Neck Circumference: An Alternative Tool for Screening Cardiovascular Risk among Adults

Introduction:Upper body obesity has been attributed to increased cardiovascular risk in various studies. Measuring the Neck Circumference (NC) is an easy and inexpensive method to determine the upper body obesity. Aim:To correlate NC with Waist to Hip ratio (W:H ratio) and to find critical cut off points for NC for the screening cardiovascular risk among adults. Materials and Methods:A community based cross-sectional study was conducted among apparently healthy adults in field practice area of a tertiary care hospital in Maharashtra, India. A predesigned and pretested questionnaire was used and following the standard guidelines Waist Circumference (WC), Hip Circumference (HC) and NC were measured. Necessary permissions were sought before the start of the study. Indian standard cut off for W:H ratio was used to classify the cardiovascular risk among the study subjects. Statistical analysis:Epi info 7.1 and Statistical Package for the Social Sciences (SPSS) version 20.00 was used for analysis. Chi square test (For proportions), independent t-test (For mean), Pearson's correlation coefficient and Receiver Operating Characteristic (ROC) analysis was done. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated. Results:Total of 300 study subjects were recruited in the present study. There were equal number of males (n=150) and females (n=150) with the average age of the study population as 44.70 +/- 20.24 years. The Pearson's correlation coefficient between NC and W:H ratio was 0.42 and 0.33 among males and females respectively. Based on receiver operating curve analysis for NC, cut off of 32.5 cm among females and 35.5 cm among males was defined as best critical cut off to screen the adults for cardiovascular risk. Conclusion:A significant association was observed between NC and W:H ratio (p<0.001). NC can be used as a fair test to screen cardiovascular risk among adults.