Association between neck circumference and the risk of decreased estimated glomerular filtration rate in the general population of China: a cross-sectional study

Abstract

Background: The burden of chronic kidney disease is increasing substantially worldwide. Neck circumference (NC), an anthropometric index for upper-body adiposity, has been recognized as an indicator of cardiometabolic diseases. However, the association between NC and renal dysfunction has not been fully disclosed. The aim of this study was to investigate the association between NC and estimated glomerular filtration rate (eGFR) in the general population in China. Methods: A total of 8805 participants (3322 men and 5483 women) were enrolled in this study. Logistic regression analysis was conducted to examine the association between NC and eGFR. The male and female subjects were divided into four groups according to the neck circumference quartiles. The primary outcome was defined as an eGFR ≤ 90 mL/min/1.73 m2.Results: Logistic regression analysis revealed that in both sexes, higher neck circumference was significantly associated with a higher risk of decreased eGFR even after fully adjusting for age; other anthropometric indexes, including body mass index and waist to hip ratio; traditional risk factors for chronic kidney diseases; and sociologic risk factors (Quartile1 as a reference; the odds ratios [95% confidence intervals] were as follows: Quartile 2, 1.26[0.99-1.59]; Quartile 3, 1.40[1.07-1.83]; Quartile 4, 1.71[1.22-2.38] in men; Quartile 2, 1.14[0.95-1.37]; Quartile 3, 1.31[1.03-1.66]; Quartile 4, 1.32[1.04-1.68] in women.) Stratified analyses suggested that the association was significant among subjects with prediabetes and those with normal serum uric acid levels. When the subjects were stratified according to blood pressure or BMI, the association persisted among male subjects with abnormal blood pressure and was strengthened among male subjects who were overweight/obese, while the association disappeared among female subjects. Conclusions: NC is independently associated with the risk of decreased eGFR in the general population in China, indicating that NC could contribute to renal dysfunction risk assessment.

Neck Circumference Is Associated With Hyperuricemia in Women With Polycystic Ovary Syndrome

“…Second, since an increased prevalence of obstructive sleep apnea has been observed in women with PCOS (42), xanthine oxidase, an enzyme that plays a key role in uric acid synthesis, could be activated under hypoxic conditions in those patients (43). Third, increasing evidence has shown that more than 60% offree fatty acids (FFAs) are released from upper-body subcutaneous adipose tissue (44). High levels of FFAs exert pathogenic effects on the glomerulus (44) and tubulointerstitium (45), leading to abnormal renal secretion and reabsorption of uric acid (27,46).…”

Neck circumference is independently associated with metabolic syndrome in women with polycystic ovary syndrome

“…Insulin resistance, although it has not been included in the diagnostic criteria of metabolic syndrome, is a central factor in the pathogenesis of both MetS and PCOS [33]. In addition, increasing evidence has shown that the variation in NC directly reflects subcutaneous adipose deposition, from which more than 60% of free fatty acids (FFAs) are released [34]. Excessive FFAs have emerged as a major cause of insulin resistance in insulin target organs, which consequently advances the development of MetS [35].…”

Neck Circumference Is a Reliable Predictor for Hyperuricemia in Women With Polycystic Ovary Syndrome: a Case Control Study

“…Second, since an increased prevalence of obstructive sleep apnea has been observed in women with PCOS(42), xanthine oxidase, an enzyme that plays a key role in uric acid synthesis, could be activated under hypoxic conditions in those patients (43). Third, increasing evidence has shown that more than 60% of free fatty acids (FFAs) are released from upper-body subcutaneous adipose tissue (44). High levels of FFAs exert pathogenic effects on the glomerulus [42] and tubulointerstitium (45), leading to abnormal renal secretion and reabsorption of uric acid (27,46).…”