NECK CIRCUMFERENCE AS A NEW ANTHROPOMETRIC INDICATOR FOR PREDICTION OF CARDIOMETABOLIC RISKS IN SAUDI POPULATION
Albassam, Reem Sulaiman
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Background: Recent studies have associated neck circumference (NC) with metabolic and cardiovascular disease risk factors. No studies designed to examine NC as a measure of cardiometabolic risks have been performed in Saudi Arabia (KSA). Objective: This study aimed to analyze the association between NC and several cardiometabolic risk factors, and to determine the cut-off point value of NC for predicting women at increased risk of metabolic syndrome (MetS). Methods: This cross-sectional study comprised of 700 participants (623 women and 77 men aged 18–70). Study performed in Riyadh city, KSA. International Diabetes Federation (IDF) guidelines were used to diagnose MetS among the subjects. The main indicators studied were NC, waist circumference (WC), body mass index (BMI), body fat %, blood pressure, plasma glucose, total cholesterol, lipoproteins, triglycerides, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) levels. Covariance, and logistic regression analyses were used to evaluate the association of NC to cardiometabolic risk factors separately by genders. Receivers operating characteristic (ROC) curves analyses were used to determine the optimal cutoffs. Results: NC is associated with BMI and WC in men and women. In women, it is associated with cardiometabolic risk factors beyond other anthropometric indices. NC is independently associated with all cardiometabolic risk factors except LDL (P < 0.001). Fully adjusted OR (95% CI) values for incremental increases in NC for women were 1.70 (1.48–2.94) for raised fasting glucose; 1.29 (1.15–1.45) for raised blood pressure; 1.25 (1.13–1.38) for high triglycerides; 1.20 (1.02–1.40) for insulin resistance; and 1.14 (1.02–1.40) for low HDLc. Women in the largest NC quartile were 13 times more likely [OR (95% CI): 13.39 (6.35 - 28.23)] to have MetS compared to the lowest NC quartile after adjustments for possible confounders (all P < 0.01). Finally, our results indicated that the appropriate NC to predict three or more metabolic risk factors in Saudi women is 35.5 cm. This cutoff value was associated with a much greater risk of MetS in participants with both high and normal BMI and WC values. Conclusion: NC is significantly and independently associated with cardiometabolic risk factors in adult Saudi women.