Waist, neck circumferences, waist-to-hip ratio: Which is the best cardiometabolic risk marker in women with severe obesity? The SOON cohort

Abstract

A centralized deposit of adiposity increases the risk of cardiometabolic diseases. Several anthropometric markers can be used to characterize fat distribution. In the case of severe obesity, several markers, such as hip and waist circumference, are prone to measurement error. Conversely, neck circumference is easy to obtain. The aim was to determine the best surrogate marker of obesity-related cardiometabolic diseases from: body mass index (BMI), waist, hip and neck circumferences and waist-to-hip ratio.MethodsData from women (n = 305, aged 43 [34; 53] years-old, BMI 44.2 [40.8; 48.2] kg/m2) included in the Severe Obesity Outcome Network (SOON) cohort were analyzed (i) to evaluate collinearity between the different anthropometric markers, (ii) to compare the association of markers with hypertension, type 2 diabetes, obstructive sleep apnea syndrome (OSAS) and other cardiometabolic risks.ResultsHip, waist and neck circumferences correlated with BMI with respectively less collinearity (r = 0.70, r = 0.59 and r = 0.37, respectively, p<0.001) whereas waist-to-hip ratio was not correlated (r = 0.11, p = 0.072). Waist and neck circumferences were significantly associated with hypertension, type 2 diabetes and OSAS in univariate logistic regressions, waist-to-hip ratio with hypertension and type 2 diabetes. Hip circumference was inversely correlated with type 2 diabetes (OR 0.970 (95CI: 0.948; 0.991) p = 0.006). BMI was only linked to OSAS (OR 1.092 (95CI: 1.043; 1.143) p<0.001). Neck circumference was the only marker significantly associated with all cardiometabolic risk markers (HOMA-IR, apnea-hypopnea index, Log Triglycerides/HDL-c, alanin-aminotransferase, aspartate-aminotransferase, gammaglutamyl transpeptidase).ConclusionsNeck circumference appears the most appropriate anthropometric marker to identify the fat distribution associated with high cardiometabolic risk in women with severe obesity.

Body composition impact on sleep in young adults: The mediating role of sedentariness, physical activity, and diet

“…According to our results, higher values of WHiR were associated with shorter sleep duration, lower sleep efficiency and increased time awake after sleep onset. These results are in accordance with previous research emphasizing that, besides being major risk factors for cardiometabolic alterations, cancer and all-cause mortality [58,59], WHiR and abdominal obesity are significantly related to severe sleep disturbances such as short sleep duration and obstructive sleep apnoea [23,60], especially in younger adults [58]. Regarding LMI, we found that those participants with higher LMI exhibited shorter sleep and lower sleep efficiency.…”

Is neck circumference an appropriate tool to predict cardiovascular risk in clinical practice? A cross-sectional study in Chilean population

“…In fact, neck circumference is also related to oxidative stress, endothelial cell dysfunction and vascular injury24 31 32 and it is correlated with visceral adipose tissue, as measured by CT 30 34 35. Therefore, neck circumference seems to be an important anthropometric marker to identify patients with a high cardiometabolic risk 36…”

Adipose tissue as a key player in obstructive sleep apnoea

“…Potentially, low adipokine production in response to IH might reflect a greater propensity for ectopic and visceral fat deposition in patients with OSA. In overweight males, after controlling for confounders, OSA is specifically associated with a higher amount of visceral adiposity whereas in females, OSA is associated with global adiposity [53,54]. Independently of BMI, OSA is involved in the development of ectopic fat depots contributing to the progression of insulin resistance in the different metabolic organs, including the pancreas, liver and muscle (figure 2) [23,24,55].…”