Neck circumference surpasses waist measurement as predictor of metabolic risk
NASHVILLE, Tenn. — A patient’s neck circumference may be a better indicator of fat mass and thus more predictive of metabolic risk than waist circumference in patients with severe obesity, according to data presented here.
“Waist circumference is universally accepted, but it also has pitfalls,” Zdravko A. Kamenov, MD, PhD, said in an oral presentation. “Clinical usefulness may vary according to subcutaneous fat contribution. Elevated waist circumference alone is not sufficient to characterize … metabolic syndrome.”
Zdravko A. Kamenov
Kamenov and colleagues at Alexandrovska University Hospital and the Medical University-Sofia, in Bulgaria, collected anthropomorphic data including neck and waist circumferences, weight and height, from 168 people with obesity and correlated those measures with biochemical indicators of metabolic syndrome, including HbA1c, liver enzymes, uric acid and lipids. Patients without a diabetes diagnosis underwent an oral glucose tolerance test with immunoreactive insulin (IRI) measurement. Associations between neck and waist measurements and metabolic measures were analyzed separately for men and women.
Participants were recruited from a hospital setting. The 50 male and 118 female participants (median age 52 years) had BMI ≥ 30 kg/m2 (median 35 kg/m2); 41% had type 2 diabetes, 42.3% prediabetes, and the remainder had normal glucose tolerance. Metabolic syndrome was present in 86.9%.
In women, neck circumference was better correlated than waist circumference with elevated IRI (r = 0.300 vs. r = 0.200), uric acid (r = 0.354 vs. r = 0.269), homeostatic model assessment of insulin resistance (r = 0.345 vs. r = 0.223), alanine transaminase (r = 0.385 vs. r = 0.256) and triglycerides (r = 0.245 vs. r = 0.177), but not with HbA1c, where waist circumference was better correlated (r = 0.368 vs. r = 0.150).
Associations were stronger for women than men.
“Neck circumference appears to provide additional information with regards to metabolic outcomes, it is easier to measure, but there appear to be some sex-related differences. A neck circumference over 36 cm in females — over 39 cm in males — are good cut-offs for determining metabolic outcomes,” Kamenov said.
Kamenov ZA, et al. Abstract #606. Presented at: AACE 24th Annual Scientific & Clinical Congress; May 13-17, 2014; Nashville, Tenn.
Disclosure: The researchers report no relevant financial disclosures.