Haapakangas Suvi M, Koskenkari Noona V S, Hurskainen Elisa L, Arffman Riikka K, Ollila Meri-Maija, Piltonen Terhi T
Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland.
Int J Obes (Lond). 2025 Apr 21. doi: 10.1038/s41366-025-01753-1.
Polycystic ovary syndrome (PCOS) is associated with obesity, insulin resistance (IR), metabolic syndrome (MetS), and abnormal fat distribution, especially fat excess in the upper body. Neck circumference (NC) reflects the adiposity accumulation in the upper body and may be a valuable and simple screening tool for metabolic risk among women with PCOS.
A systematic review was conducted using PubMed/Medline and Scopus based on the search terms "neck circumference" and "PCOS". Studies that examined associations of NC and anthropometric measurements, blood pressure (BP), lipid values, glucose metabolism, MetS, IR, or related disorders among women with PCOS were included. A meta-analysis was performed to compare NC values between women with PCOS and non-PCOS controls.
Of 139 publications, 13 full texts that met the selection criteria were included in the systematic review. Eight studies had non-PCOS controls and were thus eligible for the meta-analysis. Women with PCOS had significantly larger NC compared to non-PCOS controls (SMD: 0.78, 95% CI: 0.31-1.25, p = 0.0012). We found a positive association between larger NC and higher waist circumference, hip circumference, triglycerides, systolic BP, fasting insulin, and HOMA-IR or lower HOMA%S and higher prevalence of MetS or IR in the majority of the included studies. Neck circumference cut-off values for MetS varied from 33 cm to 34.25 cm and for IR 34.25 cm up to 42 cm among women with PCOS. Most of the studies were done with Asian populations thus limiting applicability of the study results to other ethnicities.
This meta-analysis demonstrated increased NC among women with PCOS compared to healthy controls. Women with PCOS and larger NC were more insulin resistant and had more MetS-related abnormalities when compared to women with smaller NC with or without PCOS. Data considering NC cut-off values for MetS and IR among women with PCOS are scarce, and further studies are needed, particularly among more varied ethnic populations.
多囊卵巢综合征（PCOS）与肥胖、胰岛素抵抗（IR）、代谢综合征（MetS）及异常脂肪分布相关，尤其是上身脂肪过多。颈围（NC）反映上身的脂肪堆积情况，可能是PCOS女性代谢风险的一种有价值且简便的筛查工具。
基于搜索词“颈围”和“PCOS”，使用PubMed/Medline和Scopus进行系统综述。纳入研究PCOS女性中NC与人体测量学指标、血压（BP）、血脂值、糖代谢、MetS、IR或相关疾病之间关联的研究。进行荟萃分析以比较PCOS女性与非PCOS对照者的NC值。
在139篇出版物中，13篇符合选择标准的全文被纳入系统综述。8项研究有非PCOS对照者，因此符合荟萃分析的条件。与非PCOS对照者相比，PCOS女性的NC显著更大（标准化均数差：0.78，95%可信区间：0.31 - 1.25，p = 0.0012）。在大多数纳入研究中，我们发现较大的NC与较高的腰围、臀围、甘油三酯、收缩压、空腹胰岛素及稳态模型评估胰岛素抵抗（HOMA-IR）呈正相关，或与较低的HOMA%S及较高的MetS或IR患病率呈正相关。PCOS女性中，MetS的颈围截断值在33 cm至34.25 cm之间，IR的颈围截断值在34.25 cm至42 cm之间。大多数研究是在亚洲人群中进行的，因此限制了研究结果对其他种族的适用性。
该荟萃分析表明，与健康对照者相比，PCOS女性的NC增加。与NC较小的PCOS女性或非PCOS女性相比，NC较大的PCOS女性胰岛素抵抗更强，且有更多与MetS相关的异常情况。关于PCOS女性中MetS和IR的颈围截断值的数据较少，需要进一步研究，特别是在更多样化的种族人群中。
Zotero 插件