Castro-Piñero José, Delgado-Alfonso Alvaro, Gracia-Marco Luis, Gómez-Martínez Sonia, Esteban-Cornejo Irene, Veiga Oscar L, Marcos Ascensión, Segura-Jiménez Víctor
Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain.
Children's Health and Exercise Research Centre (CHERC), Sport and Health Sciences, University of Exeter, Exeter, UK.
BMJ Open. 2017 Sep 11;7(9):e016048. doi: 10.1136/bmjopen-2017-016048.
Early detection of cardiovascular disease (CVD) risk factors, such as obesity, is crucial to prevent adverse long-term effects on individuals' health. Therefore, the aims were: (1) to explore the robustness of neck circumference (NC) as a predictor of CVD and examine its association with numerous anthropometric and body composition indices and (2) to release sex and age-specific NC cut-off values to classify youths as overweight/obese.
Cross-sectional study.
23 primary schools and 17 secondary schools from Spain.
2198 students (1060 girls), grades 1-4 and 7-10.
Pubertal development, anthropometric and body composition indices, systolic and diastolic blood pressure (SBP and DBP, respectively), cardiorespiratory fitness, blood sampling triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), glucose and inflammatory markers. Homoeostasis model assessment (HOMA-IR) and cluster of CVD risk factors were calculated.
NC was negatively associated with maximum oxygen consumption (R2=0.231, P<0.001 for boys; R2=0.018, P<0.001 for girls) and adiponectin (R2=0.049, P<0.001 for boys; R2=0.036, P<0.001 for girls); and positively associated with SBP, DBP, TC/HDL-c, TG, HOMA, complement factors C-3 and C-4, leptin and clustered CVD risk factor in both sexes (R2 from 0.035 to 0.353, P<0.01 for boys; R2 from 0.024 to 0.215, P<0.001 for girls). Moreover, NC was positively associated with serum C reactive protein and LDL-c only in boys (R2 from 0.013 to 0.055, P<0.05).
NC is a simple, low-cost and practical screening tool of excess of upper body obesity and CVD risk factors in children and adolescents. Paediatricians can easily use it as a screening tool for overweight/obesity in children and adolescents. For this purpose, sex and age-specific thresholds to classify children and adolescents as normal weight or overweight/obese are provided.
早期发现心血管疾病（CVD）风险因素，如肥胖，对于预防对个体健康的长期不良影响至关重要。因此，本研究目的如下：（1）探究颈围（NC）作为心血管疾病预测指标的稳健性，并检验其与多种人体测量和身体成分指标的关联；（2）公布按性别和年龄划分的颈围截断值，以将青少年分类为超重/肥胖。
横断面研究。
西班牙的23所小学和17所中学。
2198名学生（1060名女生），1 - 4年级和7 - 10年级。
青春期发育、人体测量和身体成分指标、收缩压和舒张压（分别为SBP和DBP）、心肺适能、血液样本中的甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL - c）、低密度脂蛋白胆固醇（LDL - c）、血糖和炎症标志物。计算稳态模型评估（HOMA - IR）和心血管疾病风险因素聚类。
颈围与最大摄氧量呈负相关（男孩R² = 0.231，P < 0.001；女孩R² = 0.018，P < 0.001）以及与脂联素呈负相关（男孩R² = 0.049，P < 0.001；女孩R² = 0.036，P < 0.001）；与收缩压、舒张压、TC/HDL - c、甘油三酯、HOMA、补体因子C - 3和C - 4、瘦素以及男女两性的心血管疾病风险因素聚类呈正相关（男孩R²从0.035至0.353，P < 0.01；女孩R²从0.024至0.215，P < 0.001）。此外，颈围仅在男孩中与血清C反应蛋白和低密度脂蛋白胆固醇呈正相关（R²从0.013至0.055，P < 0.05）。
颈围是一种简单、低成本且实用的筛查儿童和青少年上身肥胖及心血管疾病风险因素的工具。儿科医生可轻松将其用作儿童和青少年超重/肥胖的筛查工具。为此，提供了按性别和年龄划分的阈值，以将儿童和青少年分类为正常体重或超重/肥胖。
