title: Neck circumference as an independent predictive contributor to cardio-metabolic syndrome.
abstract: BACKGROUND
  The predictive potentials of neck circumference (NC) for cardio-metabolic risks remain uncertain. The aim of this study was to investigate whether NC independently contributes to the prediction of cardio-metabolic risks beyond body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHpR) in a large Chinese population.
  
  
  METHODS
  A total of 4201 participants (2508 men and 1693 women) aged 20-85 were recruited from the Health Examination Centre between May 2009 and April 2010, anthropometric indices, biochemical and clinical parameters were measured. Receiver operating characteristic, partial correlation and logistic regression analyses were employed to evaluate the association of the anthropometric indices to cardio-metabolic risks separately by gender.
  
  
  RESULTS
  Neck circumference was positively correlated with SBP and DBP (r=0.250 and 0.261), fasting blood glucose (FBP) (r=0.177), TG (r=0.240), TC (r=0.143) and LDL-C (r=0.088) and negatively correlated with HDL-C (r=-0.202) in males (all P<0.01). Similar results were found in females with the exception of TC. The AUCs of NC for metabolic abnormalities ranged from 0.558 (Increased LDL-C) to 0.683 (MS-rf) in men and 0.596 (Increased LDL-C) to 0.703 (MS-rf) in women (P<0.01). The NC of ≥37 cm for men and ≥33 cm for women were the best cut-off points for metabolic syndrome. The adjusted ORs (95% CIs) of NC in men and women respectively were 1.29 (1.12-1.48) and 1.44 (1.20-1.72) for metabolic syndrome risk factors (MS-rf), 1.15 (1.01-1.32) and 1.22 (1.03-1.46) for high BP, 1.16 (1.02-1.33) and 1.42 (1.18-1.71) for increased TG, and 1.26 (1.06-1.50) and 1.32 (1.06-1.65) for increased FBP; the adjusted OR of NC in women for decreased HDL-C was 1.29 (1.10-1.51).
  
  
  CONCLUSIONS
  Neck circumference was significantly associated with cardio-metabolic risk factors and independently contributed to the prediction of cardio-metabolic risks beyond the classical anthropometric indices in adults of China.
authors.affiliation: Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, 74th Zhongshan Road II, Guangzhou 510080, People's Republic of China.
authors.forename: Jing-ya
authors.initials: JY
authors.lastname: Zhou
authors.forename: Hui
authors.initials: H
authors.lastname: Ge
authors.forename: Ming-fan
authors.initials: MF
authors.lastname: Zhu
authors.forename: Li-jun
authors.initials: LJ
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.forename: Yao-zong
authors.initials: YZ
authors.lastname: Tan
authors.forename: Yu-ming
authors.initials: YM
authors.lastname: Chen
authors.forename: Hui-lian
authors.initials: HL
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D049628:Body Size; D002318:Cardiovascular Diseases; D050171:Dyslipidemias; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome; D008875:Middle Aged; D009333:Neck; D056128:Obesity, Abdominal; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D055815:Young Adult
chemical_list: D001786:Blood Glucose