Is Neck Circumference an Indicator for Metabolic Complication of Childhood Obesity?

Nayera E. Hassan, Abeer Atef, Sahar A. El-Masry, Amany Ibrahim, Muhammad Al-Tohamy, Enas Abdel Rasheed, Galal Ismail Ahmed Elashry


BACKGROUND: The possible role of neck circumference (NC) for screening childhood obesity and its complication is not well characterized.

AIM: To assess NC and to explore its increase as risk factor with metabolic syndrome (MS) variables.

METHODS: Cross sectional case-control study included 50 obese children (BMI ≥95th percentile) and 50 healthy (BMI 15th-‹85th percentile). All were subjected to clinical examination, measuring blood pressure (BP), body weight, height, NC, waist (WC) and hip (HC)., fasting blood glucose, insulin and lipid profile.  

RESULTS: MS was detected among 52% of obese participants, but not among controls (0%). Clinical parameters and most of the laboratory values were higher in subjects with MS than in non-metabolic subjects, with statistical significance only in blood pressure and triglycerides. Among obese without MS, NC showed significantly positive correlations with age, weight, height, WC, HC and negative with LDL. While among Obese with MS, NC showed significantly positive correlations with age, weight, height, BMI-SDS, WC, HC and DBP.

CONCLUSION: NC can be considered as a good indicator and predictor for obesity, especially central obesity. However, NC has no relation with lipid profile or fasting blood sugar.


Neck Circumference; Children; Obesity; blood pressure; lipid profile

Full Text:

PDF OnlineFirst


Daniels SR. Complications of obesity in children and adolescents. Int J Obes. 2009;33(Suppl 1):S60-5.

Lee YS. Consequences of childhood obesity. Ann Acad Med Singapore. 2009;38(1):75-7.

Hassan, NE El-Masry SA, Fouad WA, Sherif L, Elwakkad A, Anwar M, Zaki ST. Prevalence of metabolic syndrome among obese school students. E-SPEN, the European e-Journal of Clinical Nutrition and Metabolism. 2011; 248-252.

Hiernaux, J. and J.M. Tanner, ‘Growth and physical studies’, In J.S. Weiner, S.A. Lourie (Eds.), Human Biology: A guide to field methods. London: IBP; Oxford, UK: Blackwell Scientific Publications, 1969.

Silva GAP, Balaban G, Motta MEFA. Prevalência de sobrepeso e obesidade em crianças e adolescentes de diferentes condições socioeconômicas. Rev Bras Saúde Matern Infant. 2005; 5:53-9.

Giugliano R, Carneiro EC. Factors associated with obesity in school children. J Pediatr. 2004; 80(1):17-22.

Vague J. The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. 1956. Nutrition. 1999; 15(1):89-90.

Androutsos O, Grammatikaki E, Moschonis G, Roma-Giannikou E, Chrousos GP, Manios Y, Kanaka-Gantenbein C. Neck circumference: a useful screening tool of cardiovascular risk in children. Pediatr Obes. 2012;7(3):187-95.

Ben-Noun LL, Laor A. Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardiol. 2006;11(1):14-20.

Kurtoglu S, Hatipoglu N, Mazicioglu MM, Kondolot M. Neck circumference as a novel parameter to determine metabolic risk factors in obese children. Eur J Clin Invest. 2012; 42(6):623-30.

Guo X, Li Y, Sun G, Yang Y, Zheng L, Zhang X, Sun Z, Ma H, Wang N, Jiang M, Li J, Sun Y. Prehypertension in children and adolescents: association with body weight and neck circumference. Intern Med. 2012;51(1):23-7.

Ghali I, Salah N, Hussien F, Erfan M, El-Ruby M, Mazen I, Sabry M, Abd El-Razik M, Saad M, Hossney S, Ismaail and Abd El-Dayem S (2002). Egyptian growth curves for infants, children and adolescents. Published in: Crecere nel mondo. Satorio A, Buckler JMH and Marazzi N. Ferring Publisher, Italy, 2008.

Hiernaux J, Tanner JM. Growth and physical studies. In: Human Biology: guide to field methods. Eds. Weiner J.S., Lourie S.A., IBP. London, Blackwell Scientific Publications. Oxford. U.K., 1969.

Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health andNutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med. 2003;157(8):821-7.

Pedrosa C, Oliveira BM, Albuquerque I, Simões-Pereira C, Vaz-de-Almeida MD, Correia F. Obesity and metabolic syndrome in 7-9 years-old Portuguese schoolchildren. Diabetol Metab Syndr. 2010;2(1):40.

Diaconis P. & Gupta S. (ed.). Group Representations in Probability and Statistics. IMS Lecture Notes - Monograph Series, 11 Institute of Mathematical Statistics, Hayward Ca., 1988.

Berg AH, Scherer PE, Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005; 96(9):939-49.

Nascimento H, Costa E, Rocha-Pereira P, Rego C, Mansilha HF, Quintanilha A, Santos-Silva A, Belo L. Cardiovascular risk factors in Portuguese obese children and adolescents: impact of small reductions in body mass index imposed by lifestyle modifications. Open Biochem J. 2012;6:43-50.

d'Annunzio G, Vanelli M, Pistorio A, Minuto N, Bergamino L, Lafusco D, Lorini R. Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetes. Insulin resistance and secretion indexes in healthy Italian children and adolescents: a multicentre study. Acta Biomed. 2009;80(1):21-8.

López-Capapé M, Alonso M, Colino E, Mustieles C, Corbatón J, Barrio R. Frequency of the metabolic syndrome in obese Spanish pediatric population. Eur J Endocrinol. 2006;155(2):313-9.

Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, Zhang JD, Du XP, Li YL, Ji Y, Gu XN, Li Y; Beijing Community Diabetes Study Group. Neck circumference positively related with central obesity, overweight, and metabolic syndrome in Chinese subjects with type 2 diabetes: Beijing Community Diabetes Study 4. Diabetes Care. 2010; 33(11):2465-7.

Lou DH, Yin FZ, Wang R, Ma CM, Liu XL, Lu Q. Neck circumference is an accurate and simple index for evaluating overweight and obesity in Han children. Ann Hum Biol. 2012; 39(2):161-5.

Nafiu OO, Burke C, Lee J, Voepel-Lewis T, Malviya S, Tremper KK. Neck circumference as a screening measure for identifying children with high body mass index. Pediatrics. 2010;126(2):e306-10.

Kim Y, Lee JM, Laurson K, Bai Y, Gaesser GA, Welk GJ. 2014. Accuracy of Neck Circumference in Classifying Overweight and Obese US Children. ISRN Obes. 2014;30:781841.

Grandone A, Amato A, Luongo C, Santoro N, Perrone L, del Giudice EM. High-normal fasting glucose levels are associated with increased prevalence of impaired glucose tolerance in obese children. J Endocrinol Invest. 2008;31(12):1098-102.

O'Malley G, Santoro N, Northrup V, D'Adamo E, Shaw M, Eldrich S, Caprio S. High normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation. Diabetologia. 2010;53(6):1199-209.

Eapen V, Mabrouk A, Yousef S. Metabolic syndrome among the young obese in the United Arab Emirates. J Trop Pediatr. 2010;56(5):325-8.

Johnson WD, Kroon JJ, Greenway FL, Bouchard C, Ryan D, Katzmarzyk PT. Prevalence of risk factors for metabolic syndrome in adolescents: National Health and Nutrition Examination Survey (NHANES), 2001-2006. Arch Pediatr Adolesc Med. 2009;163(4):371-7.

Invitti C, Maffeis C, Gilardini L, Pontiggia B, Mazzilli G, Girola A, Sartorio A, Morabito F, Viberti GC. Metabolic syndrome in obese Caucasian children: prevalence using WHO-derived criteria and association with nontraditional cardiovascular risk factors. Int J Obes (Lond). 2006;30(4):627-33.

Nafiu OO, Zepeda A, Curcio C, Prasad Y. Association of neck circumference and obesity status with elevated blood pressure in children. J Hum Hypertens. 2014;28(4):263-8.


Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


  • There are currently no refbacks.

Copyright (c) 2015 Nayera E. Hassan, Abeer Atef, Sahar A. El-Masry, Amany Ibrahim, Muhammad Al-Tohamy, Enas Abdel Rasheed, Galal Ismail Ahmed Elashry

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


Published by: Id Design 2012/DOOEL Skopje, Republic of Macedonia