Laboratory of Research in Metabolism and Diabetes, Department of Medical Clinic, State University of Campinas UNICAMP, Campinas, São Paulo, Brazil.
Clin Endocrinol (Oxf). 2013 Jun;78(6):874-81. doi: 10.1111/j.1365-2265.2012.04487.x. Epub 2013 Mar 25.
To investigate the relationship of the neck circumference (NC) with the metabolic syndrome (MetS) and insulin resistance (IR) in a large Brazilian population-based sample, within a wide range of adiposity and glucose tolerance, and to establish cut-off values of the NC for MetS and IR.
The NC correlates with cardiovascular risk factors, IR and components of MetS. Upper-body subcutaneous (sc) fat, as estimated by the NC, is associated with cardiovascular risk factors as much as abdominal fat, which is usually estimated by the waist circumference (WC). There are few epidemiological population-based studies on the clinical significance of the NC to MetS and IR.
This is a cross-sectional study.
About 1053 Brazilian adults (18-60 years).
Patients with BMI 18.5-40.0 kg/m(2), with normal glucose tolerance or type 2 diabetes (T2DM), were submitted to anthropometric measurements including waist circumference (WC), NC and BMI. Abdominal visceral fat (VF) was assessed by ultrasound. Insulin sensitivity (IS) was assessed by euglycaemic-hyperinsulinaemic clamp (10% of total sample) and HOMA-IR. Spearman correlations were used to evaluate the association between NC and IR and MetS risk factors. Receiver operating characteristic (ROC) curves were used for gender-specific cut-off values for the prediction of IR and MetS. Binary logistic regression analysis was used to assess the chance of developing IR or MetS according to the enlargement of NC and WC.
The sample consisted of 28.6% men, with a mean age of 39.4 (12 years). T2DM diagnosis was present in 306 individuals, of whom 34% were men. NC correlated with WC and BMI in both men and women (P < 0.001). In both genders, NC showed a positive correlation with triglycerides, fasting glucose, fasting insulin and HOMA-IR, and NC had a negative association with high-density lipoprotein (HDL). NC and IS showed a moderate negative correlation. A significant correlation was demonstrated between VF and NC. In the ROC curves, NC presented the largest AUC for IR in women (P < 0.001), while NC presented a large AUC for MetS in both genders.
Neck circumference measurements are an alternative and innovative approach for determining body fat distribution. The NC is positively associated with MetS risk factors, IR and VF, with established cut-off values for the prediction of MetS and IR.
在一个广泛的肥胖和葡萄糖耐量范围内，调查颈围（NC）与代谢综合征（MetS）和胰岛素抵抗（IR）的关系，并为 NC 与 MetS 和 IR 建立截断值。
NC 与心血管危险因素、IR 和 MetS 成分相关。通过 NC 估计的上半身皮下（sc）脂肪与心血管危险因素的相关性与通常通过腰围（WC）估计的腹部脂肪一样多。关于 NC 对 MetS 和 IR 的临床意义，很少有基于人群的流行病学研究。
这是一项横断面研究。
约 1053 名巴西成年人（18-60 岁）。
BMI 为 18.5-40.0kg/m²、血糖正常或 2 型糖尿病（T2DM）的患者接受了包括腰围（WC）、NC 和 BMI 在内的人体测量。腹部内脏脂肪（VF）通过超声评估。通过葡萄糖正常的高胰岛素血症钳夹术（占总样本的 10%）和 HOMA-IR 评估胰岛素敏感性（IS）。Spearman 相关用于评估 NC 与 IR 和 MetS 危险因素之间的相关性。受试者工作特征（ROC）曲线用于为男性和女性预测 IR 和 MetS 建立 NC 的截断值。二元逻辑回归分析用于评估根据 NC 和 WC 的增大，发生 IR 或 MetS 的几率。
样本由 28.6%的男性组成，平均年龄为 39.4（12 岁）。306 名患者诊断为 T2DM，其中 34%为男性。NC 与男性和女性的 WC 和 BMI 均相关（P<0.001）。在两性中，NC 与甘油三酯、空腹血糖、空腹胰岛素和 HOMA-IR 呈正相关，与高密度脂蛋白（HDL）呈负相关。NC 和 IS 呈中度负相关。NC 与 VF 之间存在显著相关性。在 ROC 曲线中，NC 在女性中显示出对 IR 的最大 AUC（P<0.001），而 NC 在两性中对 MetS 显示出大 AUC。
颈围测量是一种确定体脂分布的替代和创新方法。NC 与 MetS 危险因素、IR 和 VF 呈正相关，并且为预测 MetS 和 IR 建立了截断值。
