title: Neck circumference as a predictor of metabolic syndrome, insulin resistance and low-grade systemic inflammation in children: the ACFIES study.
abstract: BACKGROUND
  The current study aims to evaluate the association between neck circumference (NC) and several cardio-metabolic risk factors, to compare it with well-established anthropometric indices, and to determine the cut-off point value of NC for predicting children at increased risk of metabolic syndrome, insulin resistance and low-grade systemic inflammation.
  
  
  METHODS
  A total of 669 school children, aged 8-14, were recruited. Demographic, clinical, anthropometric and biochemical data from all patients were collected. Correlations between cardio-metabolic risk factors and NC and other anthropometric variables were evaluated using the Spearman's correlation coefficient. Multiple linear regression analysis was applied to further examine these associations. We then determined by receiver operating characteristic (ROC) analyses the optimal cut-off for NC for identifying children with elevated cardio-metabolic risk.
  
  
  RESULTS
  NC was positively associated with fasting plasma glucose and triglycerides (p = 0.001 for all), and systolic and diastolic blood pressure, C-reactive protein, insulin and HOMA-IR (p < 0.001 for all), and negatively with HDL-C (p = 0.001). Whereas, other anthropometric indices were associated with fewer risk factors.
  
  
  CONCLUSIONS
  NC could be used as clinically relevant and easy to implement indicator of cardio-metabolic risk in children.
authors.affiliation: Dirección de Investigaciones, Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Colombia. diedgomez@gmail.com.|Instituto MASIRA, Facultad de la Ciencias de la Salud, Universidad de Santander - UDES, Bucaramanga, Colombia. diedgomez@gmail.com.|Departamento de Endocrinología, Escuela de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, España. diedgomez@gmail.com.
authors.forename: Diego
authors.initials: D
authors.lastname: Gomez-Arbelaez
authors.affiliation: Dirección de Investigaciones, Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Colombia. camacholopez.paul@gmail.com.
authors.forename: Paul Anthony
authors.initials: PA
authors.lastname: Camacho
authors.affiliation: Dirección de Investigaciones, Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Colombia. danielcohen1971@gmail.com.|Instituto MASIRA, Facultad de la Ciencias de la Salud, Universidad de Santander - UDES, Bucaramanga, Colombia. danielcohen1971@gmail.com.
authors.forename: Daniel Dylan
authors.initials: DD
authors.lastname: Cohen
authors.affiliation: Instituto MASIRA, Facultad de la Ciencias de la Salud, Universidad de Santander - UDES, Bucaramanga, Colombia. sandralucia.71@hotmail.com.
authors.forename: Sandra
authors.initials: S
authors.lastname: Saavedra-Cortes
authors.affiliation: Escuela de Medicina, Universidad Autónoma de Bucaramanga - UNAB, Bucaramanga, Colombia. mlopez791@unab.edu.co.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lopez-Lopez
authors.affiliation: Dirección de Investigaciones, Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Colombia. jplopezj@gmail.com.|Instituto MASIRA, Facultad de la Ciencias de la Salud, Universidad de Santander - UDES, Bucaramanga, Colombia. jplopezj@gmail.com.
authors.forename: Patricio
authors.initials: P
authors.lastname: Lopez-Jaramillo
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003105:Colombia; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D009333:Neck / Q000033:anatomy & histology*; D012372:ROC Curve; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D002097:C-Reactive Protein