Abstract
Obesity, particularly in the upper part of body, is a major health problem. Central obesity is related to cardiovascular disease and metabolic disorders. There are various techniques for assessing upper body fat content for the overweight and obese subjects other than waist circumference (WC). We tried to find out if neck circumference (NC) alone can be used to assess overweight and obesity. Four hundred twelve overweight and obese patients (208 girls and 204 boys) and 555 healthy children (284 girls and 271 boys) aged 6–18 years were recruited for this present study. There were significant and positive correlations between BMI-WC, BMI-NC, and WC-NC (p < 0.001). NC cutoffs for overweight and obesity were determined for each age and pubertal period. NC cutoffs of boys were increased from 28.0 to 38.0. This range was 27.0–34.5 for girls in the same range. We also calculated NC cutoffs for prepubertal and pubertal periods (respectively, 29.0 and 32.5 for boys and 28.0–31.0 for girls). Conclusion: NC is a reliable and easy to use tool to determine overweight and obesity in children, and NC is not as good as WC in determining overweight and obesity, both providing similar information.
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Ashwell M, Cole TJ, Dixon AK (1985) Obesity: New insight into the anthropometric classification of fat distribution shown by computed tomography. Br Med J 290:1692–1694
Ben-Noun LL, Laor A (2006) Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardiol 11:14–20
Ben-Noun L, Sohar E, Laor A (2001) Neck circumference as a simple screening measure for identifying overweight and obese patients. Obes Res 9:470–477
(1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Am J Clin Nutr 68:899–917
Daniels SR, Morrison JA, Sprecher DL et al (1999) Association of body fat distribution and cardiovascular risk factors in children and adolescents. Circulation 99:541–545
de Ridder CM, de Boer RW, Seidell JC et al (1992) Body fat distribution in pubertal girls quantified by magnetic resonance imaging. Int J Obes Relat Metab Disord 16:443–449
Dixon JB, O'Brien PE (2002) Neck circumference a good predictor of raised insulin and free androgen index in obese premenopausal women: changes with weight loss. Clin Endocrinol (Oxf) 57:769–778
Fredriks AM, van Buuren S, Fekkes M et al (2005) Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice? Eur J Pediatr 164:216–222
Freedman DS, Kahn HS, Mei Z et al (2007) Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 86:33–40
Freedman DS, Rimm AA (1989) The relation of body fat distribution, as assessed by six girth measurements, to diabetes mellitus in women. Am J Public Health 79:715–720
Gillum RF (1999) Distribution of waist-to-hip ratio, other indices of body fat distribution and obesity and associations with HDL cholesterol in children and young adults aged 4–19 years: the Third National Health and Nutrition Examination Survey. Int J Obes Relat Metab Disord 23:556–563
Owens S, Gutin B, Ferguson M (1998) Visceral adipose tissue and cardiovascular risk factors in obese children. J Pediatr 133:41–45
Haas JD, Campirano F (2006) Interpopulation variation in height among children 7 to 18 years of age. Food Nutr Bull 27(4 Suppl Growth Standard):S212–S223
Haffner SM, Stern MP, Hazuda HP (1987) Do upper-body and centralized adiposity measure different aspects of regional body-fat distribution? Relationship to non-insulin-dependent diabetes mellitus, lipids, and lipoproteins. Diabetes 36:43–51
Hatipoglu N, Ozturk A, Mazicioglu MM et al (2008) Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr 167:383–389
Kissebah AH, Krakower GR (1994) Regional adiposity and morbidity. Physiol Rev 74:761–811
Kissebah AH, Vydelingum N, Murray R et al (1982) Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 54:254–260
Kopelman PG (2000) Obesity as a medical problem. Nature 404:635–643
Laakso M, Matilainen V, Keina¨nen-Kiukaanniemi S (2002) Association of neck circumference with insulin resistance-related factors. Int J Obes 26:873–875
LaBerge RC, Vaccani JP, Gow RM et al (2009) Inter- and intra-rater reliability of neck circumference measurements in children. Pediatr Pulmonol 44:64–69
Lean ME, Han TS, Seidell JC (1998) Impairment of health and quality of life in people with large waist circumference. Lancet 351:853–856
Lemieux S, Prud'homme D, Bouchard C et al (1996) A single threshold value of waist girth identifies normal-weight and overweight subjects with excess visceral adipose tissue. Am J Clin Nutr 64:685–693
Martinez-Rivera C, Abad J, Fiz JA et al (2008) Usefulness of truncal obesity indices as predictive factors for obstructive sleep apnea syndrome. Obesity (Silver Spring) 16:113–118
Metz CE (1978) Basic principles of ROC analysis. Sem Nuc Med 8:283–298
Must A, Spadano J, Coakley EH et al (1999) The disease burden associated with overweight and obesity. JAMA 282:1523–1529
Owens S, Gutin B, Ferguson M et al (1998) Visceral adipose tissue and cardiovascular risk factors in obese children. J Pediatr 133:41–45
Ozturk A, Budak N, Cicek B et al (2008) Cross-sectional reference values for mid-upper arm circumference, triceps skinfold thickness and arm fat area of Turkish children and adolescents. Int J Food Sci Nutr 12:1–14
Peiris AN, Struve MF, Mueller RA et al (1988) Glucose metabolism in obesity: influence of body fat distribution. J Clin Endocrinol Metab 67:760–767
Pouliot MC, Despres JP, Lemieux S et al (1994) Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 73:460–468
Rankinen T, Kim SY, Pérusse L et al (1999) The prediction of abdominal visceral fat level from body composition and anthropometry: ROC analysis. Int J Obes Relat Metab Disord 23:801–809
Rudolf MC, Walker J, Cole TJ (2007) What is the best way to measure waist circumference? Int J Pediatr Obes 2:58–61
Sarría A, Moreno LA, García-Llop LA, Fleta J, Morellón MP, Bueno M (2001) Body mass index, triceps skinfold and waist circumference in screening for adiposity in male children and adolescents. Acta Paediatr 90:387–392
Taylor RW, Jones IE, Williams SM, Goulding A (2000) Evaluation of waist circumference, waist-to-hip ratio, and the conicity index as screening tools for high trunk fat mass, as measured by dual-energy X-ray absorptiometry, in children aged 3–19 y. Am J Clin Nutr 72:490–495
Vague J (1956) The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr 4:20–34
Verhulst SL, Schrauwen N, Haentjens D et al (2007) Sleep-disordered breathing in overweight and obese children and adolescents: prevalence, characteristics and the role of fat distribution. Arch Dis Child 92:205–208
Vikram NK, Misra A, Pandey RM et al (2003) Anthropometry and body composition in northern Asian Indian patients with type 2 diabetes: receiver operating characteristics (ROC) curve analysis of body mass index with percentage body fat as standard. Diabetes Nutr Metab 16:32–40
Wing RR, Jeffery RW, Burton LR et al (1992) Change in waist-hip ratio with weight loss and its association with change in cardiovascular risk factors. Am J Clin Nutr 55:1086–1092
World Health Organisation. Obesity: preventing and managing the global epidemic. Report of a WHO consultation, Geneva, 3–5 Jun 1997. WHO, Geneva
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Hatipoglu, N., Mazicioglu, M.M., Kurtoglu, S. et al. Neck circumference: an additional tool of screening overweight and obesity in childhood. Eur J Pediatr 169, 733–739 (2010). https://doi.org/10.1007/s00431-009-1104-z
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DOI: https://doi.org/10.1007/s00431-009-1104-z