Neck circumference as an independent predictor for NAFLD among postmenopausal women with normal body mass index

Jie Shi,Guang Ning,Ning Lin,Xiaoyong Li,Zhen Yang,Hongmei Zhang,Weiwei Zhang,Yixin Niu,Zixuan Wang,Li Qin,Jiangao Fan,Qing Su

doi:10.1186/s12986-021-00562-3

Jie Shi, Guang Ning + Show 10 more

Open Access

https://doi.org/10.1186/s12986-021-00562-3

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Abstract

BackgroundNeck circumference, a proxy for upper-body subcutaneous fat, is a unique and pathogenic fat depot that confers additional metabolic risk. The purpose of present study was to determine whether neck circumference associates with nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with normal body mass index.MethodsA cross-sectional survey (n = 2492) and a 3.1-year follow-up investigation (n = 1354) were conducted among Chinese postmenopausal women with normal BMI (18.5 to < 25 kg/m2). Neck circumference was measured horizontally at the lower margin of the laryngeal prominence.ResultsIn the cross-sectional analysis, large neck circumference was associated with the presence of NAFLD (odds ratio 2.28; 95% CI 1.74–2.98; highest tertile versus lowest tertile) after adjustment for confounding factors. Among 1354 subjects without the NAFLD at baseline, 429 (31.7%) incident NAFLD cases occurred at 3.1 years. Neck circumference was positively associated with triglycerides, homeostasis model assessment of insulin resistance, C-reactive protein, and negatively associated with high-density lipoprotein cholesterol and adiponectin. Individuals with large baseline neck circumference had a significantly higher risk of NAFLD than those with small neck circumference. The multivariable adjusted hazard ratio was 1.42 (95% CI 1.15–1.97; p for trend = 0.004) for the highest versus the lowest tertile of neck circumference, and was 1.22 (95% CI 1.10–1.41; p = 0.006) per 1-standard deviation increment in neck circumference.ConclusionsAmong postmenopausal women with normal BMI, relatively large neck circumference levels are associated with an increased risk of NAFLD.

Highlights

Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive fat accumulation in the liver with the absence of alcohol and other liver diseases
We evaluated the relationship between neck circumference and nonalcoholic fatty liver disease (NAFLD) among postmenopausal women with normal Body mass index (BMI)
According to logistic regression analyses, large neck circumference was associated with the presence of NAFLD after adjustment for age, smoking status, physical activity, educational attainment, BMI, waist circumference, homeostasis model assessment-insulin resistance (HOMA-IR), C-reactive protein (CRP), adiponectin, fasting plasma glucose, post-loading plasma glucose, systolic blood pressure, diastolic blood pressure, lipid profiles, and liver enzymes (Table 2)

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive fat accumulation in the liver with the absence of alcohol and other liver diseases. Shi et al Nutr Metab (Lond) (2021) 18:30 mass index (BMI), a condition termed as ‘‘non-obese” NAFLD. The prevalence of NAFLD was around 10% in nonobese adults in Western countries, and about 8–19% of Asians with BMI less than 25 kg/ m 2 are found to have NAFLD [3]. Given this trend, a reliable predictor of NAFLD in nonobese people is essential for its prevention and management. The purpose of present study was to determine whether neck circumference associates with nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with normal body mass index

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