title: Neck circumference is associated with carotid intimal-media thickness but not with coronary artery calcium: Results from The ELSA-Brasil.
abstract: OBJECTIVE
  It is uncertain whether neck circumference can be a risk indicator for subclinical atherosclerosis. We aimed to investigate their relationships measured by coronary artery calcium (CAC) and common carotid intima-media thickness (cc-IMT) with neck circumference in ELSA-Brasil.
  
  
  RESULTS
  In cross-sectional and sex-specific analyses of 2266 women (50.6 ± 8.4 yrs) and 1886 men (50.7 ± 9.0 yrs) with both cc-IMT and CAC, free from previous cardiovascular disease at baseline, we built logistic models using diverse cut-off points for CAC score (0 vs > 0, < 100 vs ≥ 100, < 400 vs ≥ 400 Agatston units) and cc-IMT (< 75 th percentile vs ≥ 75 th; <90th percentile vs ≥ 90 th) as dependent variables, after which adjustments for age and traditional cardiovascular risk factors were made. Mean neck circumference was 33.6 (± 2.4 cm) for women and 38.8 (± 2.6 cm) for men. In fully adjusted models including sociodemographic, cardiovascular risk factors and body-mass index and waist circumference, for each 1 standard deviation increase in neck circumference we found an odds ratio (OR, 95% CI) for IMT above the 75th percentile of (1.52, 1.16; 1.99) for women and (1.66, 1.28; 2.14) for men, and above the 90th cc-IMT percentile [1.66 (1.19; 2.32) for men but not for women [1.21 (0.80; 1.82)]. We found no association between neck circumference and CAC using different cut-off points (p > 0.05 for all).
  
  
  CONCLUSIONS
  Neck circumference was significantly and independently associated with cc-IMT but not with CAC in women and men, indicating a possible effect of perivascular fat tissue on atherosclerosis.
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, São Paulo, Brazil; School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
authors.forename: C P
authors.initials: CP
authors.lastname: Baena
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, São Paulo, Brazil; School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: P A
authors.initials: PA
authors.lastname: Lotufo
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, São Paulo, Brazil; School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: I S
authors.initials: IS
authors.lastname: Santos
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, São Paulo, Brazil.
authors.forename: A C
authors.initials: AC
authors.lastname: Goulart
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, São Paulo, Brazil.
authors.forename: M S
authors.initials: MS
authors.lastname: Bittencourt
authors.affiliation: Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: B B
authors.initials: BB
authors.lastname: Duncan
authors.affiliation: School of Public Health, Brown University, Providence, RD, USA.
authors.forename: S
authors.initials: S
authors.lastname: Liu
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, São Paulo, Brazil; School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: I M
authors.initials: IM
authors.lastname: Benseñor
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001938:Brazil; D002114:Calcinosis / Q000000981:diagnostic imaging*; D002118:Calcium / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology*; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D002118:Calcium
keywords: Body fat distribution; Carotid artery diseases; Neck