The association between neck adiposity and long-term outcome

Abstract

Anthropometric indices of obesity (e.g. body mass index, waist circumference and neck circumference) are associated with poor long-term cardiovascular outcome. Prior studies have associated neck circumference and central body adiposity. We explored the association between neck fat volume (NFV) and long-term cardiovascular outcome. The study provides a retrospective analysis of all patients undergoing computerized tomography angiography for suspected cerebrovascular accident between January and December 2013. NFV was assessed by three dimensional reconstructions and was adjusted to height to account for differences in body sizes, thus yielding the NFV/height ratio (NHR). Univariate and multivariate analysis were utilized to explore the association between various indices including NHR and all-cause mortality. The analysis included 302 patients. The average age was 61.9±14.3 years, 60.6% of male gender. Diabetes mellitus, hypertension and cardiovascular disease were frequent in 31.5%, 69.9%, and 72.2% of patients, respectively. The median NHR was 492.53cm 2 [IQR 393.93–607.82]. Median follow up time was 41.2 months, during which 40 patients (13.2%) died. Multivariate analysis adjusting for age, sex, and diabetes mellitus indicated an independent association between the upper quartile of NHR and all-cause mortality (hazard ratio = 2.279; 95% CI = 1.209–4.299; p = .011). NHR is a readily available anthropometric index which significantly correlated with poor long-term outcome. Following validation in larger scale studies, this index may serve a risk stratifying tool for cardiovascular disease and future outcome.

Obesity Indices to Use for Identifying Metabolic Syndrome among Rural Adults in South Africa

“…Accumulating evidence indicates that the location and distribution of fat in the body can be a good indicator of MetS and related risk factors [ 6 ]. Therefore, it is of utmost importance to find out a reliable obesity/anthropometric index to determine overall obesity/body fat and visceral/abdominal obesity [ 7 , 8 ]. Obesity indices such as Body mass index (BMI), WC, Waist to height ratio (WHtR) and Neck circumference (NC) are used widely in clinical and epidemiological studies [ 9 , 10 ].…”

“…Obesity indices such as Body mass index (BMI), WC, Waist to height ratio (WHtR) and Neck circumference (NC) are used widely in clinical and epidemiological studies [ 9 , 10 ]. However, these indices were reported to be the best determinants of metabolic health complications such as insulin resistance, hypertension, dyslipidaemia, CVDs and MetS [ 8 , 9 , 10 ].…”

“…Studies indicated that, although BMI can be a good indicator of overall obesity and known to correlate positively with metabolic conditions it cannot discriminate between fat mass and fat-free mass [ 8 , 9 , 10 ]. Waist circumference and WHtR are used as the simplest and alternative anthropometric indices that assess central/abdominal obesity and are a precise reflection of the visceral fats which is strongly linked to metabolic complications [ 10 , 11 ].…”

“…Waist circumference and WHtR are used as the simplest and alternative anthropometric indices that assess central/abdominal obesity and are a precise reflection of the visceral fats which is strongly linked to metabolic complications [ 10 , 11 ]. However, WC is also not suitable for use in obese individuals as its measurement is affected by fullness (meals) and respiration [ 8 , 9 ]. Thus, emerging evidence points NC as a relevant technique to measure fat distribution due to its simplicity and ability to identify measures of MetS [ 12 ].…”

“…Several studies have indicated that obesity indices can be used as a diagnostic tool to determine MetS, however, these were conducted mostly in developed countries [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The value of the previous obesity-based studies in a rural setting of South Africa is limited, the focus was more on finding the cut-off values of obesity indices to determine MetS and most were done in urban settings [ 16 , 17 ].…”