Cut-off points of neck and waist circumference as predictors of obstructive sleep apnea in the Colombian population: a comparison with polysomnography

ABSTRACT BACKGROUND: Neck circumference (NC) is a useful anthropometric measure for predicting obstructive sleep apnea (OSA). Ethnicity and sex also influence obesity phenotypes. NC cut-offs for defining OSA have not been established for the Latin American population. OBJECTIVES: To evaluate NC, waist circumference (WC), and body mass index (BMI) as predictors of OSA in the Colombian population and to determine optimal cut-off points. DESIGN AND SETTING: Diagnostic tests were conducted at the Javeriana University, Bogota. METHODS: Adults from three cities in Colombia were included. NC, WC, and BMI were measured, and a polysomnogram provided the reference standard. The discrimination capacity and best cut-off points for diagnosing OSA were calculated. RESULTS: 964 patients were included (57.7% men; median age, 58 years) and 43.4% had OSA. The discrimination capacity of NC was similar for men and women (area under curve, AUC 0.63 versus 0.66, P = 0.39) but better for women under 60 years old (AUC 0.69 versus 0.57, P < 0.05). WC had better discrimination capacity for women (AUC 0.69 versus 0.57, P < 0.001). There were no significant differences in BMI. Optimal NC cut-off points were 36.5 cm for women (sensitivity [S]: 71.7%, specificity [E]: 55.3%) and 41 cm for men (S: 56%, E: 62%); and for WC, 97 cm for women (S: 65%, E: 69%) and 99 cm for men (S: 53%, E: 58%). CONCLUSIONS: NC and WC have moderate discrimination capacities for diagnosing OSA. The cut-off values suggest differences between Latin- and North American as well as Asian populations.

Precisión diagnóstica de la circunferencia de cuello para la predicción de sobrepeso y obesidad en estudiantes universitarios mexicanos / Diagnostic accuracy of neck circumference for the prediction of overweight and obesity in Mexican university students

Introducción. La circunferencia de cuello es una medida de fácil acceso y bajo costo, que podría ayudar a la identificación del sobrepeso u obesidad. Objetivo. Determinar la precisión diagnóstica de la circunferencia de cuello para la predicción de sobrepeso y obesidad en estudiantes universitarios mexicanos y analizar la correlación entre la circunferencia de cuello con otros indicadores antropométricos y la presión arterial como factor de riesgo cardiovascular. Materiales y métodos. Estudio transversal, analítico en 236 universitarios. Se realizaron mediciones antropométricas y presión arterial. Se realizaron análisis de las curvas ROC para obtener la sensibilidad y especificidad de los puntos de corte para la predicción de sobrepeso u obesidad y correlaciones de Pearson de circunferencia de cuello vs variables antropométricas. Resultados. Se observó, en hombres y mujeres, una correlación fuerte entre circunferencia de cuello y peso [r= 0,74 y r= 0,82 (p<0,01), respectivamente], seguida por IMC [r= 0,77 y r= 0,75 (p<0,01), respectivamente], circunferencia de cintura [r= 0,73 y r= 0,77 (p<0,01), respectivamente] e ICT [r= 0,71 y r= 0,73 (p<0,01), respectivamente]; se encontraron correlaciones moderadas para porcentaje de masa grasa y tensión arterial. La circunferencia de cuello vs circunferencia de cintura fue la mejor prueba de predicción para asociar el sobrepeso u obesidad tanto en hombres (AUC= 0,93; 89,3% sensibilidad y 82,3% especificidad) como mujeres (AUC= 0,95: 94,3% sensibilidad y 82,3% especificidad). Conclusiones. Los puntos de corte de la circunferencia de cuello presentan una adecuada capacidad para predecir el sobrepeso y obesidad en jóvenes adultos mexicanos(AU)

Introduction. Neck circumference is an easily accessible and low-cost measure, which could help in the identification of overweight or obesity. Objective. To determine the diagnostic accuracy of neck circumference for the prediction of overweight and obesity in Mexican university students and to analyze the correlation between neck circumference and other anthropometric indicators and blood pressure as a cardiovascular risk factor. Materials and methods. Cross-sectional, analytical study in 236 university students. Anthropometric and blood pressure measurements were taken. ROC curve analysis was performed to obtain the sensitivity and specificity of the cut-off points for the prediction of overweight or obesity and Pearson correlations of neck circumference vs anthropometric variables. Results. A strong correlation was observed, in men and women, between neck circumference and weight [r= 0.74 and r= 0.82 (p<0.01), respectively], followed by BMI [r= 0.77 and r= 0.75 (p<0.01), respectively], waist circumference [r= 0.73 and r= 0.77 (p<0.01), respectively] and ICT [r= 0.71 and r= 0.73 (p<0.01), respectively]; moderate correlations were found for percent fat mass and blood pressure. Neck circumference vs waist circumference was the best predictive test for associating overweight or obesity in both men (AUC= 0.93; 89.3% sensitivity and 82.3% specificity) and women (AUC= 0.95: 94.3% sensitivity and 82.3% specificity). Conclusions. Neck circumference cut-off points present adequate ability to predict overweight and obesity in Mexican young adults(AU)

A study on correlation of sagittal abdominal diameter and blood pressure

Background: Obesity has reached epidemic proportions in our country due to modernization. The distribution of body fat plays an important role in complications due to obesity. Sagittal abdominal diameter (SAD) is considered as an index of abdominal obesity and cardiovascular risk, but its correlation with blood pressure (BP) is poorly understood in our population. Hence, this study is designed. Aims and Objectives: This study aims to measure SAD and to correlate it with neck circumference (NC), systolic BP, and diastolic BP. Materials and Methods: An analytical cross-sectional study was done on 155 participants both males and females attending non-communicable disease outpatient department. Written informed consent was obtained. SAD, NC, and systolic and diastolic BPs were measured. Results: Results were analyzed statistically using Pearson’s correlation coefficient. Positive correlation was obtained for SAD with systolic BP, diastolic BP, and NC. Conclusion: As SAD increases, systolic BP and diastolic BP increase. This shows that SAD is a simple and inexpensive anthropometric parameter to identify early cardiovascular risk. NC is also a valuable tool for the estimation of upper body distribution of fat and helps to identify complications of obesity.

Neck Circumference as A Screening Tool to Predict Obesity: A Cross Sectional Study in Coastal Karnataka, India

Background: BMI is commonly used to classify obesity in adults. WC and WHR are considered as ac-ceptable measures of obesity. However in community settings these can be a time-consuming method. Instead, Neck circumference (NC) can be used to screen for obesity. Methodology: A cross sectional study among 310 study participants in rural field practice area of Karwar Medical College. Data was collected using pre designed semi structured questionnaire and an-thropometric measurements as per standard guidelines. Pearson’s correlation coefficient was used to assess correlation. NC cut off values were obtained from ROC. Results: In our study, the correlation of NC with BMI was highly correlated among both males(r=0.529), and females (r=0.565). Kappa statistics depicted moderate agreement with BMI males (κ = 0.512); fe-males (κ = 0.496) and NC. The cut-off values obtained for NC using ROC curve for males (35.5cm) and females (31.5cm) were statically significant associated in comparison to BMI to determine obesity in both males (χ2 = 58.57, and females (χ2 = 21.54). Conclusion: This study concluded that men with NC ≥ 35.5 cm and females with NC ≥ 31.5 cm are to be considered obese.

Is Neck Circumference A Better Measure for Determining Obesity? A Cross-Sectional Analytical Study to Assess Its Validity in Type II Diabetes Mellitus Patient

Introduction: Several anthropometric measurements like Body mass index (BMI), skin fold thickness, Waist circumference (WC), waist-height ratio (WHtR), and Waist hip ratio (WHR) are available for diag-nosing obesity at the population level. But each of them has its disadvantage as well. Neck circumference, which has been the recent anthropometric tool of interest can be used as an alternative to these meas-urements. Objective: To determine the validity of neck circumference as an anthropometric parameter of obesity and to estimate the cut-off points for obesity in type II diabetes mellitus patients. Material & Methods: This analytical cross-sectional study was done among 141 Type II diabetes pa-tients attending rural and urban health training centre non-communicable disease clinic of Sri Rama-chandra Institute of higher education and research, Chennai. After obtaining informed consent, their an-thropometric measurements like NC, BMI, WC, HC, and WHR was measured. Results: Neck circumference ≥36.5cm in males and ≥33.2cm in females is conceivably the perfect cut-off point for diagnosing overweight/Obesity in Type II diabetes mellitus. Conclusion: This analytical study deduced that NC is a valid anthropometric measurement for diagnos-ing obesity among Type II diabetes mellitus with plausible sensitivity and specificity.

Neck circumference as a predictor of gestational diabetes and risk of adverse outcomes in pregnancy of Brazilian woman with overweight and obesity

ABSTRACT Objective: To evaluate the association of neck circumference (NC) with gestational diabetes (GDM) and adverse outcomes in women with overweight and obesity. Subjects and methods: This prospective study included 132 (BMI > 25 kg/m2) pregnant women without and with GDM. Standardized questionnaire and biochemical/physical evaluation were performed during the 1st to 3rd trimester. Fifth-five women were evaluated regarding hypertension in pregnancy, type of delivery and neonatal complications (death, intensive care unit admission and hypoglycemia). Results: Women with (n = 61) and without (n = 71) GDM had similar mean (SD) pre-gestational BMI [30.3 (4.0) vs. 29.4 (3.5) kg/m2, p = 0.16]. Women with GDM were older [32 (6) vs. 28 (6) yrs, p < 0.001] and had greater NC [36.0 (2.7) vs. 34.5 (1.8) cm, p < 0.001]. NC was similar in women with GDM diagnosed in first or third trimester [p = 0.4] and was correlated with FPG [r 0.29, p = 0.01] and systolic [r 0.28, p = 0.001] and diastolic [r 0.25, p = 0.004] blood pressure. NC was associated with GDM [OR 1.25, 95%CI 1.03-1.52] adjusted for age, physical activity, education and familiar history of diabetes. In ROC analysis, the area under the curve was 0.655 and the cut-off value of 34.5 cm had 0.70 of sensitivity and 0.51 of specificity for GDM. Women who had NC ≥ 34.5 vs. < 34.5 cm had higher frequencies of hypertension [32.3 vs. 4.2%, p = 0.01]. Conclusions: In a group of pregnant women with overweight or obesity, NC can be a useful tool for identifying risk of GDM and obstetric adverse outcomes.

Association between neck circumference and non-alcoholic fatty liver disease: cross-sectional analysis from ELSA-Brasil

Abstract BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has become a public health problem worldwide. Neck circumference (NC) is a simple anthropometric adiposity parameter that has been correlated with cardiometabolic disorders like NAFLD. OBJECTIVES: To investigate the association between NC and NAFLD, considering their obesity-modifying effect, among participants from the Longitudinal Study of Adult Health (ELSA-Brasil) baseline study. DESIGN AND SETTINGS: Cross-sectional study at the ELSA-Brasil centers of six public research institutions. METHODS: This analysis was conducted on 5,187 women and 4,270 men of mean age 51.8 (± 9.2) years. Anthropometric indexes (NC, waist circumference [WC] and body mass index [BMI]), biochemical and clinical parameters (diabetes, hypertension and dyslipidemia) and hepatic ultrasound were measured. The association between NC and NAFLD was estimated using multinomial logistic regression, considering potential confounding effects (age, WC, diabetes, hypertension and dyslipidemia). Effect modification was investigated by including the interaction term NC x BMI in the final model. RESULTS: The frequency of NAFLD and mean value of NC were 33.6% and 33.9 (± 2.5) cm in women, and 45.8% and 39.4 (± 2.8) cm in men, respectively. Even after all adjustments, larger NC was associated with a greater chance of moderate/severe NAFLD (1.16; 95% confidence interval [CI] for women; 1.05, 95% CI for men; P < 0.001). Presence of multiplicative interaction between NC and BMI (P < 0.001) was also observed. CONCLUSION: NC was positively associated with NAFLD in both sexes, regardless of traditional adiposity indexes such as BMI and WC. The magnitude of the association was more pronounced among women.

Neck circumference – Height ratio cut-off as a predictor of obstructive sleep apnea severity among adult patients diagnosed with obstructive sleep apnea at the Lung Center of the Philippines

Introduction@#Obstructive sleep apnea (OSA) is the most common breathing-related sleep disorder. OSA is mainly characterized by a set of symptoms resulting from apnea events that have negative outcomes on health, such as excessive daytime sleepiness, cardiovascular impairment, and increased morbidity and mortality. It is important to develop simple, reliable, cost-effective methods to predict obstructive sleep apnea. Neck circumference - height ratio has limited studies in its relation to obstructive sleep apnea compared to neck circumference. @*Method@#This is a retrospective cross-sectional study using chart review of all patients who had been diagnosed with obstructive sleep apnea by polysomnogram at the Lung Center of the Philippines from January 2019 to December 2019. Demographic characteristics like age, gender, weight, height, neck circumference, BMI, neck circumference - height ratio [NHR], and apnea-hypopnea index were determined. Accuracy of the neck circumference - height radio cutoff had been determined in predicting obstructive sleep apnea and its severity by comparing neck - circumference - height ratio cut-off with a polysomnogram. @*Results@#Among the 384 charts collected and reviewed, this study had a total of 194 participants were included. Most participants were male (72.68%) and the age range was between 35 to 60 years old. There were 12 (6%) participants in the Mild OSA group, 19 (10%) in the Moderate OSA group, and 163 (84%) were categorized as Severe. Median Neck Circumference -Height Ratio was 0.23 to 0.26. A cutoff of > 0.23 NHR was used to predict Mild OSA showed PPV of 46.15% (24.47 to 65.98), NPV was 66.67% (50.78 to 79.49), AUC of 0.5307 (0.30 to 0.76), and accuracy of 58.06% (39.08 to 75.45). A cutoff of > 0.23 NH was used to predict Moderate OSA showed positive predictive value (PPV) was 15.94% (10.91 to 22.7), NPV of 93.6% (89.52 to 96.16), AUC of 0.6421 (0.52 to 0.77), and accuracy of 65.98% (58.85 to 72.61). A cutoff of > 0.23 HR was used to predict Severe OSA showed PPV of 15.94% (10.91 to 22.7), NPV of 93.6% (89.52 to 96.16), AUC of 0.6421 (0.52 to 0.77), and accuracy of 65.98% (58.85 to 72.61).@*Conclusion@#The HR cut-off demonstrated a moderate positive correlation with OSA, and NH increases as the apnea-hypopnea index are increased. NH cut-off of 0.23 is sufficient to predict severe OSA but has poor diagnostic accuracy for mild and moderate OSA. Moreover, the HR cut-off may also be an integral tool to predict severe OSA.

Neck circumference and excess weight: proposal of cutoff points for Brazilian adolescents

Abstract Objective: To indicate neck circumference (NC) cutoff points to identify excess weight at different stages of somatic maturation and evaluate the association between NC and body mass index (BMI). Methods: Cross-sectional study with 1715 adolescents. BMI was classified according to the World Health Organization (WHO) criteria. Somatic maturation was obtained through the peak growth velocity (PGV). To define the cutoff points, curves of the receiver operating characteristic (ROC) model were constructed. The agreement between the anthropometric evaluation instruments was analyzed. The association between the variables was verified. Results: Of the girls, 93 were in the pre-PGV stage, 266 in the PGV stage, and 481 in the post-PGV stage. Of the boys, 264 were in the pre-PGV stage, 334 in the PGV stage, and 277 in the post-PGV stage. For the pre-PGV group, the cutoff point was 28 cm for females and 29 cm for males; for the group during PGV, the cutoff points were 30 cm for females and 33 cm for males; in the post-PGV group the cutoff values were 32 cm in females and 35 cm in males. The prevalence of excess weight was higher in the pre-PGV stage in males and in the PGV stage in females. The correlation coefficients were higher in the pre-PGV and PGV stages. Conclusion: The cutoff points for NC found in this study showed good sensitivity and specificity to identify excess weight in Brazilian adolescents and can be used as a reference in epidemiological studies.

The value of neck circumference for identifying metabolic syndrome in type 2 diabetes / 中国医师进修杂志

Objective:To investigate the value of neck circumference (NC) for identifying metabolic syndrome (MS) in patients with type 2 diabetes.Methods:a total of 413 type 2 diabetic patients (188 male and 225 female) in Qinhuangdao Chinese Medicine Hospital from August 2018 to July 2019 were recruited. Waist circumference (WC), NC and metabolic indicators were measured. The association between WC, NC and metabolic indicators was explored. Area under the curve (AUC) was used to evaluate the abilities of NC.Results:The average age of male was (55.35 ± 14.15) years, and the detection rate of MS was 74.47% (140/188). The average age of female was (60.19 ± 10.29) years, and the detection rate of MS was 71.11% (160/225). In male group, WC showed a negative correlation with age and high density lipoprotein-cholesterol (HDL-C) ( P<0.05); NC showed a negative correlation with glycated hemoglobin, total cholesterol (TC) and HDL-C ( P<0.05), and a positive correlation with diastolic blood pressure (DBP) ( P<0.05). In female group, WC showed a positive correlation with fasting plasma glucose (FPG) and systolic blood pressure (SBP), and a negative correlation with HDL-C; NC showed a positive correlation with FPG and SBP. WC and HC were good indexes for identifying metabolic syndrome in type 2 diabetes (WC: AUC male 0.862, female 0.870; NC: AUC male 0.745, female 0.752). After applying the ROC analysis, neck circumferences ≥ 34.5 cm in males and ≥ 31.75 cm in females were determined as the best cutoff values to predict MS in type 2 diabetes. Conclusions:NC is a helpful tool to detect MS in type 2 diabetes.

Correlation between neck circumference and stable coronary artery disease: A cross-sectional study / 西安交通大学学报(医学版)

Objective To investigate the relationship between neck circumference and stable coronary artery disease (SCAD). Methods A total of 1638 patients who had undergone coronary angiography in our hospital from June 2016 to June 2018 were enrolled into this study and analyzed retrospectively. Of them, 756 patients were diagnosed with SCAD and 882 patients were diagnosed with non-CAD. We measured the patients' body fat indexes such as neck circumference and recorded their clinical data and biochemical examination results. The correlation between neck circumference and SCAD in male and female patients was compared by gender. Logistic regression was used to analyze the independent association between the four different neck circumference groups and the occurrence of SCAD. Results Individuals with greater length of neck circumference tended to have a significantly higher prevalence of SCAD in the males (P<0.001), but no significant difference in the female patients. Univariate logistic regression analysis suggested that the risk of SCAD increased gradually with the increase of neck circumference in the males. After adjustment by the factors, multivariate logistic regression analysis indicated that Q2 (OR=1.870, 95% CI: 1.200-2.915, P=0.006), Q3 (OR=1.978, 95% CI: 1.246-3.140, P=0.004) and Q4 (OR=2.299, 95% CI: 1.439-3.674, P<0.001) were associated with the occurrence of SCAD in the males. However, no significant difference was found between the different neck circumference and the occurrence of SCAD in the females. Conclusion The risk of SCAD increased gradually in men with an increased neck circumference. Men with neck circumference above 41.50 cm had the highest prevalence of SCAD. In women, neck circumference was not associated with the prevalence of SCAD.

Role of neck circumference in measuring obesity in healthy adults

Background: Visceral fat or intra-abdominal fat is the adipose tissue surrounding mesenteries and omentum. This has been linked to lifestyle diseases like heart diseases, arthritis, stroke and even cancer. At present we have three tools to measure visceral fat area (VFA) – Bio impedance analysis, Magnetic resonance analyser and DEXA scan. Neck circumference measurement is a simple, easy to do and a quantifiable method of measuring visceral fat. Aim & Objective: This study aims to find correlation of visceral body fat with Neck Circumference (NC) and Body Mass Index. Methodology: A cross sectional study was carried out in a medical college of western Maharashtra, wherein 290 healthy males (>18 years) were selected by simple random sampling over a period of 7 months from (February 2018 – August 2018). Data was analyzed using SPSS version 20.0. Visceral body fat was measured using Body Space 720 and neck circumference using measuring tape. Results: We found a significant association between neck circumference and VFA. There is a strong association between NC of >35cm and VFA >100cm2. NC can be useful in field settings as it can be used easily by health care workers in predicting risk of lifestyle diseases.

Evaluation of Modified Mallampati Score with Neck Circumference and Thyromental Distance to Predict Difficult Intubation in Non-obese Patients

Introduction: Preoperative diagnostic validity of airwayassessment help for prediction of difficult airway. Severalmodels were established for prediction of difficult intubation.In this study, we aim to predict difficult intubation in nonobese patients from various airway predictive indices suchas modified mallampati grade, neck movement (NM), neckcircumference (NC), thyrometal distance (TM), NC/TMD.Material and Methods: Total 121 patients with 18-72 yearsof age, ASA grade I or II, scheduled for elective surgerythat required general anaesthesia. Difficulty of intubationwas assessed using the IDS for each non-obese patient. Thestudy population was divided into two groups Easy (IDS <5)and Difficult intubation (IDS ≥5). Preoperative assessmentsincluded Mouth Opening (MO), modified mallampati grade,neck movement (NM), neck circumference (NC), thyrometaldistance (TM), NC/TMD. Multivariate analysis was usedto predict independent risk factors. Receiver OperatingCharacteristic Curve analysis (ROC analysis) was performedfor the airway assessment tests. The area under curve (AUC)was calculated.Results: The weight (59.74±7.76 kg and 65.00±5.92 kg)and BMI (21.51±1.79 and 23.8157±1.09) were significantlydifferent in between easy and difficult intubation. TheMouth Opening, NC, TMD, and NC/TMD were significantlyindependent risk factor for difficult intubation. NC/TMDwas showed higher sensitivity, specificity, positive predictivevalue (PPV) and a negative predictive value (NPV) with thirdlarge area under the curve (AUC) on the ROC curve.Conclusions: This study shows that the NC/TMD ratio canbe considered as a better predictor of difficult intubation innon-obese patients.

Association between neck circumferences and cardiometabolic risk factors

Background: Anthropometric measures have been used for screening patients for cardiovascular abnormalities and metabolic syndrome since many years. There are numerous methods to assessing overweight and obesity, such as measurements of weight, height, waist circumference, hip circumference and calculation of waist hip ratio and BMI. Due to cultural inhibitions measurement of hip, thigh or waist circumference is cumbersome in females, neck circumference could be an acceptable option for such patients.Methods: A cross-sectional study was conducted on patients attending the outpatient department in Yenepoya medical college Hospital between the period of May 2017 to May 2018. Total 201 patients chosen randomly in which 145 males and 56 females, fulfilling criteria of age >20 years were included. Pregnant females, patients with thyroid disorders, history of previous neck surgery were excluded.Results: Out of the 201 population studied, Cardio metabolic syndrome was present in 94 participants according to criteria of NCEP ATP III. In our study there is a significant correlation between neck circumference and metabolic syndrome (p value <0.001).Conclusions: Patients with Neck Circumference (NC) >37 cm in males and >34 cm in females are more prone for having cardio metabolic risk factors than patients with NC <37 cm in males and <34 cm in females. NC may be used as a simple and time saving screening measure to identify cardio metabolic risk factors in patients.

B-mode and Doppler ultrasonography in the assessment of the common carotid arteries of equines and mules and the relation with body mass, age and neck circumference / Estudo de ultrassonografia modo-B e Doppler na avaliação das artérias carótidas comuns de equinos e muares e a relação com o peso, idade e a circunferência do pescoço

As age increases, changes in cardiovascular anatomy and physiology occur, even in the absence of disease. Thus, studies of vessel hemodynamics are considered primordial to detect any cardiovascular changes. The objective of this study has been to describe the parameters of B-mode and spectral Doppler ultrasonography in the evaluation of the common carotid arteries of 11 equine and 11 mules, and correlate with age, body mass and neck circumferences. The diameters, intima - media thickness (IMT), resistivity index (RI), pulsatility index (PI), systolic velocity (SV), diastolic velocity (DV), maximum velocity (MV), vascular flow index (VFI), body mass, age, circumference and neck length. Ultrasonographic variables were evaluated in three different region called cranial, middle and caudal. Equine females presented higher values regarding the body mass, age and neck length, as compared to the neck circumferences of the animals, those of the mules were superior. The age of the mules had a positive correlation with the body mass, diameter and neck circumferences, it has a negative correlation between age and vessel diameters. The body mass of the mules had a positive correlation with age and vessel diameters, and with vessel diameters and neck circumferences in equine females. The RI and PI variables had a positive correlation with body mass for mules, and with age for equine females. The DV had a negative correlation with body mass for both equine and mule females. Regarding the variables MV and VFI, age correlated negatively for mules, while it was not significant for equine females. It found a difference between equine females and mules in the correlations performed, with body mass, age, neck circumferences and between B-mode and Doppler ultrasonography variables.(AU)

Com o aumento da idade ocorrem alterações na anatomia e fisiologia cardiovascular, mesmo na ausência de doenças. Assim, os estudos da hemodinâmica dos vasos são considerados primordiais para detectar quaisquer alterações cardiovasculares. Esse trabalho tem como objetivo descrever as variáveis de ultrassonografia modo-B e Doppler espectral na avaliação das artérias carótidas comuns de 11 fêmeas equinas e 11 muares, e correlacionar com idade, massa corpórea e circunferências dos pescoços. Para tais procedimentos foram avaliados os diâmetros, espessura da camada íntima média (EIM), índice de resistividade (IR), índice de pulsatilidade (IP), velocidade sistólica (VS), velocidade diastólica (VD), velocidade máxima (VM), índice de vascularização de fluxo (IVF), massa corpórea, idade, circunferências e comprimentos dos pescoços. As variáveis ultrassonográficas foram avaliadas em três regiões diferentes denominados de crania médio e caudal. As fêmeas equinas apresentaram valores maiores referente ao massa corpórea, idade e comprimento dos pescoços, já em relação às circunferências dos pescoços dos animais, as dos muares foram superiores. A idade dos muares possuiu correlação positiva com a massa corpórea, diâmetro e com as circunferências dos pescoços, com as fêmeas equinas, possui correlação negativa entre idade e os diâmetros dos vasos. A massa corpórea dos muares teve correlação positiva com idade e diâmetros dos vasos, já às fêmeas equinas com diâmetros dos vasos e as circunferências dos pescoços. As variáveis IR e IP tiveram correlação positiva com a massa corpórea para os muares, e com idade para fêmeas equinas. O VD teve correlação negativa com a massa corpórea tanto para as fêmeas equinas quanto nos muares. Já as variáveis VM e IVF, a idade correlacionou negativamente para os muares, enquanto não foi significativo para as fêmeas equinas. Averiguou diferença entre fêmeas equinas e muares nas correlações realizadas, com a massa corpórea, idade, circunferências dos pescoços e entre as variáveis da ultrassonografia modo-B e Doppler.(AU)

Anthropometric measurements as a potential non-invasive alternative for the diagnosis of metabolic syndrome in adolescents

ABSTRACT Objective: To identify which anthropometric measurement would be the best predictor of metabolic syndrome (MetS) in Brazilian adolescents. Subjects and methods: Cross-sectional study conducted on 222 adolescents (15-17 years) from a city in southern Brazil. Anthropometric, physical activity, blood pressure and biochemical parameters were investigated. MetS criteria were transformed into a continuous variable (MetS score). Linear regression analyses were performed to assess the associations of BMI, hip circumference, neck circumference (NC), triceps skinfold, subscapular skinfold and body fat percentage with MetS score. ROC curves were constructed to determine the cutoff for each anthropometric measurement. Results: The prevalence of MetS was 7.2%. Each anthropometric measurement was significantly (p < 0.001) associated with MetS score. After adjusting for potential confounding variables (age, sex, physical activity, and maternal education), the standardized coefficients of NC and body fat percentage appeared to have the strongest association (beta = 0.69 standard deviation) with MetS score. The regression of BMI provided the best model fit (adjusted R2 = 0.31). BMI predicted MetS with high sensitivity (100.0%) and specificity (86.4%). Conclusions: Our results suggest that BMI and NC are effective screening tools for MetS in adolescents. The early diagnosis of MetS combined with targeted lifestyle interventions in adolescence may help reduce the burden of cardiovascular diseases and diabetes in adulthood.

The role of body fat rate in the evaluation of obstructive sleep apnea / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the role of body fat ratio in the evaluation of obstructive sleep apnea(OSA).@*Methods@#A retrospective analysis was made on 174 cases (between November, 2017 and April, 2018 showed that) of sleep monitoring in the Department of Otorhinolaryngology in Peking University Third Hospital. The data included the gender, age, body fat rate, body mass index (BMI), neck circumference, and apnea-hypopnea index (AHI). The above data were analyzed by non parametric correlation analysis, receiver operating characterristic (ROC) curve analysis and multiple factor Logistic regression analysis to study the relationship between the gender,age,body fat rate,BMI,neck circumference and other indexes of the patients with AHI.@*Results@#Nonparametric correlation analysis showed that the correlation from strong to weak to AHI among women was BMI (r=0.621, P<0.001),body fat rate (r=0.602, P<0.001), age (r=0.570, P<0.001), neck circumference (r=0.402, P=0.014), respectively. BMI (r=0.599, P<0.001), neck circumference (r=0.493, P<0.001), body fat rate (r=0.318, P<0.001), and age (r=0.256, P=0.003) among men. ROC curve analysis showed that the strong to weak index (area under curve,AUC) of the AHI>15/h among women was the body fat rate (AUC=0.884, P=0.001), BMI(AUC=0.810, P=0.008), neck circumference (AUC=0.759, P=0.027), age (AUC=0.750, P=0.033), and the male was BMI (AUC=0.765,P<0.001), neck circumference (AUC=0.720, P<0.001), age (AUC=0.634, P=0.008), and body fat rate (AUC=0.632, P=0.010), respectively. Multifactor Logistic regression analysis showed that the body fat rate (OR=1.704,95%CI=1.012-2.870) in women was an independent risk factor for AHI greater than 15/h; the age of male (OR=1. 044, 95%CI=1.005-1.085) and BMI (OR=1.285, 95%CI=1.056-1.562) were independent risk factors for AHI greater than 15/h.@*Conclusion@#Body fat rate can be used as a new indicator for predicting the severity of OSA,especially in adult female population. In adult female moderate to severe OSA patients (AHI>15/h), compared with BMI,neck circumference and age,the body fat rate has the greatest correlation with AHI. Compared with BMI,neck circumference and age,the body fat rate has a decisive role in predicting moderate to severe OSA (AHI>15/h).

Relationship between neck circumference and metabolic syndrome in over 40 years old community residents / 中国医师进修杂志

Objective@#To investigate the relationship between neck circumference and metabolic syndrome (MS) in ≥ 40 years old community residents.@*Methods@#A total of 5 017 Dalian community residents who participated in "the risk evaluation of cancers in Chinese diabetic individuals: a longitudinal study" from July to December 2014 were selected, with 1 256 male cases and 3 761 female cases, aged ≥ 40 years old. The basic information was selected by questionnaire. The neck circumference, waist circumference (WC), body height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), 2 h-postprandial plasma glucose (2 h PG), glycosylated hemoglobin (HbA1c) and blood fat were measured; the body mass index (BMI) was calculated.@*Results@#The age, neck circumference, WC, FPG, 2 h PG, SBP, DBP, incidence of obesity, incidence of hypertension and incidence of type 2 diabetes mellitus in male were significantly higher than those in female: (63.5 ± 8.4) years vs. (60.8 ± 8.0) years, (38.6 ± 3.0) cm vs. (34.4 ± 2.6) cm, (92.3 ± 9.1) cm vs. (87.3 ± 9.6) cm, 5.59 (5.20, 6.42) mmol/L vs. 5.43 (5.09, 5.99) mmol/L, 7.67 (6.06, 11.08) mmol/L vs. 7.20 (5.97, 9.64) mmol/L, (135.3 ± 18.8) mmHg (1 mmHg = 0.133 kPa) vs. (129.8 ± 19.5) mmHg, (79.8 ± 10.7) mmHg vs. (74.8 ± 10.0) mmHg, 53.0% (666/1 256) vs. 48.9% (1 841/3 761), 49.9% (627/1 256) vs. 40.6% (1 528/3 761) and 29.8% (374/1 256) vs. 22.5% (846/3 761); the total cholesterol, triacylglycerol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and incidence of central obesity in male were significantly lower than those in female: (5.04 ± 0.94) mmol/L vs. (5.58 ± 1.03) mmol/L, 1.35 (0.97, 1.95) mmol/L vs. 1.45 (1.06, 2.04) mmol/L, (1.18 ± 0.27) mmol/L vs. (1.32 ± 0.29) mmol/L, (2.99 ± 0.78) mmol/L vs. (3.27 ± 0.85) mmol/L and 63.7% (800/1 256) vs. 79.7% (2 998/3 761), and there were statistical differences (P<0.01 or <0.05). There were no statistical differences in BMI, HbA1c and incidence of MS between male and female (P>0.05). After adjustment for age, smoking, drinking, menopausal status (female), BMI and WC, Logistic regression analysis result showed that increased neck circumference in male increased the risk of type 2 diabetes mellitus (OR = 1.075, 95% CI 1.012 to 1.142, P = 0.019); increased neck circumference in female increased the risks of type 2 diabetes mellitus (OR = 1.143, 95% CI 1.096 to 1.192, P = 0.000), hypertension (OR = 1.112, 95% CI 1.071 to 1.156, P = 0.000), hypertriacylglyceremia (OR = 1.099, 95% CI 1.060 to 1.139, P = 0.000), low HDL-C (OR = 1.104, 95% CI 1.064 to 1.144, P = 0.000) and MS (OR = 1.167, 95% CI 1.120 to 1.217, P = 0.000). Taking neck circumference as detection variable and MS as outcome variable, the receiver operating characteristic curve was analyzed. In male, the area under curve was 0.733, the optimal cut-off value of neck circumference was 37.9 cm, with a sensitivity of 77.9%, and a specificity of 55.9%. In female, the area under curve was 0.720, the optimal cut-off value of neck circumference 33.3 cm, with a sensitivity of 76.7%, and a specificity of 56.0%.@*Conclusions@#Neck circumference is associated with MS in ≥ 40 years old community residents. Male neck circumference >37.9 cm and female neck circumference>33.3 cm are the optimal cut-off value for forecasting MS.

Neck circumference as a marker of malnutrition among children attending the under five clinic of a tertiary care hospital in Nagpur, Maharashtra

India is facing a dual burden of overweight/obesity and under nutrition among children less than 5 years of age. Neck circumference is recently studied marker for malnutrition among adults and older children. Objective: To correlate neck circumference with body mass index and to associate it with wasting and underweight status. Material & Methods: A cross sectional study was conducted among children less than 5 years of age attending the outpatient setup of a tertiary care setup in Nagpur, Maharashtra. Demographic details and anthropometric measurements were done for the children with necessary permission before the start of the study. Anthropometry was done using standard guidelines and WHO charts were used for classification of wasting and underweight Results: We included 260 study subjects in our study. The mean age of the children was 21.55 ± 17.31 months and majority of them were females, belonged to Hindu religion (58.07%), belonged to Class 4 (33.08%) and the mothers were educated up to senior secondary (34.62%). Neck circumference had significant positive correlation with birth weight (r=0.138) and body mass index (r=0.211). The average neck circumference was significantly lower in case of wasted (p<0.05) and underweight children (p<0.05). Conclusion: Neck circumference correlated significantly with body mass index and was significantly lower in wasted and underweight in children less than 5 years of age.

Value of Neck Circumference and Waist Circumference Measurement in Assessment of Overweight/Obesity in Adolescent Children

Background: To measure neck circumference and waist circumference, to compare it between normal and overweight/obese adolescents and to validate these with body mass index. Methods: A cross-sectional study was conducted in 500 school going children/adolescents. Body mass index, waist circumference and neck circumference were measured. Independent samples t-test and Pearson’s correlation were used as tests of significance to analyse quantitative data. Results: A positive correlation of neck circumference and waist circumference with body mass index was observed. The neck circumference and waist circumference in overweight/obese adolescents were significantly higher than adolescents with normal body mass index (P<0.001). Area under curve of waist circumference was more than area under curve of neck circumference. Cut off value of neck circumference for screening adolescent obesity in boys and girls were 30.73 cm, and 29.73 cm, respectively, and waist circumference cut off value were 70.73 cm for boys and 69.23 cm for girls at fairly good levels of  sensitivity and specificity. Conclusion: Neck circumference and waist circumference may be used in clinical practice and epidemiological studies as an index of overweight/obesity among school-going adolescents.