title: Elevated neck circumference and associated factors in adolescents.
abstract: BACKGROUND
  Upper body subcutaneous fat, estimated by neck circumference (NC), may present greater metabolic risk than visceral fat. The aim of this study was to determine cutoff values for NC in adolescents that identify overweight and obesity, the prevalence of elevated NC, and its association with associated factors.
  
  
  METHODS
  Cross-sectional study with adolescents from public schools in São Paulo. Anthropometric variables, blood pressure and pubertal stage were collected. Cutoff values for NC were determined by Receiver Operating Characteristic curves. A binary logistic regression was used to determine relationships between NC and associated factors.
  
  
  RESULTS
  Among 1668 adolescents studied, 54.92% were female. The cutoff values of NC in girls and boys that identified overweight were 31.25 and 34.25 cm, and obesity, 32.65 and 37.95 cm, respectively, and the prevalence of adolescents with high NC was 32.63% in females and 37.63% among males. NC for overweight was observed that there was an association with sex, weight, body mass index, arm, waist and thigh circumferences, pubertal stages and body fat percent (BF%). NC for obesity was found association with gender, weight, arm and thigh circumferences, and BF% (p < 0.001).
  
  
  CONCLUSIONS
  It was concluded that there is high prevalence of elevated NC and higher risks for this outcome considering overweight and obesity, sex, weight, arm and thigh circumferences, BF%, besides being an easy and simple measure for use in clinical practice.
authors.affiliation: Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil. betaferretti@yahoo.com.br.|Department of Nursing and Nutrition of the Taubate University, São Paulo, Brazil. betaferretti@yahoo.com.br.
authors.forename: Roberta de Lucena
authors.initials: Rde L
authors.lastname: Ferretti
authors.affiliation: Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil. ipcintra@uol.com.br.
authors.forename: Isa de Pádua
authors.initials: Ide P
authors.lastname: Cintra
authors.affiliation: Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil. cidazpassos94@yahoo.com.br.
authors.forename: Maria Aparecida Zanetti
authors.initials: MA
authors.lastname: Passos
authors.affiliation: Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil. gersonferrari08@yahoo.com.br.|Center for Physical Fitness Laboratory Studies of São Caetano do Sul (CELAFISCS), São Paulo, Brazil. gersonferrari08@yahoo.com.br.
authors.forename: Gerson Luis
authors.initials: GL
authors.lastname: de Moraes Ferrari
authors.affiliation: Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil. mauro.fisberg@gmail.com.
authors.forename: Mauro
authors.initials: M
authors.lastname: Fisberg
mesh_terms: D000273:Adipose Tissue; D000293:Adolescent; D000886:Anthropometry; D001794:Blood Pressure; D015992:Body Mass Index; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat; D008297:Male; D009333:Neck / Q000033:anatomy & histology*; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D012372:ROC Curve