Positive association of neck circumference and cardio-metabolic risk factors in Ekiti, Nigeria

Öz

Aim: The association between neck circumference (NC) and cardiometabolic risk factors in Southwest Nigeria is unknown. The study aimed at determining the relationship between NC and cardiometabolic risk factors. 

Methods: Result of a cross-sectional health survey involving residents of Ado-Ekiti/Ika community in Ekiti State was analyzed. Clinical measurements of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), neck circumference, systolic/diastolic blood pressures (SBP & DBP) were taken, and random blood glucose (RBG) determined. Bivariate correlations and linear regression models were computed for each sex. 

Results: There were 211 participants out of which 78 (37.0%) were men. Among men, NC was significantly correlated with weight (r=0.412, p<0.001) and BMI (r=0.362, p<0.01). Among women, NC correlated with weight (r=0.319, p<0.001), BMI (r=0.228, p<0.01), WC (r=0.238, p<0.01), SBP (r=0.444, p<0.001), DBP (r=0.423, p<0.05), and RBG (r=0.203, p<0.05). NC independently predicted SBP, ORs (95%CI), 2.707 (1.468-3.946) and DBP, ORs (95%CI), 1.780 (0.950-2.611) in women, but not in men. While only the NC of men with general obesity was greater than those who do not have, 39.27(5.68)cm vs 36.96(3.46)cm, p=0.04, the NC of women who were obese or had hypertension were significantly greater than those who were not: general obesity, 33.17(2.58)cm vs 31.57(3.08cm), p=0.002; central obesity, 32.88(2.99)cm vs 31.09(2.62)cm, p<0.001; hypertension, 34.39(2.77)cm vs 31.88(2.88)cm, p=0.001). Compared with those in the upper tertile, men with NC in the middle tertile had lower mean weight [60.82 (8.67) kg vs 68.90 (10.08) kg, p=0.005], BMI [21.31 (2.54) kgm2 vs 23.72 (3.77) kgm2, p=0.022], WC [78.32 (5.57) cm vs 85.14 (8.72), p=0.003], and WHtR [0.464 (0.06) vs 0.50 (0.06), p=0.004].Compared with those in the upper tertile, women with NC in the lower tertile had lower mean weight [56.81(9.80) kg vs 66.08(13.50)kg, p=0.031], SBP [107.53 (15.59) mmHg vs 132.38 (15.85) mmHg, p<0.001], and DBP [69.27 (10.91) mmHg vs 84.69 (10.52) mmHg, p<0.001].

Conclusions: Neck circumference has positive association with, and predicts cardiometabolic risk factors, and may serve as an index of obesity in Ekiti, Nigeria.

Anahtar Kelimeler

• Cardiometabolic risk factors,Correlations,Neck circumference,Obesity,Hypertension

Nijerya'da Ekiti'de boyun çevresi ve kardiyo-metabolik risk faktörlerinin pozitif ilişkisi

Öz

Amaç: Güneybatı Nijerya'da boyun çevresi (NC) ve kardiyometabolik risk faktörleri arasındaki ilişki bilinmemektedir. Çalışma, NC ve kardiyometabolik risk faktörleri arasındaki ilişkiyi belirlemeyi amaçlamıştır.

Yöntemler: Ekiti Devletinde Ado-Ekiti / Ika topluluğu sakinlerini içeren kesitsel bir sağlık araştırması sonuçları analiz edildi. Vücut kitle indeksi (BMI), bel çevresi (WC), bel-boy oranı (WHtR), boyun çevresi, sistolik / diyastolik kan basınçları (SBP ve DBP) klinik ölçümleri alındı ve rastgele kan şekeri (RBG) belirlendi. Her cinsiyet için iki değişkenli korelasyonlar ve doğrusal regresyon modelleri hesaplandı.

Bulgular: 78'i (%37,0) erkek olan 211 katılımcı vardı. Erkekler arasında NC, ağırlıkla (r=0,412, p<0,001) ve BMI (r=0.362, p<0,01) ile anlamlı olarak koreleydi. Erkeklerde olmamakla birlikte kadınlar arasında NC (r=0,319, p<0,001), BMI (r=0,228, p<0,01), WC (r=0,238, p<0,01), SBP (r=0,444, p<0,001) ile korele bulundu. DBP (r=0,423, p<0,05) ve RBG (r=0,203, p<0,05). NC bağımsız olarak, kadınlarda SBP, OR (%95 CI), 2,707 (1,468-3,946) ve DBP, OR (%95 CI), 1,780 (0,950-2,611). Genel obezitesi olan erkeklerin sadece NC'si olmayanlardan 39,27 (5,68) cm'ye karşılık 36,96 (3,46) cm, p=0.04 iken, obez olan veya hipertansiyonu olan kadınların NC'si, değil: genel obezite, 33,17 (2,58) cm vs 31,57 (3,08 cm), p=0.002; santral obezite, 32,88 (2,99) cm'ye karşı 31,09 (2,62) cm, p<0.001; hipertansiyon, 34,39 (2,77) cm'ye karşı 31,88 (2,88) cm, p = 0.001) idi. Üst tersiyer ile karşılaştırıldığında, orta hüviyette NC olan erkeklerin oranı daha düşüktü [60,82 (8,67) kg / 68,90 (10,08) kg, p=0,005], BMI [21,31 (2,54) kg/m2 ve 23,72 (3,77) kg/m2 idi. , p=0,022], WC [78,32 (5,57) cm'ye karşı 85,14 (8,72), p=0,003] ve WHtR [0,464 (0,06) / 0,50 (0,06), p=0,004]. Üst tersiyerde bulunanlarla karşılaştırıldı, alt kadranda KKY'li kadınlar daha düşük ortalama ağırlığa sahipti [56,81 (9,80) kg / 66,08 (13,50) kg, p=0,031], SBP [107,53 (15,59) mmHg ve 132,38 (15,85) mmHg, p=0,000] ve DBP [69,27 (10,91) mmHg, 84,69 (10,52) mmHg, p=0,000].

Sonuçlar: Boyun çevresi kardiyometabolik risk faktörleri ile pozitif ilişkilidir ve tahmin eder ve Nijerya'daki Ekiti'de bir obezite endeksi olarak hizmet edebilir.

Anahtar Kelimeler

• Kardiyometabolik risk faktörleri,Korelasyonlar,Boyun çevresi,Obezite,Hipertansiyon

Kaynakça

1. 1. World Health Organization, http://www.who.int/mediacentre/factsheets/fs311/en/
2. 2. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. WHO Technical Report Series 894. Geneva: World Health Organization, 2000.
3. 3. Okafor C, Gezawa I, Sabir A, Raimi T, Enang O. Obesity, overweight, and underweight among urban Nigerians. Nig J Clin Pract. 2014;17(6):743-9. doi:10.4103/1119-3077.144389
4. 4. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome-a new worldwide definition. Lancet. 2005;366(9491):1059-62.
5. 5. Ashwell M, Gibson S. Waist-to-height ratio as an indicator of ‘early health risk’: simpler and more predictive than using a ‘matrix’ based on BMI and waist circumference. BMJ Open. 2016 Mar 14;6(3):e010159. doi:10.1136/bmjopen-2015-010159
6. 6. Kim MK, Han K, Kwon HS, Song KH, Yim HW, Lee WC, et al. Normal weight obesity in Korean adults. Clin Endocrinol (Oxf). 2014;80(2):214-20. doi:10.1186/2052-9538-1-9
7. 7. Pasco JA. Body mass index and measures of body fat for defining obesity and underweight: a cross-sectional, population-based study. BMC Obes. 2014 Jun 23;1:9. doi: 10.1186/2052-9538-1-9.
8. 8. Dunkley AJ, Stone MA, Patel N, Davies MJ, Khunti K. Waist circumference measurement: knowledge, attitudes and barriers in patients and practitioners in a multi-ethnic population. Family Practice. 2009;26(5):365-71.

9. 9. Brown RE, Randhawa AK, Canning KL, Fung M, Jiandani D, Wharton S, et al. Waist circumference at five common measurement sites in normal weight and overweight adults: which site is most optimal? Clin Obes. 2018;8(1):21-9. doi:10.1111/cob.12231
10. 10. Preis SR, Massaro JM, Hoffmann U, D'Agostino RB Sr, Levy D, Robins SJ, et al. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J Clin Endocrinol Metab. 2010;95(8):3701-10. doi:10.1210/jc.2009-1779
11. 11. Saka M, Türker P, Ercan A, Kızıltan G, Baş M. Is neck circumference measurement an indicator for abdominal obesity? A pilot study on Turkish Adults. Afr Health Sci. 2014;14(3):570-5. doi 10.4314/ahs.v14i3.11
12. 12. Volaco A, Martins CM, Soares JQ, Cavalcanti AM, Moyses ST, Filho RP, et al. Neck Circumference and its Correlation to Other Anthropometric Parameters and Finnish Diabetes Risk Score (FINDRISC). Curr Diabetes Rev. 2017 Oct 2. pii: CDR-EPUB-86087 doi: 10.2174/1573399813666171002113442
13. 13. Ozkaya I, Tunckale A. Neck Circumference Positively Related with Central Obesity and Overweight in Turkish University Students: A Preliminary Study. Cent Eur J Public Health. 2016;24(2):91-4. doi:10.21101/cejph.a4555
14. 14. Alfadhli EM, Sandokji AA, Zahid BN, Makkawi MA, Alshenaifi RF, Thani TS, et al. Neck circumference as a marker of obesity and a predictor of cardiometabolic risk among Saudi subjects. Saudi Med J. 2017;38(12):1219-23. doi: 10.15537/smj.2017.12.20926
15. 15. Zhou JY, Ge H, Zhu MF, Wang LJ, Chen L, Tan YZ, et al. Neck circumference as an independent predictive contributor to cardio-metabolic syndrome. Cardiovasc Diabetol. 2013;12:76. doi:10.1186/1475-2840-12-76
16. 16. Li HX, Zhang F, Zhao D, Xin Z, Guo SQ, Wang SM, et al. Neck circumference as a measure of neck fat and abdominal visceral fat in Chinese adults. BMC Public Health. 2014;14:311. doi: 10.1186/1471-2458-14-311
17. 17. Wang X, Zhang N, Yu C, Ji Z. Evaluation of neck circumference as a predictor of central obesity and insulin resistance in Chinese adults. Int J Clin Exp Med. 2015 Oct 15;8(10):19107-13. eCollection 2015.
18. 18. Kumar NV, Ismail MH, Mahesha P, Girish M, Tripathy M. Neck circumference and cardio- metabolic syndrome. J Clin Diagn Res. 2014;8(7):23-5. doi: 10.7860/jcdr/2014/8455.4641
19. 19. Verma M, Rajput M, Sahoo SS, Kaur N. Neck Circumference: Independent Predictor for Overweight and Obesity in Adult Population. Indian J Community Med. 2017;42(4):209-13. doi: 10.4103/ijcm.IJCM_196_16
20. 20. Lindarto D, Shierly, Syafril S. Neck Circumference in Overweight/Obese Subjects who Visited the Binjai Supermall in Indonesia. Open Access Maced J Med Sci. 2016;4(3):319-23. doi:10.3889/oamjms.2016.072
21. 21. Qureshi NK, Hossain T, Hassan MI, Akter N, Rahman MM, Sultana MM, et al. Neck Circumference as a Marker of Overweight and Obesity and Cut-off Values for Bangladeshi Adults. Indian J Endocrinol Metab. 2017;21(6):803-8. doi: 10.4103/ijem.IJEM_196_17
22. 22. Fan S, Yang B, Zhi X, He J, Ma P, Yu L, et al. Neck circumference associated with arterial blood pressures and hypertension: A cross-sectional community-based study in northern Han Chinese. Sci Rep. 2017;7(1):2620. doi:10.1038/s41598-017-02879-7
23. 23. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52.
24. 24. Adamu L, Asuku A, Taura M, Tela I, Datti SS, Imam A. Neck circumference: An upcoming tool of adiposity indices. Niger J Basic Clin Sci. 2013;10(2):82-5. doi:10.4103/0331-8540.122766
25. 25. Selvan C, Dutta D, Thukral A, Nargis T, Kumar M, Mukhopadhyay S, et al. Neck height ratio is an important predictor of metabolic syndrome among Asian Indians. Indian J Endocrinol Metab. 2016;20(6):831-7. doi:10.4103/2230-8210.192927
26. 26. Joshipura K, Munoz-Torres F, Vergara J, Palacios C, Perez CM. Neck Circumference May Be a Better Alternative to Standard Anthropometric Measures. J Diabetes Res. 2016;2016:6058916. doi:10.1155/2016/6058916
27. 27. Ceccato F, Bernkopf E, Scaroni C. Sleep apnea syndrome in endocrine clinics. J Endocrinol Invest. 2015;38(8):827-34. doi: 10.1007/s40618-015-0338-z
28. 28. Simonenko VB, Goriutskii VN, Dulin PA. The role of insulin resistance in pathogenesis of arterial hypertension. Klin Med (Mosk). 2014;92(9):27-33.
29. 29. Assyov Y, Gateva A, Tsakova A, Kamenov Z. A comparison of the clinical usefulness of neck circumference and waist circumference in individuals with severe obesity. Endocr Res. 2017;42(1):6-14. doi:10.3109/07435800.2016.1155598