Neck circumference, cardiometabolic risk, and Framingham risk score: Population-based study

ZANUNCIO, Virgínia Vinha; PESSOA, Milene Cristine; PEREIRA, Patrícia Feliciano; LONGO, Giana Zarbato

doi:10.1590/1678-98652017000600009

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ORIGINAL ARTICLES • Rev Nutr 30 (6) • Nov-Dec 2017 • https://doi.org/10.1590/1678-98652017000600009 copy

Neck circumference, cardiometabolic risk, and Framingham risk score: Population-based study

Circunferência do pescoço, risco cardiometabólico e escore de risco de Framingham: estudo de base populacional

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To investigate the association of the neck circumference with cardiometabolic risk factors and the Framingham risk score.

Methods

The study was a cross-sectional population-based one with 948 adults (522 women) aged 20–59 years. Sociodemographic, anthropometric, body composition, behavioral, biochemical, and hemodynamic factors were evaluated. The association between neck circumference, anthropometric variables, body composition and cardiometabolic risk factors was evaluated by multiple linear regression, adjusted for sociodemographic and behavioral factors.

Results

Are presented as β coefficients, standard errors, and 95% confidence intervals with a 0.05 significance level. The neck circumference was positively associated with triglycerides, insulin resistance index, uric acid, systolic and diastolic blood pressure, C-reactive protein, waist circumference, body mass index and total body fat estimated by dual energy X-ray absorptiometry. The neck circumference and high-density lipoprotein cholesterol were negatively associated, even after adjustment for sociodemographic and behavioral factors. Individuals with a neck circumference below the cut-off point to predicting cardiometabolic risks, 39.5cm for men and 33.3cm for women, had lower probability of having a coronary event in 10 years compared to those with a neck circumference above the cut-off point.

Conclusion

Neck circumference is an alternative measure to estimate body fat and as an additional marker to screen for cardiovascular risk diseases.

Keywords
Anthropometry; Insulin resistance; Neck; Obesity; Risks

Parameters	Men		Women
Parameters	Mean	95%CI	Mean	95%CI
Age (years)	36.44	33.80-39.08	40.06	38.10-42.03
Height (m)*	1.73	1.72-1.75	1.59	1.58-1.61
Weight (kg)*	80.10	76.39-83.81	65.15	63.70-66.60
Body mass index (kg/m²)	25.66	24.91-26.41	25.55	24.73-26.37
Waist circumference (m)*	87.47	85.37-89.56	80.62	78.60-82.64
Neck circumference (m)*	38.63	38.27-38.99	33.11	32.73-33.50
Glucose (mg/dL)	86.65	84.82-87.48	86.13	82.81-89.44
HDL (mg/dL)*	43.82	42.25-45.40	54.50	52.48-56.52
SBP (mmHg)*	123.29	121.24-125.35	117.04	114.30-119.77
DBP (mmHg)	77.69	75.97-79.41	76.22	74.46-77.97
Triglycerides (mmHg)	141.60	122.50-160.70	122.23	1 13.95-130.50
HOMA-IR	1.77	1.51-2.02	2.08	1.85-2.32
Uric acid (mg/dL)*	4.76	4.58-4.95	3.47	3.31-3.63
Physical activity (min)	134.19	89.72-178.67	79.40	57.75-101.05
Smoking (%)
Non-smoking	61.47	52.01-70.14	69.14	62.59-75.00
Ex-smoker	24.83	16.65-35.32	21.01	16.16-26.85
Smoker	13.69	10.26-18.05	9.84	6.74-14.16

Dependent variables	Model 0	Model 1	Model 2
HDL (mg/dL)
β ± SE	-1.73 ±0.13	-1.41 ± 0.14	-1.37 ±0.14
95%CI	(-2.00; -1.46)	(-1.70; -1.12)	(-1.67; -1.07)
R²	0.187	0.194	0.202
LDL (mg/dL)
β ± SE	0.36 ± 0.28	0.43 ± 0.50	0.49 ± 0.49
95%CI	(-0.20; 0.94)	(-0.58; 1.45)	(-0.51; 1.50)
R²	0.002	0.134	0.143
Triglycerides (mg/dL)
β ± SE	0.04 ± 0.01	0.05 ±0.01	0.050 ± 0.01
IC95%	(0.03; 0.05)	(0.03; 0.06)	(0.03; 0.06)
R²	0.077	0.162	0.180
HOMA-IR
β ± SE	0.04 ± 0.01	0.12 ± 0.12	0.12 ± 0.01
95%CI	(0.02; 0.05)	(0.09; 0.15)	(0.09; 0.14)
R²	0.055	0.238	0.238
Uric acid (mg/dL)
β ± SE	0.19 ± 0.01	0.13 ± 0.02	0.13 ± 0.02
95%CI	(0.16; 0.21)	(0.10; 0.17)	(0.10; 0.16)
R²	0.323	0.346	0.369
SBP (mmHg)
β ± SE	1.60 ± 0.15	1.58 ± 0.22	1.46 ± 0.22
95%CI	(1.29; 1.93)	(1.12; 2.03)	(1.00; 1.92)
R²	0.146	0.254	0.251
DBP (mmHg)
β ± SE	0.70 ± 0.12	0.80 ± 0.12	0.77 ± 0.12
95%CI	(0.46; 0.95)	(0.44; 1.16)	(0.44; 1.09)
R²	0.064	0.199	0.211
C-Reactive Protein (mg/dL)
β ± SE	0.005 ± 0.01	0.096 ± 0.02	0.093 ± 0.02
95%CI	(-0.01; 0.02)	(0.06; 0.12)	(0.06; 0.12)
R²	0.000	0.086	0.090
Waist circumference (cm)
β ± SE	2.14 ± 0.09	3.06± 0.17	3.02 ± 0.16
95%CI	(1.95; 2.32)	(2.71; 3.41)	(2.68; 3.36)
R²	0.460	0.637	0.643
Body Mass Index (kg/m²)
β ± SE	0.66 ± 0.05	1.32 ± 0.09	1.30 ± 0.08
95%CI	(0.55; 0.77)	(1.14; 1.50)	(1.12; 1.47)
R²	0.265	0.551	0.558
DXA (% total body fat)
β ± SE	-0.36 ± 0.07	1.47 ± 0.12	1.46 ± 0.12
95%CI	(-0.50; -0.22)	(1.21; 1.72)	(1.20; 1.71)
R²	0.019	0.553	0.562

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[1] Note:

[TFN01] ^*
Significant difference between the sexes (p<0.05).

[3] HDL: High-Density Lipoprotein; SBP: Systolic Blood Pressure; DBP: Diastolic Blood Pressure; HOMA-IR: Insulin Resistance Index; 95%CI: 95% Confidence Interval.