Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Ann Nutr Metab. 2022;78(5):273-280. doi: 10.1159/000526075. Epub 2022 Jul 20.
Neck circumference (NC), a proxy for upper-body subcutaneous fat, is closely related to metabolic dysfunction, independent of other obesity indices. The purpose of this study was to explore the relationship between NC and the incidence and remission of metabolic associated fatty liver disease (MAFLD), a novel concept proposed by an international consensus panel in 2020 through a community-based longitudinal cohort.
This study included 1,549 community participants and was conducted from 2013 to 2016. MAFLD was diagnosed using the International Expert Consensus (2020) criteria. All participants underwent NC measurement and biochemical measurements. Elevated NC was defined as NC ≥38.5 cm in men and NC ≥34.5 cm in women.
A total of 1,549 subjects (638 men and 911 women), with an average age of 59.6 ± 7.3 years, were included. During a mean follow-up of 2.1 years, MAFLD occurred in 146 of the 870 participants without baseline MAFLD and was resolved in 225 of the 679 participants with baseline MAFLD. After adjusting for confounding factors such as age, sex, body mass index, waist circumference, fasting plasma glucose, and liver enzyme levels, multivariable logistic regression showed that higher NC at baseline was positively correlated with MAFLD occurrence (OR 1.96, 95% confidence interval: 1.21-3.31; p = 0.003) and negatively correlated with MAFLD remission (OR 0.57, 95% confidence interval: 0.40-0.80; p < 0.001).
A higher NC is associated with an increased risk of MAFLD occurrence and a reduced probability of MAFLD remission, making NC measurement a potential predictor in MAFLD management.
颈围（NC）是上半身皮下脂肪的替代指标，与代谢功能障碍密切相关，与其他肥胖指数无关。本研究旨在通过一项基于社区的纵向队列，探讨 NC 与代谢相关脂肪性肝病（MAFLD）的发生和缓解之间的关系，MAFLD 是 2020 年国际共识专家组提出的新概念。
本研究纳入了 1549 名社区参与者，研究时间为 2013 年至 2016 年。MAFLD 的诊断采用国际专家共识（2020）标准。所有参与者均进行 NC 测量和生化指标检测。NC 升高定义为男性 NC≥38.5cm，女性 NC≥34.5cm。
共纳入 1549 名受试者（638 名男性和 911 名女性），平均年龄为 59.6±7.3 岁。在平均 2.1 年的随访期间，870 名基线无 MAFLD 的参与者中有 146 名发生 MAFLD，679 名基线有 MAFLD 的参与者中有 225 名 MAFLD 缓解。在校正年龄、性别、体重指数、腰围、空腹血糖和肝酶水平等混杂因素后，多变量 logistic 回归显示，基线时 NC 较高与 MAFLD 发生呈正相关（OR 1.96，95%置信区间：1.21-3.31；p=0.003），与 MAFLD 缓解呈负相关（OR 0.57，95%置信区间：0.40-0.80；p<0.001）。
较高的 NC 与 MAFLD 发生风险增加和 MAFLD 缓解概率降低相关，使 NC 测量成为 MAFLD 管理的潜在预测指标。
