Neck circumference and clustered cardiovascular risk factors in children and adolescents: cross-sectional study

BMJ Open. 2017 Sep 11;7(9):e016048. doi: 10.1136/bmjopen-2017-016048.

Abstract

Objective: Early detection of cardiovascular disease (CVD) risk factors, such as obesity, is crucial to prevent adverse long-term effects on individuals' health. Therefore, the aims were: (1) to explore the robustness of neck circumference (NC) as a predictor of CVD and examine its association with numerous anthropometric and body composition indices and (2) to release sex and age-specific NC cut-off values to classify youths as overweight/obese.

Design: Cross-sectional study.

Setting: 23 primary schools and 17 secondary schools from Spain.

Participants: 2198 students (1060 girls), grades 1-4 and 7-10.

Measures: Pubertal development, anthropometric and body composition indices, systolic and diastolic blood pressure (SBP and DBP, respectively), cardiorespiratory fitness, blood sampling triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), glucose and inflammatory markers. Homoeostasis model assessment (HOMA-IR) and cluster of CVD risk factors were calculated.

Results: NC was negatively associated with maximum oxygen consumption (R2=0.231, P<0.001 for boys; R2=0.018, P<0.001 for girls) and adiponectin (R2=0.049, P<0.001 for boys; R2=0.036, P<0.001 for girls); and positively associated with SBP, DBP, TC/HDL-c, TG, HOMA, complement factors C-3 and C-4, leptin and clustered CVD risk factor in both sexes (R2 from 0.035 to 0.353, P<0.01 for boys; R2 from 0.024 to 0.215, P<0.001 for girls). Moreover, NC was positively associated with serum C reactive protein and LDL-c only in boys (R2 from 0.013 to 0.055, P<0.05).

Conclusion: NC is a simple, low-cost and practical screening tool of excess of upper body obesity and CVD risk factors in children and adolescents. Paediatricians can easily use it as a screening tool for overweight/obesity in children and adolescents. For this purpose, sex and age-specific thresholds to classify children and adolescents as normal weight or overweight/obese are provided.

Keywords: anthropometry and body composition; cardiometabolic risk and cardiovascular disease; inflammatory markers; neck circumference; youth..

Publication types

  • Validation Study

MeSH terms

  • Adipokines / blood
  • Adolescent
  • Age Factors
  • Blood Pressure
  • Body Size*
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Child
  • Complement System Proteins / metabolism
  • Cross-Sectional Studies
  • Female
  • Humans
  • Inflammation / blood
  • Inflammation / etiology
  • Insulin Resistance
  • Lipids / blood
  • Male
  • Neck*
  • Nicotinamide Phosphoribosyltransferase / blood
  • Obesity / complications
  • Obesity / diagnosis*
  • Oxygen Consumption
  • Reference Values
  • Risk Factors
  • Sex Factors

Substances

  • Adipokines
  • Lipids
  • Complement System Proteins
  • C-Reactive Protein
  • Nicotinamide Phosphoribosyltransferase