title: Neck height ratio is an important predictor of metabolic syndrome among Asian Indians.
abstract: OBJECTIVE
  The predictive potential of neck circumference (NC) based indices (a measure of upper body fat distribution) for predicting metabolic syndrome (MetS) and its components among Indians is not known. This study aimed to evaluate the role of NC and neck height ratio (NHtR) as independent predictors of MetS and its components as compared to traditional anthropometric indices.
  
  
  METHODS
  A total of 451 individuals from 867 screened individuals, 30-80 years age, without any co-morbid state who gave informed written consent underwent clinical, anthropometric, and biochemical assessment.
  
  
  RESULTS
  Patients with MetS in both the sexes had significantly higher NC, NHtR, glycated hemoglobin, fasting glucose, and dyslipidemia (higher triglycerides, total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio, low-density lipoprotein cholesterol/HDL-C ratio, and lower HDL-C). In both sexes, individuals in the highest tertile of NC had significantly greater central and generalized obesity, lower HDL-C, and significantly higher MetS. Receiver operating characteristic analysis revealed waist circumference (WC) to have the largest area under the curve for predicting MetS in both sexes, followed by NHtR, NC, and body mass index. NC and NHtR of >34.9 cm (sensitivity 78.6%; specificity 59.3%) and >21.17 cm/m (sensitivity 80.7% and specificity 64.6%) respectively for men and >31.25 cm (sensitivity 72.3%; specificity 64.4%) and >20.48 cm/m (sensitivity 80.4% and specificity 60%) respectively for women were the best values for identifying MetS. Increased NC and NHtR had odds ratio of 1.52 (95% confidence interval [CI]: 1.37-1.68;P< 0.001) and 1.96 (95% CI: 1.67-2.29;P< 0.001) respectively in identifying MetS.
  
  
  CONCLUSIONS
  NC and NHtR are good predictors of MetS and cardiovascular risk factors in Asian Indians. NHtR is reliable and perhaps an even better index than NC with regards to cardiovascular risk prediction.
authors.affiliation: Department of Endocrinology, MS Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Chitra
authors.initials: C
authors.lastname: Selvan
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India.
authors.forename: Deep
authors.initials: D
authors.lastname: Dutta
authors.affiliation: Department of Endocrinology, Institute of Post Graduate Institute of Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.
authors.forename: Anubhav
authors.initials: A
authors.lastname: Thukral
authors.affiliation: PhD Scholar, Indian Institute of Chemical Biology, Kolkata, West Bengal, India.
authors.forename: Titli
authors.initials: T
authors.lastname: Nargis
authors.affiliation: Department of Endocrinology, Institute of Post Graduate Institute of Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Endocrinology, Institute of Post Graduate Institute of Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.
authors.forename: Satinath
authors.initials: S
authors.lastname: Mukhopadhyay
authors.affiliation: Department of Endocrinology, Institute of Post Graduate Institute of Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.
authors.forename: Subhankar
authors.initials: S
authors.lastname: Chowdhury
keywords: Insulin resistance; metabolic syndrome; neck height ratio; waist circumference