title: Neck circumference as a screening measure for identifying children with high body mass index.
abstract: OBJECTIVE
  Overweight in children is most commonly described by using BMI. Because BMI does not adequately describe regional (central) adiposity, other indices of body fatness are being explored. Neck circumference (NC) is positively associated with obstructive sleep apnea, diabetes, and hypertension in adults. NC also has positive correlation with BMI in adults. The possible role of NC in screening for high BMI in children is not well characterized. The aims of this investigation were to examine the correlation between BMI and NC in children and to determine the best NC cutoff that identifies children with high BMI.
  
  
  METHODS
  Children who were aged 6 to 18 years and undergoing elective noncardiac surgeries were the subjects of this study. Trained research assistants collected clinical and anthropometric data from all patients. We calculated Pearson correlation coefficients between NC and other indices of obesity. We then determined by receiver operating characteristic analyses the optimal NC cutoff for identifying children with high BMI.
  
  
  RESULTS
  Among 1102 children, 52% were male. NC was significantly correlated with age, BMI, and waist circumference in both boys and girls, although the correlation was stronger in older children. Optimal NC cutoff indicative of high BMI in boys ranged from 28.5 to 39.0 cm. Corresponding values in girls ranged from 27.0 to 34.6 cm.
  
  
  CONCLUSIONS
  NC is significantly correlated with indices of adiposity and can reliably identify children with high BMI. NC is a simple technique that has good interrater reliability and could be used to screen for overweight and obesity in children.
authors.affiliation: Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA. onafiu@med.umich.edu
authors.forename: Olubukola O
authors.initials: OO
authors.lastname: Nafiu
authors.forename: Constance
authors.initials: C
authors.lastname: Burke
authors.forename: Joyce
authors.initials: J
authors.lastname: Lee
authors.forename: Terri
authors.initials: T
authors.lastname: Voepel-Lewis
authors.forename: Shobha
authors.initials: S
authors.lastname: Malviya
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Tremper
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D015992:Body Mass Index; D002648:Child; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009333:Neck / Q000033:anatomy & histology*; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology*