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

12 Sep 2017


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 positively correlated with all anthropometric and body composition indices. 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 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 (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, LDL-c and visfatin only in boys (R2 from 0.013 to 0.107, 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.

Click here to view the full article which appeared in BMJ Open