 94 cm for males and ≥80 cm for females [ 2 ].…”

“…Several studies have indicated that obesity indices can be used as a diagnostic tool to determine MetS, however, these were conducted mostly in developed countries [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The value of the previous obesity-based studies in a rural setting of South Africa is limited, the focus was more on finding the cut-off values of obesity indices to determine MetS and most were done in urban settings [ 16 , 17 ].…”

Association Between Neck Circumference and Poor Outcome in Spontaneous Intracerebral Hemorrhage Patients: A Prospective Observational Study.

“…NC is an indicator of obesity that re ects human health [16][17][18][19][20][21]. Previous studies have shown that NC is associated with an increased risk of hypertension [18], diabetes [17,21] and metabolic syndrome [19]. NC is also found to be associated with congestive heart failure incidence and coronary heart disease mortality [20].…”

“…In addition, previous studies have shown that NC was associated with an increased risk of hypertension [18], diabetes [17,21] and metabolic syndrome [19], which also played a role in the occurrence and development of ICH [41][42][43]. Furthermore, Pezzini et al found that obesity, mainly through its indirect effect on hypertension and obesity-related complication, played a role in ICH [44].…”