Neck circumference as a reliable predictor of obesity and metabolic Syndrome in rural south-west Nigeria: A cross-sectional study
DOI:
https://doi.org/10.71637/tnhj.v25i1.992Keywords:
anthropometry, rural community, neck circumference, cardiovascular risk, south-west NigeriaAbstract
Background: Neck size is a potential indicator for excess weight and metabolic disorders, offering a simple, non-intrusive, and cost-effective evaluation method in remote regions. This study assessed the predictive value of neck size in Nigerian adults, whatever the gender.
Methods: The anthropometries (weights, heights and the waist, hip and neck circumferences) the blood pressure, lipid panel, blood glucose, and HBA1c were determined and analyzed to predict obesity and metabolic syndrome. A multiple logistic regression analysis assessed the relationship between neck circumference and outcomes.
Results: The mean age of the 250 (67 males and 183 females) participants was 58.50 ± 18.73 years, the males were older (60.84 ± 20.09 years vs. 57.64 ± 14.63 years, p= 0.001. The neck circumference was positively associated with body mass index, waist hip ratio and the waist circumference. It was predictive of obesity, central obesity, and metabolic syndrome. The area under the curve (AUC) for non-diabetics and for diabetic males and females were 0.82 to 0.88, and 0.86 and 0.81 respectively. The cutoff values for obesity were 37.75 cm (males) and 32.75 cm (females). Regression analysis showed a positive association between neck circumference and obesity, with odds ratios of 1.774 (males) and 1.559 (females).
Conclusion: The neck circumference was positively associated with, and predictive of central obesity, and metabolic syndrome. It is a reliable, convenient and affordable measure for assessing obesity and metabolic syndrome in Nigeria. Incorporating neck circumference measurements into routine evaluations can provide insights into obesity, central obesity, and metabolic syndrome risk.
Downloads
References
1. Bray GA, Kim KK, Wilding J, World Obesity Federation. Obesity: A Chronic Relapsing Progressive Disease Process. A Position Statement of the World Obesity Federation. Obes Rev 2017; 18:715–723.
2. World Health Organization (African Region). Obesity Rising in Africa, WHO Analysis Finds. Available online at: https://www.afro.who.int/news/obesity-rising-africa-who-analysis-finds Accessed March 14/3/ 2023.
3. Adeboye B, Bermano G, Rolland C. Obesity and its health impact in Africa: a systematic review. Cardiovasc J Afr. 2012; 23:512–1.
4. Chukwuonye II, Ohagwu KA, Ogah OS, John C, Oviasu E, Anyabolu EN, et al. (2022) Prevalence of overweight and obesity in Nigeria: Systematic review and meta-analysis of population-based studies. PLOS Glob Public Health 2022; 2(6): e0000515.
5. Adeloye D, Ige-Elegbede JO, Ezejimofor M, Owolabi EO, Ezeigwe N, Omoyele C, et al. Estimating the prevalence of overweight and obesity in Nigeria in 2020: a systematic review and meta-analysis. Ann Med. 2021;53(1):495-507.
6. Ramalan MA, Gezawa ID, Musa BM, Uloko AE, Fakhraddeen YM. Prevalence and trends of adult overweight and obesity in Nigeria - A systematic review and meta-analysis. Niger J ClinPract. 2023;26(1):1-15.
7. Khanna D, Peltzer C, Kahar P, Parmar M. Body Mass Index (BMI): A Screening Tool Analysis. Cureus 2022; 14(2): e22119
8. WHO: Waistcircumferenceandwaist-hipratio: ReportofaWHOexpertconsultation, Geneva,8–11. 2008.http://apps.who.int/iris/bitstream/10665/44583/1/9789241501491 2011Acceessed 1/11/2017.
9. Silver HJ, Welch EB, Avison MJ, Niswender KD. Imaging body composition in obesity and weight loss: challenges and opportunities. Diabetes MetabSyndrObes. 2010; 28(3):337-47.
10. Raimi TH, Dele-Ojo BF, Dada SA, Ajayi DD. Neck Circumference Cut-Off for Obesity and Metabolic Syndrome in Nigeria. Ethn Dis. 2021;31(4):501-508.
11. Alfadhli EM, Sandokji AA, Zahid BN, et al. Neck circumference as a marker of obesity and a predictor of cardiometabolic risk among Saudi subjects. Saudi Med J. 2017;38(12):1219-1223.
12. Zhao, L., Huang, G., Xia, F. et al. Neck circumference as an independent indicator of visceral obesity in a Chinese population. Lipids Health Dis 2018; 17:85.
13. Alzeidan R, Fayed A, Hersi AS, Elmorshedy H. Performance of neck circumference to predict obesity and metabolic syndrome among adult Saudis: a cross-sectional study. BMC Obes. 2019;6(1):13.
14. Zhou, Jy.,Ge, H., Zhu, Mf. et al. Neck circumference as an independent predictive contributor to cardio-metabolic syndrome. CardiovascDiabetol 2013; 12:76
15. Ataie-Jafari, A., Namazi, N., Djalalinia, S. et al. Neck circumference and its association with cardiometabolic risk factors: a systematic review and meta-analysis. DiabetolMetabSyndr 2018; 10:72.
16. Kaumudi J, Francisco M, José V, Cristina P, Cynthia P. Neck Circumference May Be a Better Alternative to Standard Anthropometric Measures. J Diabetes Res 2016; 2016:8.
17. Sjostrom CD, Hakangard AC, Lissner L, Sjostrom L. Body compartment and subcutaneous adipose tissue distribution--risk factor patterns in obese subjects. Obes Res. 1995;3(1):9–22.
18. Horska K, Kucerova J, Suchy P, Kotolova H. Metabolic syndrome - dysregulation of adipose tissue endocrine function. CeskaSlov Farm. 2014;63(4):152–159.
19. Alfadhli EM, Sandokji AA, Zahid BN, Makkawi MA, Alshenaifi RF, Thani TS, Habeeb HA. Neck circumference as a marker of obesity and a predictor of cardiometabolic risk among Saudi subjects. Saudi med. J. 2017;38(12):1219–1223.
20. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, Jones DW, Materson BJ, Oparil S, Wright JT, Jr, et al. Seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206–1252.
21. Martinho FL, Tangerina RP, Moura SM, Gregorio LC, Tufik S, Bittencourt LR. Systematic head and neck physical examination as a predictor of obstructive sleep apnea in class III obese patients. BrazJ Med BiolRes. 2008;41(12):1093–1097.
22. Padilla CJ,Ferreyro FA, Arnold WD. Anthropometry as a readily accessible health assessment of older adults. Exp. Geronto 2021; 153:1111464
23. Son YJ, Kim J, Park HJ, Park SE, Park CY, Lee WY, et al. Association of Waist-Height Ratio with Diabetes Risk:A 4-Year Longitudinal Retrospective Study. EndocrinolMetab. 2016; 31:127–133.
24. Global Database on Boday Mass Index [http://apps.who.int/bmi/index.jsp?introPage=intro_3.html].
25. Bauer JA, Zámocká M, Majtán J, Bauerová-Hlinková V. Glucose Oxidase, an Enzyme "Ferrari": Its Structure, Function, Production and Properties in the Light of Various Industrial and Biotechnological Applications. Biomolecules. 2022;12:472. doi: 10.3390/biom12030472.
26. Li L, Dutkiewicz P, Huang Y, Zhou H, Hsu C, Analytical methods for cholesterol quantification J Food Drug Anal. 2019; 27(2):375-386
27. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 ;18(6):499-502.
28. Diabetes Standards of Care: ADA guidelines (2018), Available at: http://diabetesed.net/wp-content/uploads/2017/12/2018-ADA-Standards-of-Care.pdf. Accessed22/4/ 2020.
29. do Vale Moreira NC, Montenegro RM Jr, Meyer HE, Bhowmik B, Mdala I, Siddiquee T, Oliveira Fernandes V, Hussain A. Glycated Hemoglobin in the Diagnosis of Diabetes Mellitus in a Semi-Urban Brazilian Population. Int J Environ Res Public Health. 2019; 16:3598. doi: 10.3390/ijerph16193598
30. Asgari, S., Abdi, H., Hezaveh, A.M. et al. The Burden of Statin Therapy based on ACC/AHA and NCEP ATP-III Guidelines: An Iranian Survey of Non-Communicable Diseases Risk Factors. Sci Rep 2018; 8:4928
31. Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, Zhang JD, Du XP, Li YL, Ji Y, et al. 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):2465–2467.
32. Ferretti RDL, Cintra IDP, Passos MAZ, Costa THM, Silva DAS, Pereira RA, et al. Elevated neck circumference and associated factors in adolescents. BMC Public Health. 2015; 15:208. doi: 10.1186/s12889-015-1517-8.
33. Fantin F, Comellato G, Rossi AP, Grison E, Zoico E, Mazzali G, Zamboni M. Relationship between neck circumference, insulin resistance and arterial stiffness in overweight and obese subjects. Eur J PrevCardiol. 2017;24(14):1532–1540.
34. Stabe C, Vasques AC, Lima MM, Tambascia MA, Pareja JC, Yamanaka A, Geloneze B. Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian metabolic syndrome Study. ClinEndocrinol. 2013;78(6):874–881
35. Iwuala AA, Olamoyegun MO, Fasanmade OA, Ohwovoriole AE. The relationship between neck circumference and other indices of adiposity in a healthy Nigerian Population. Nig Q J Hosp Med. 2014; 24: 218-221.
36. Cizza G, de Jonge L, Piaggi P, Mattingly M, Zhao X, Lucassen E, Rother KI, Sumner AE, Csako G, Study NSE. Neck circumference is a predictor of metabolic syndrome and obstructive sleep apnea in short-sleeping obese men and women. MetabSyndrRelatDisord. 2014;12(4):231–241.
37. LaBerge RC, Vaccani JP, Gow RM, Gaboury I, Hoey L, Katz SL. Inter- and intra-rater reliability of neck circumference measurements in children. PediatrPulmonol. 2009;44(1):64–69.
38. Stabe C, Vasques AC, Lima MM, Tambascia MA, Pareja JC, Yamanaka A, Geloneze B. Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian metabolic syndrome Study. ClinEndocrinol. 2013;78(6):874–881.
39. Joshipura K, Muñoz-Torres F, Vergara J, Palacios C, Pérez CM. Neck circumference may be a better alternative to standard anthropometric measures. J Diabetes Res. 2016; 2016:6058916
40. Sinaga, M., Worku, M., Yemane, T. et al. Optimal cut-off for obesity and markers of metabolic syndrome for Ethiopian adults. Nutr J 2019; 17:109.
41. Qureshi NK, Hossain T, Hassan MI, et al. Neck circumference as a marker of overweight and obesity and cutoff values for Bangladeshi adults. Indian J Endocrinol Metab.2017;21(6):803-808.
42. Vallianou NG, Evangelopoulos AA, Bountziouka V, Vogiatzakis ED, Bonou MS, Barbetseas J, Avgerinos PC, Panagiotakos DB. Neck circumference is correlated with triglycerides and inversely related with HDL cholesterol beyond BMI and waist circumference. Diabetes/Metabol Res Rev 2013; 29:90–97.
43. Shokri-Mashhadi N, Moradi S, Mohammadi H, Ghavami A, Rouhani MH. Association between neck circumference and lipid profile: a systematic review and meta-analysis of observational studies. Eur J CardiovascNurs. 2021;20(6):588-603.
Published
Issue
Section
License
Copyright (c) 2025 Oluwabukola Ayodele Ala, Patience Akinwusi, Opeyemi Oni, Abiola Oluwadamilola Odeyemi, Gbenga Michael Israel, Oluwaseyi Kikelomo Israel

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.