title: Neck circumference: a useful screening tool of cardiovascular risk in children.
abstract: OBJECTIVE
  Early identification of cardiovascular risk factors consists an essential target for public health. The current study aims to examine the association between neck circumference and several cardiovascular risk factors and to compare it with well-established anthropometric indices.
  
  
  METHODS
  Demographic, anthropometric (body weight and height, waist, hip and neck circumference [WC, HC and NC, respectively]), biochemical (total cholesterol, high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol, triglycerides [TG], fasting plasma glucose and serum insulin), clinical (pubertal stage, systolic and diastolic blood pressure [SBP and DBP, respectively]) and lifestyle (dietary intake, physical activity level) data were collected from 324 children (51.5% boys; 48.5% girls) aged 9-13 in Greece. Body mass index z-score (BMI z-score), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), homeostasis model assessment (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and fasting glucose to insulin ratio (FGIR) were calculated.
  
  
  RESULTS
  All indices (BMI z-score, NC, WC, HC, WHR and WHtR) were correlated with SBP, HDL and insulin-related indices (insulin, HOMA-IR, QUICKI and FGIR) and all indices except WHR with TG. LDL was correlated with BMI z-score, WC, WHR and WHtR, whereas DBP was correlated with BMI z-score, WC, HC and WHtR. In multivariate analysis, HDL, TG, SBP, insulin, HOMA-IR, QUICKI and FGIR were associated with all anthropometric indices; DBP with WC, HC, NC and WHtR; LDL with BMI z-score, WC, HC and WHtR.
  
  
  CONCLUSIONS
  NC is associated with most cardiovascular disease risk factors. These associations are comparable with those observed for BMI z-score, WC, HC, WHR and WHtR. NC could be a simple, alternative screening tool of cardiovascular risk in children.
authors.affiliation: First Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece. oandrouts@med.uoa.gr
authors.forename: O
authors.initials: O
authors.lastname: Androutsos
authors.forename: E
authors.initials: E
authors.lastname: Grammatikaki
authors.forename: G
authors.initials: G
authors.lastname: Moschonis
authors.forename: E
authors.initials: E
authors.lastname: Roma-Giannikou
authors.forename: G P
authors.initials: GP
authors.lastname: Chrousos
authors.forename: Y
authors.initials: Y
authors.lastname: Manios
authors.forename: C
authors.initials: C
authors.lastname: Kanaka-Gantenbein
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D002648:Child; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007328:Insulin / Q000097:blood; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009333:Neck / Q000473:pathology*; D009765:Obesity / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids