title: Efficacy of neck circumference to identify metabolic syndrome in 3-10 year-old European children: Results from IDEFICS study.
abstract: Several studies demonstrated that larger neck circumference (NC) in children and adolescents may help to identify obesity and cardio-metabolic abnormalities. We aimed to evaluate the correlation between NC and metabolic syndrome (MetS) risk factors and to determine the utility of this anthropometric index to identify MetS in European children.
  
  
  
  The present cross-sectional analysis includes 15,673 children (3-10 years) participating in the IDEFICS study. A continuous MetS (cMetS) score was calculated summing age and sex standardized z-scores of specific MetS risk factors. Receiver Operating Characteristic analysis, stratified by one-year age groups, was used to determine the ability of NC to identify children with unfavorable metabolic profile, corresponding to cMetS score ≥ 90th percentile. The areas under the curve values for NC associated with cMetS score values ≥ 90th percentile were significantly greater in girls than in boys (p < 0.001), except for 5 < 6 years group. For boys, optimal NC cut-off values ranged from 26.2 cm for the lowest age group (3 < 4 years), up to 30.9 cm for the highest age group (9 < 10 years). In girls, corresponding values varied from 24.9 cm to 29.6 cm.
  
  
  
  The study demonstrated the efficacy of NC in identifying European children with an unfavorable metabolic profile.
authors.affiliation: Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Formisano
authors.affiliation: Institute for Public Health and Nursing Science, Bremen University, Bremen, Germany; Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH, Bremen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Bammann
authors.affiliation: Laboratoriumsmedizin Dortmund, Eberhard & Partner, Dortmund, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Fraterman
authors.affiliation: Child Health research and educational institute, Strovolos, Cyprus.
authors.forename: C
authors.initials: C
authors.lastname: Hadjigeorgiou
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH, Bremen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Herrmann
authors.affiliation: Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Mediterranean Neurological Institute Neuromed, Pozzilli, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Iacoviello
authors.affiliation: Department of Pediatrics, Queen Silvia Children's Hospital, University of Gothenburg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Marild
authors.affiliation: Growth, Exercise, Nutrition, and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.
authors.forename: L A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: Department of Pediatrics, University of Pécs, Pécs, Hungary.
authors.forename: P
authors.initials: P
authors.lastname: Nagy
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Van Den Bussche
authors.affiliation: National Institute for Health Development, Tallinn, Estonia.
authors.forename: T
authors.initials: T
authors.lastname: Veidebaum
authors.affiliation: Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Lauria
authors.affiliation: Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy. Electronic address: asiani@isa.cnr.it.
authors.forename: A
authors.initials: A
authors.lastname: Siani
mesh_terms: D000367:Age Factors; D000886:Anthropometry / Q000379:methods*; D019540:Area Under Curve; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D009333:Neck / Q000473:pathology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012737:Sex Factors
keywords: Children; Metabolic syndrome; Neck circumference; ROC curve; Upper-body fat