National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, 73 Mount Wayte Avenue, Suite 2, Framingham, Massachusetts 01702, USA.
J Clin Endocrinol Metab. 2010 Aug;95(8):3701-10. doi: 10.1210/jc.2009-1779. Epub 2010 May 19.
Neck circumference, a proxy for upper-body sc fat, may be a unique fat depot that confers additional cardiovascular risk above and beyond central body fat.
Participants with neck circumference measures who underwent multidetector computed tomography to assess visceral adipose tissue (VAT) were included [n=3307, 48% women; mean age=51 yr; mean body mass index (BMI)=27.8 kg/m2; mean neck circumference=40.5 cm (men) and 34.2 cm (women)]. Sex-specific linear regression models were used to assess the association between sd increase in neck circumference and cardiovascular disease (CVD) risk factors (systolic and diastolic blood pressure; total, low-density lipoprotein, and high-density lipoprotein cholesterol and triglycerides; and fasting plasma glucose, insulin, proinsulin, and homeostasis model assessment of insulin resistance). Neck circumference was correlated with VAT [r=0.63 (men); r=0.74 (women); P<0.001] and BMI [r=0.79 (men); r=0.80 (women); P<0.001]. After further adjustment for VAT, neck circumference was positively associated with systolic blood pressure, diastolic blood pressure in men only, triglycerides, fasting plasma glucose in women only, insulin, proinsulin, and homeostasis model assessment of insulin resistance and was inversely associated with high-density lipoprotein (all P values<0.01). Similar results were observed in models that adjusted for both VAT and BMI. In a secondary analysis of incident CVD as an outcome, there was no statistically significant association observed for neck circumference in multivariable-adjusted models.
Neck circumference is associated with CVD risk factors even after adjustment for VAT and BMI. These findings suggest that upper-body sc fat may be a unique, pathogenic fat depot.
颈围是上半身皮下脂肪的一个替代指标，可能是一个独特的脂肪储存库，除了中央身体脂肪外，还会增加心血管风险。
纳入了接受多排螺旋 CT 评估内脏脂肪组织 (VAT) 的颈围测量参与者[n=3307，48%为女性；平均年龄为 51 岁；平均体重指数 (BMI)=27.8kg/m2；平均颈围为男性 40.5cm 和女性 34.2cm]。使用性别特异性线性回归模型评估颈围标准差增加与心血管疾病 (CVD) 危险因素（收缩压和舒张压；总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯；以及空腹血糖、胰岛素、胰岛素原和胰岛素抵抗的稳态模型评估）之间的关系。颈围与 VAT 呈正相关[r=0.63（男性）；r=0.74（女性）；P<0.001]和 BMI [r=0.79（男性）；r=0.80（女性）；P<0.001]。进一步调整 VAT 后，颈围与收缩压、仅男性的舒张压、甘油三酯、仅女性的空腹血糖、胰岛素、胰岛素原和胰岛素抵抗的稳态模型评估呈正相关，与高密度脂蛋白呈负相关（所有 P 值均<0.01）。在同时调整 VAT 和 BMI 的模型中也观察到了类似的结果。在作为结局的 CVD 事件的二次分析中，在多变量调整模型中，颈围与 CVD 无统计学显著关联。
即使在调整了 VAT 和 BMI 后，颈围仍与 CVD 危险因素相关。这些发现表明，上半身皮下脂肪可能是一个独特的、致病的脂肪储存库。
