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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.

SUBMITTER: Caro P

PROVIDER: S-EPMC6858176 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Is neck circumference an appropriate tool to predict cardiovascular risk in clinical practice? A cross-sectional study in Chilean population.

Caro Patricia P Guerra Ximena X Canals Andrea A Weisstaub Gerardo G Sandaña Carlos C

BMJ open 20191107 11

<h4>Objectives</h4>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.<h4>Design</h4>Cross-sectional study.<h4>Setting</h4>General Chilean population.<h4>Participants</h4>Data of 4607 ad ...[more]

PMID: 31699715

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Project description: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 negatively associated with maximum oxygen consumption (R2=0.231, P<0.001 for boys; R2=0.018, P<0.001 for girls) and adiponectin (R2=0.049, P<0.001 for boys; R2=0.036, P<0.001 for girls); and positively associated with SBP, DBP, TC/HDL-c, TG, HOMA, complement factors C-3 and C-4, leptin 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 and LDL-c only in boys (R2 from 0.013 to 0.055, 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.

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 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.

Dataset Information

Is neck circumference an appropriate tool to predict cardiovascular risk in clinical practice? A cross-sectional study in Chilean population.

Publications

Is neck circumference an appropriate tool to predict cardiovascular risk in clinical practice? A cross-sectional study in Chilean population.

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