Neck height ratio is an important predictor of metabolic syndrome among Asian Indians

Chitra Selvan; Deep Dutta; Anubhav Thukral; Titli Nargis; Manoj Kumar; Satinath Mukhopadhyay; Subhankar Chowdhury

doi:10.4103/2230-8210.192927

Neck height ratio is an important predictor of metabolic syndrome among Asian Indians

Indian J Endocrinol Metab. 2016 Nov-Dec;20(6):831-837. doi: 10.4103/2230-8210.192927.

Authors

Chitra Selvan¹, Deep Dutta², Anubhav Thukral³, Titli Nargis⁴, Manoj Kumar³, Satinath Mukhopadhyay³, Subhankar Chowdhury³

Affiliations

¹ Department of Endocrinology, MS Ramaiah Medical College, Bengaluru, Karnataka, India.
² Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India.
³ Department of Endocrinology, Institute of Post Graduate Institute of Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.
⁴ PhD Scholar, Indian Institute of Chemical Biology, Kolkata, West Bengal, India.

Abstract

Background and aims: The predictive potential of neck circumference (NC) based indices (a measure of upper body fat distribution) for predicting metabolic syndrome (MetS) and its components among Indians is not known. This study aimed to evaluate the role of NC and neck height ratio (NHtR) as independent predictors of MetS and its components as compared to traditional anthropometric indices.

Materials and methods: A total of 451 individuals from 867 screened individuals, 30-80 years age, without any co-morbid state who gave informed written consent underwent clinical, anthropometric, and biochemical assessment.

Results: Patients with MetS in both the sexes had significantly higher NC, NHtR, glycated hemoglobin, fasting glucose, and dyslipidemia (higher triglycerides, total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio, low-density lipoprotein cholesterol/HDL-C ratio, and lower HDL-C). In both sexes, individuals in the highest tertile of NC had significantly greater central and generalized obesity, lower HDL-C, and significantly higher MetS. Receiver operating characteristic analysis revealed waist circumference (WC) to have the largest area under the curve for predicting MetS in both sexes, followed by NHtR, NC, and body mass index. NC and NHtR of >34.9 cm (sensitivity 78.6%; specificity 59.3%) and >21.17 cm/m (sensitivity 80.7% and specificity 64.6%) respectively for men and >31.25 cm (sensitivity 72.3%; specificity 64.4%) and >20.48 cm/m (sensitivity 80.4% and specificity 60%) respectively for women were the best values for identifying MetS. Increased NC and NHtR had odds ratio of 1.52 (95% confidence interval [CI]: 1.37-1.68; P < 0.001) and 1.96 (95% CI: 1.67-2.29; P < 0.001) respectively in identifying MetS.

Conclusion: NC and NHtR are good predictors of MetS and cardiovascular risk factors in Asian Indians. NHtR is reliable and perhaps an even better index than NC with regards to cardiovascular risk prediction.

Keywords: Insulin resistance; metabolic syndrome; neck height ratio; waist circumference.