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

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2019 Jul 9

PMID 31281839

Citations 18

Authors

Thunyarat Anothaisintawee

Nakarin Sansanayudh

Sangsulee Thamakaison

Dumrongrat Lertrattananon

Ammarin Thakkinstian

Affiliations

Soon will be listed here.

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 -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.

Citing Articles

Anthropometric and metabolic parameters associated with visceral fat in non-obese type 2 diabetes individuals.

Jiao M, Chen J, Wang X, Tao W, Feng Y, Yang H Diabetol Metab Syndr. 2025; 17(1):28.

PMID: 39844248 PMC: 11753141. DOI: 10.1186/s13098-025-01583-1.

Effectiveness of comparing calf circumference with neck circumference regarding their association with skeletal muscle indices in Japanese nursing home residents.

Kubo A, Ishizaka M, Tsukahara S, Numaguchi S, Takayama A J Phys Ther Sci. 2024; 36(5):240-244.

PMID: 38694005 PMC: 11060766. DOI: 10.1589/jpts.36.240.

Predicting mechanical neck pain intensity in computer professionals using machine learning: identification and correlation of key features.

Khanum F, Khan A, Khan A, Aafreen A, Khan A, Ahmad A Front Public Health. 2024; 12:1307592.

PMID: 38577273 PMC: 10993996. DOI: 10.3389/fpubh.2024.1307592.

Association between Neck Circumference and Chronic Kidney Disease in Korean Adults in the 2019-2021 Korea National Health and Nutrition Examination Survey.

Yoon Y, Kim Y, Lee S, Shin B, Kim H, Chung J Nutrients. 2023; 15(24).

PMID: 38140298 PMC: 10745966. DOI: 10.3390/nu15245039.

Abdominal volume index, waist-to-height ratio, and waist circumference are optimal predictors of cardiometabolic abnormalities in a sample of Lebanese adults: A cross-sectional study.

Abboud M, Haidar S, Mahboub N, Papandreou D, Rizk R PLOS Glob Public Health. 2023; 3(12):e0002726.

PMID: 38127883 PMC: 10734963. DOI: 10.1371/journal.pgph.0002726.

References

Gabir M, Hanson R, Dabelea D, Imperatore G, Roumain J, BENNETT P . The 1997 American Diabetes Association and 1999 World Health Organization criteria for hyperglycemia in the diagnosis and prediction of diabetes. Diabetes Care. 2000; 23(8):1108-12. DOI: 10.2337/diacare.23.8.1108. View

de Vegt F, Dekker J, Jager A, Hienkens E, Kostense P, Stehouwer C . Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population: The Hoorn Study. JAMA. 2001; 285(16):2109-13. DOI: 10.1001/jama.285.16.2109. View

Ben-Noun L, SOHAR E, Laor A . Neck circumference as a simple screening measure for identifying overweight and obese patients. Obes Res. 2001; 9(8):470-7. DOI: 10.1038/oby.2001.61. View

. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25):3143-421. View

Borch-Johnsen K, Colagiuri S, Balkau B, Glumer C, Carstensen B, Ramachandran A . Creating a pandemic of prediabetes: the proposed new diagnostic criteria for impaired fasting glycaemia. Diabetologia. 2004; 47(8):1396-402. DOI: 10.1007/s00125-004-1468-6. View

Pan W, Yeh W . How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations. Asia Pac J Clin Nutr. 2008; 17(3):370-4. View

Onat A, Hergenc G, Yuksel H, Can G, Ayhan E, Kaya Z . Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr. 2008; 28(1):46-51. DOI: 10.1016/j.clnu.2008.10.006. View

Agarwal S, Misra A, Aggarwal P, Bardia A, Goel R, Vikram N . Waist circumference measurement by site, posture, respiratory phase, and meal time: implications for methodology. Obesity (Silver Spring). 2009; 17(5):1056-61. DOI: 10.1038/oby.2008.635. View

Yang L, Samarasinghe Y, Kane P, Amiel S, Aylwin S . Visceral adiposity is closely correlated with neck circumference and represents a significant indicator of insulin resistance in WHO grade III obesity. Clin Endocrinol (Oxf). 2010; 73(2):197-200. DOI: 10.1111/j.1365-2265.2009.03772.x. View

10.

Ford E, Zhao G, Li C . Pre-diabetes and the risk for cardiovascular disease: a systematic review of the evidence. J Am Coll Cardiol. 2010; 55(13):1310-7. DOI: 10.1016/j.jacc.2009.10.060. View

11.

Preis S, Massaro J, Hoffmann U, DAgostino Sr R, Levy D, Robins S . Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J Clin Endocrinol Metab. 2010; 95(8):3701-10. PMC: 2913042. DOI: 10.1210/jc.2009-1779. View

12.

Yang G, Yuan S, Fu H, Wan G, Zhu L, Bu X . Neck circumference positively related with central obesity, overweight, and metabolic syndrome in Chinese subjects with type 2 diabetes: Beijing Community Diabetes Study 4. Diabetes Care. 2010; 33(11):2465-7. PMC: 2963514. DOI: 10.2337/dc10-0798. View

13.

Colagiuri S . Epidemiology of prediabetes. Med Clin North Am. 2011; 95(2):299-307, vii. DOI: 10.1016/j.mcna.2010.11.003. View

14.

Ferrannini E, Gastaldelli A, Iozzo P . Pathophysiology of prediabetes. Med Clin North Am. 2011; 95(2):327-39, vii-viii. DOI: 10.1016/j.mcna.2010.11.005. View

15.

Hoebel S, Malan L, de Ridder J . Determining cut-off values for neck circumference as a measure of the metabolic syndrome amongst a South African cohort: the SABPA study. Endocrine. 2012; 42(2):335-42. DOI: 10.1007/s12020-012-9642-y. View

16.

Verweij L, Terwee C, Proper K, Hulshof C, van Mechelen W . Measurement error of waist circumference: gaps in knowledge. Public Health Nutr. 2012; 16(2):281-8. PMC: 10271771. DOI: 10.1017/S1368980012002741. View

17.

Stabe C, Vasques A, Lima M, Tambascia M, Pareja J, Yamanaka A . Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian Metabolic Syndrome Study. Clin Endocrinol (Oxf). 2012; 78(6):874-81. DOI: 10.1111/j.1365-2265.2012.04487.x. View

18.

Pettitt D, Talton J, Liese A, Liu L, Crimmins N, West N . Comparison of two waist circumference measurement protocols: the SEARCH for diabetes in youth study. Pediatr Obes. 2012; 7(6):e81-5. PMC: 3494800. DOI: 10.1111/j.2047-6310.2012.00088.x. View

19.

Patry-Parisien J, Shields M, Bryan S . Comparison of waist circumference using the World Health Organization and National Institutes of Health protocols. Health Rep. 2012; 23(3):53-60. View

20.

Aswathappa J, Garg S, Kutty K, Shankar V . Neck circumference as an anthropometric measure of obesity in diabetics. N Am J Med Sci. 2013; 5(1):28-31. PMC: 3560135. DOI: 10.4103/1947-2714.106188. View