Creation of a reference dataset of neck sizes in children: standardizing a potential new tool for prediction of obesity-associated diseases?

Abstract

BackgroundNeck circumference (NC), is an emerging marker of obesity and associated disease risk, but is challenging to use as a screening tool in children, as age and sex standardized cutoffs have not been determined. A population-based sample of NC in Canadian children was collected, and age- and sex-specific reference curves for NC were developed.MethodsNC, waist circumference (WC), weight and height were measured on participants aged 6–17 years in cycle 2 of the Canadian Health Measures Survey. Quantile regression of NC versus age in males and females was used to obtain NC percentiles. Linear regression was used to examine association between NC, body mass index (BMI) and WC. NC was compared in healthy weight (BMI < 85th percentile) and overweight/obese (BMI > 85th percentile) subjects.ResultsThe sample included 936 females and 977 males. For all age and sex groups, NC was larger in overweight/obese children (p < 0.0001). For each additional unit of BMI, average NC in males was 0.49 cm higher and in females, 0.43 cm higher. For each additional cm of WC, average NC in males was 0.18 cm higher and in females, 0.17 cm higher.ConclusionThis study presents the first reference data on Canadian children’s NC. The reference curves may have future clinical applicability in identifying children at risk of central obesity-associated conditions and thresholds associated with disease risk.

Neck circumference as a complementary measure to identify excess body weight in children aged 13-24 months

“…The results of this study have shown that body weight and BMI have a positive correlation with NC, corroborating other studies conducted with children older than 2 years of age, in Brazil and other countries. 7,9,12,13,[15][16][17][18]20 The results of the present study also show that there was a moderate positive correlation between NC and BMI in both genders according to age group, supporting the results from studies conducted with Turkish, American and Chinese children. 7,12,18 However, some important limitations should be considered.…”

“…The values for sensitivity were also high and similar to those of other studies that have investigated the use of NC as a measure to evaluate excess body weight in children and adolescents. 7,12,15,16,18 However, in the present study, specificity was lower than that found in other studies, 7,12,15,18,21 resulting in a higher number of false-positives, i.e., a high proportion of children classified as having excess body weight when in fact they did not.…”

“…7 As an alternative to WC, the measurement of NC appears to be a good option for identifying excess body weight and assessing upper body fat. In addition to obesity, 13 NC measurements have been shown to be suitable for assessing other risk factors in adults and children, including metabolic syndrome, 10,26 obstructive sleep apnea, 16 perioperative adverse respiratory events, 13 and cardio-metabolic risk factors. 9,11,14 Furthermore, in addition to its accuracy in identifying excess body weight and risk of other related health outcomes, La Berge et al 27 have reported that NC showed good inter-and intra-rater reliability and that it does not require multiple measurements for precision and reliability.…”

“…8,9 More recently, neck circumference (NC) has been proposed by a number of authors as an effective, inexpensive and easily applied measure for evaluating upper body fat distribution 7,9-15 and thereby identifying children at risk of developing conditions related to central obesity. 16 An additional advantage of using NC as a proxy for upper body fat distribution is that it shows no variation in size throughout the day. 7,12 Although several studies have been published that have examined NC as a measure for identifying excess body weight, 7,9,12,13,[15][16][17][18][19][20][21] to our knowledge, no study has been conducted with children under two years of age.…”

“…16 An additional advantage of using NC as a proxy for upper body fat distribution is that it shows no variation in size throughout the day. 7,12 Although several studies have been published that have examined NC as a measure for identifying excess body weight, 7,9,12,13,[15][16][17][18][19][20][21] to our knowledge, no study has been conducted with children under two years of age. The purpose of the present study was thus to evaluate the accuracy of NC as a measure for assessing excess body weight in children aged [13][14][15][16][17][18][19][20][21][22][23][24] and to provide NC data to help establish guidelines that can be used to identify excess body weight in children under two years of age.…”