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The association of neck circumference with risk of metabolic syndrome and its components in adults: A systematic review and meta-analysis
Authors:N Namazi  B Larijani  PJ Surkan  L Azadbakht
Institution:1. Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular- Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran;2. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran;3. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA;4. Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran;5. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran;6. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract:

Background & aims

Several prior studies suggested that neck circumference (NC) is a reliable diagnostic tool for risk of metabolic syndrome (MetS) and its features. However, not all studies support this view. Therefore, we aimed to perform a meta-analysis to summarize the association between NC with MetS and its components in adult populations.

Methods and Results

PubMed/Medline, Web of Knowledge, and Scopus electronic databases were searched until May 31, 2017 to find relevant English-language papers. We included studies that examined the association of NC with risk of MetS, or at minimum, one of its components as outcomes.Of 2628 publications identified, 19 papers met selection criteria. We found no association between NC and MetS (odd ratio (OR): 0.73; 95% CI: 0.003, 1.47). However, there was a positive association between NC and waist circumference (WC) (r = 0.85; 95%: 0.75, 0.95; I2: 98.2%; p = 0.0001), BMI: (r:0.88; 95% CI: 0.74, 0.91, I2:97.3%), triglycerides (TG) (OR: 1.87; 95% CI: 1.60, 2.19; I2:58.4%; p = 0.03), TC (r:0.14; 95%CI: 0.05, 0.23, I2:94.1%), LDL-C (r: 0.18; 95%CI: 0.07, 0.29, I2:94.3%), hypertension (OR: 1.94; 95% CI:1.43, 2.64, I2:87.3%), systolic (r: 0.21, 95%CI: 0.19, 0.23; I2:67.1%) and diastolic blood pressures (r: 0.20, 95%CI: 0.16, 0.23; I2:79.7%), low HDL-C (r:-0.21; 95% CI: ?0.26, ?0.15, I2 = 92.5%), as well as fasting blood sugar (FBS) concentrations (r: 0.20, 95%CI: 0.16, 0.24; I2:88.1%).

Conclusion

Subjects with higher NC were at approximately two-fold higher risk for hypertriglyceridemia compared to those with lower NC. We found positive associations between NC, WC, BMI, hypertension, FBS, TC, LDL-C, SBP, DBP, and low HDL-C concentrations. However, heterogeneity was considerably high. Therefore, the findings should be taken with caution. Future studies using longitudinal designs are needed to further understand the association between NC and features of MetS.
Keywords:Neck  MetS  Cardio-metabolic risks  Adults  Meta-analysis  BMI  body mass index  DBP  Diastolic blood pressure  FFA  free fatty acid  HDL-C  high density lipoprotein cholesterol  LDL-C  low density lipoprotein cholesterol  MetS  Metabolic syndrome  NC  Neck circumference  SABPA  Sympathetic Activity and Ambulatory Blood Pressure  SBP  Systolic blood pressure  T2DM  type 2 diabetes  TC  Total cholesterol  WC  Waist circumference
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