Neck circumference and clustered cardiovascular risk factors in children and adolescents: cross-sectional study

OBJECTIVE: 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. DESIGN: Cross-sectional study. SETTING: 23 primary schools and 17 secondary schools from Spain. PARTICIPANTS: 2198 students (1060 girls), grades 1–4 and 7–10. MEASURES: 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. RESULTS: NC was positively correlated with all anthropometric and body composition indices. NC was negatively associated with maximum oxygen consumption (R(2)=0.231, p<0.001 for boys; R(2)=0.018, p<0.001 for girls) and positively associated with SBP, DBP, TC/HDL-c, TG, HOMA, complement factors C-3 and C-4, leptin, adiponectin and clustered CVD risk factor in both sexes (R(2) from 0.035 to 0.353, p<0.01 for boys; R(2) from 0.024 to 0.215, p<0.001 for girls). Moreover, NC was positively associated with serum C reactive protein, LDL-c and visfatin only in boys (R(2) from 0.013 to 0.107, p<0.05). CONCLUSION: 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.