title: Neck Circumference Is Independently Associated with Cardiometabolic Risk Factors: Cross-Sectional Analysis from ELSA-Brasil.
abstract: BACKGROUND
  Neck circumference (NC) is a simple anthropometric measurement that may be linked with cardiometabolic risk factors. We analyzed the association between NC and a range of cardiometabolic risk factors.
  
  
  METHODS
  In a cross-sectional and sex-specific analysis of the ELSA-Brasil study (15,105 civil servants aged 35-74 years), we excluded participants with diabetes, taking antihypertensive and/or lipid-lowering drugs. Cardiometabolic risk factors were homeostasis model assessment of insulin resistance (≥ 75th percentile), low high-density lipoprotein (HDL; <50 mg/dL for women and <40 mg/dL for men), high triglycerides ≥ 150 mg/dL, systolic blood pressure ≥ 130 mmHg, or diastolic blood pressure ≥ 85 mmHg. Logistic regression models were built to analyze the association between individual and clustered risk factors and 1-standard deviation (SD) increase in NC after adjustments for age, smoking, alcohol, body mass index, and waist circumference.
  
  
  RESULTS
  We analyzed 8726 participants (56.3% women), with a mean age of 49.2 ± 8.0 years. Mean NC was 38.9 ± 2.6 cm for men and 33.4 ± 2.6 cm for women. Fully adjusted odds ratios (ORs) [95% confidence intervals (CIs)] per 1-SD increase in NC in men and women were, respectively, 1.32 (1.16-1.51) and 1.47 (1.31-1.64) for insulin resistance; 1.24 (1.11-1.39) and 1.25 (1.11-1.40) for raised blood pressure; 1.50 (1.33-1.70) and 1.51 (1.33-1.70) for high triglycerides; and 1.22 (0.92-1.61) and 1.54 (1.23-1.86) for low HDL. Fully adjusted ORs (95% CI) of three or more clustered risk factors per 1-SD increase in NC in men and women were 1.54 (1.34-1.79) and 1.71 (1.41-2.06).
  
  
  CONCLUSIONS
  NC is significantly and independently associated with cardiometabolic risk factors in a well-defined apparently healthy population.
authors.affiliation: 1 Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo , São Paulo, Brazil .|2 Escola de Medicina, Pontifícia Universidade Católica do Paraná , Curitiba, Brazil .
authors.forename: Cristina P
authors.initials: CP
authors.lastname: Baena
authors.affiliation: 1 Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo , São Paulo, Brazil .
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.affiliation: 3 Fundação Oswaldo Cruz , Rio de Janeiro, Brazil .
authors.forename: Maria G M
authors.initials: MG
authors.lastname: Fonseca
authors.affiliation: 1 Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo , São Paulo, Brazil .
authors.forename: Itamar S
authors.initials: IS
authors.lastname: Santos
authors.affiliation: 1 Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo , São Paulo, Brazil .
authors.forename: Alessandra C
authors.initials: AC
authors.lastname: Goulart
authors.affiliation: 1 Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo , São Paulo, Brazil .
authors.forename: Isabela M J
authors.initials: IM
authors.lastname: Benseñor
mesh_terms: D000328:Adult; D000368:Aged; D001837:Body Weights and Measures; D001938:Brazil; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology*; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors