Association between neck circumference and cardiometabolic disease in Chinese adults: a community-based cross-sectional study

BMJ Open. 2019 Dec 10;9(12):e026253. doi: 10.1136/bmjopen-2018-026253.


Objectives: Several studies have indicated that neck circumference (NC) was associated with cardiometabolic disease in some Western countries. However, there are limited data regarding this association among Chinese adults.

Design: A community-based cross-sectional study.

Setting: A multistage-stratified random cluster survey was conducted in Xixiang Street, Bao'an District of Shenzhen in southeast China.

Participants: This study included 4000 participants (1605 men and 2395 women) with a mean age of 56.0±9.8 years.

Main outcome measures: Categorical data were reported as percentage and continuous data were reported as mean±SD. Receiver operating characteristic analysis and logistic regression analysis were used to evaluate the association of NC with cardiometabolic disease.

Results: The mean NC values were 35.50±4.23 cm for men and 32.32±3.59 cm for women. After adjusting for body mass index and waist circumference, NC was significantly associated with the risk of hypertension (OR: 1.42 in women), decreased high-density lipoprotein (HDL) levels (OR: 1.27 in men; OR: 1.12 in women), high triglyceride (TG) levels (OR: 1.54 in women) and diabetes (OR: 1.41 in men; OR: 1.37 in women). Among men, the optimal NC cut-off values were 38.10 cm for identifying hypertension, 32.32 cm for decreased HDL levels, 36.6 cm for high TG levels and 36.6 cm for diabetes. Among women, the optimal NC cut-off values were 32.35 cm for identifying hypertension, 33.40 cm for decreased HDL levels, 32.90 cm for high TG levels and 33.40 cm for diabetes.

Conclusions: NC was significantly associated with cardiometabolic disease in Chinese population. Although further studies are needed to confirm the optimal cut-off values, evaluating NC may be useful for predicting cardiometabolic disease risk during clinical assessments.

Keywords: cardiac epidemiology; diabetes and endocrinology; epidemiology; hypertension.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anthropometry
  • Blood Glucose / metabolism
  • Body Mass Index
  • China
  • Cross-Sectional Studies
  • Diabetes Mellitus / etiology*
  • Diabetes Mellitus / physiopathology
  • Dyslipidemias / etiology*
  • Dyslipidemias / physiopathology
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / etiology*
  • Lipids / blood
  • Male
  • Middle Aged
  • Neck*
  • ROC Curve
  • Risk Factors
  • Waist Circumference


  • Blood Glucose
  • Lipids