Association of neck circumference-related indices with metabolic, atherogenic and liver function biomarkers in patients with non-alcoholic fatty liver disease: a cross-sectional study

OBJECTIVE: The present study aimed to establish the association of neck circumference (NC)-related indices with metabolic, atherogenic and liver function biomarkers in patients with non-alcoholic fatty liver disease (NAFLD). DESIGN: Cross-sectional study. SETTING: Outpatient clinics of Tabriz University of Medical Sciences. PARTICIPANTS: A total of 175 adult patients with NAFLD diagnosed by abdominal ultrasonography were included in this study. Sociodemographic characteristics, anthropometric measures and metabolic, atherogenic and liver function biomarkers were assessed. RESULTS: Results on 107 women and 68 men with NAFLD showed that 52%, 45.1% and 2.9% of patients had mild, moderate and severe NAFLD, respectively. There were significant differences in most of the anthropometric indices, serum levels of ferritin, creatinine and uric acid as well as liver enzymes, and Aspartate Aminotransferase (AST) to Platelet Ratio Index (APRI) between the genders (p<0.01). However, no significant differences were found in the glycaemic, lipid profile and atherogenic biomarkers. Both NC and neck-to-height ratio (NHtR) were significantly associated with body mass index (BMI) (p=0.018, p<0.001, respectively), waist circumference (WC) (p<0.001, p=0.044, respectively) and waist-to-hip ratio (WHR) (p<0.001, p=0.026, respectively) while results showed only a significant relationship between neck-to-waist ratio (NWR) with BMI (p<0.001) and WC (p<0.001). Among metabolic factors, there were significant and positive correlations between NC and serum haemoglobin A1c (r=0.198, p<0.001), AST (r=0.300, p<0.001), alanine aminotransferase (ALT) (r=0.348, p<0.001), ferritin (r=0.403, p<0.001) and uric acid (r=0.347, p=0.003) while AST/ALT ratio was inversely related to NC (r=−0.226, p=0.003). APRI, Lipid Accumulation Product Index and also Hepatic Steatosis Index were significantly correlated with NC, NHtR and NWR (p<0.01). CONCLUSIONS AND RELEVANCE: NC-related indices, particularly NC and NHtR, were correlated with some metabolic and liver function biomarkers (apart from lipid profile and atherogenic factors) in patients with NAFLD.