Hingorjo Mozaffer Rahim, Zehra Sitwat, Imran Erum, Qureshi Masood Anwar
Department of Physiology, Jinnah Medical & Dental College, Karachi.
Dr. A. Q. Khan Institute of Biotechnology & Genetic Engineering, University of Karachi.
J Pak Med Assoc. 2016 Oct;66(10):1221-1226.
To explore the usefulness of neck circumference as a supplemental tool for diagnosing metabolic syndrome while identifying its cut-off values.
This case-control study was conducted at Dr. Essa's Laboratory and Diagnostic Centre, Karachi, from December 2014 to April 2015, and comprised subjects with and without metabolic syndrome aged between 35 and 65 years regardless of their diabetic status. Evaluation was done for metabolic syndrome by measuring anthropometric, clinical and biochemical parameters according to the criteria proposed by the International Diabetes Federation. Variables in both cases and controls were correlated with neck circumference and its cut-off values were determined for diagnosing metabolic syndrome. SPSS 20 was used for statistical analysis.
Of the 215 subjects enrolled, 164(76.28%) were selected. Of them, 83(50.61%) were cases and 81(49.39%) were controls. Moreover, 90(55%) of them were men and 74(45%) were women. The overall mean age was 51.15±10.36 years (range: 35 to 65 years).The mean neck circumference was 36.13±2.14 cm and 31.59±1.18 cm in normal-weight men and women, respectively, compared with 40.0±2.13 cm and 35.75 ± 2.74 cm among obese men and women. The neck circumference correlated best with waist circumference in men (p=0.001) and with body surface area in women (p=0.001). The area under the curve of neck circumference for metabolic syndrome was 0.760 for men (p<0.001) and 0.631 for women (p<0.05). Optimal neck circumference cut-off points to determine metabolic syndrome were >38 cm for men and >34 cm for women. The odds ratio for metabolic syndrome was 12.44 (95% confidence interval: 4.13-37.41) among male cases and controls compared to 3.34 (1.26-8.80) among women.
Neck circumference strongly correlated with adiposity indices and had a definite cut-off point. It can therefore be used as a useful adjunct for clinical screening of metabolic syndrome.
探讨颈围作为诊断代谢综合征的辅助工具的实用性，并确定其临界值。
本病例对照研究于2014年12月至2015年4月在卡拉奇的伊萨博士实验室和诊断中心进行，纳入年龄在35至65岁之间、有无代谢综合征且不考虑糖尿病状态的受试者。根据国际糖尿病联盟提出的标准，通过测量人体测量学、临床和生化参数对代谢综合征进行评估。对病例组和对照组的变量与颈围进行相关性分析，并确定诊断代谢综合征的颈围临界值。使用SPSS 20进行统计分析。
在纳入的215名受试者中，选取了164名（76.28%）。其中，83名（50.61%）为病例组，81名（49.39%）为对照组。此外，90名（55%）为男性，74名（45%）为女性。总体平均年龄为51.15±10.36岁（范围：35至65岁）。正常体重男性和女性的平均颈围分别为36.13±2.14厘米和31.59±1.18厘米，而肥胖男性和女性的平均颈围分别为40.0±2.13厘米和35.75±2.74厘米。男性中颈围与腰围的相关性最佳（p=0.001），女性中颈围与体表面积的相关性最佳（p=0.001）。男性代谢综合征颈围曲线下面积为0.760（p<0.001），女性为0.631（p<0.05）。确定代谢综合征的最佳颈围临界值为男性>38厘米，女性>34厘米。男性病例组与对照组相比，代谢综合征的比值比为12.44（95%置信区间：4.13 - 37.41），女性为3.34（1.26 - 8.80）。
颈围与肥胖指数密切相关且有明确的临界值。因此，它可作为代谢综合征临床筛查的有用辅助指标。
