Abstract
BackgroundNeck circumference (NC) is associated with traditional cardiovascular risk factors (CVRF), but its usefulness to identify earlier atherogenic risk has been scarcely examined. Associations of NC with non-traditional CVRF were investigated in participants at low-to-moderate risk from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).Methods807 individuals (35–54 years) without obesity, diabetes or cardiovascular disease was stratified into quartiles of NC (cut-off for men: 36.5; 37.9 and 39.5 cm; women: 31.4; 32.5 and 34 cm) and traditional and non-traditional risk factors (lipoprotein subfractions by Vertical Auto Profile, adiponectin, leptin, E-selectin) were compared across groups. In linear regression models, associations of NC with non-traditional risk factors were tested for the entire sample and for low-risk group (≤ 2 CVRF).ResultsIn both sexes, BMI, waist circumference, systolic and diastolic blood pressure, fasting and 2-h plasma glucose, HOMA-IR, triglycerides, leptin, E-selectin, small dense LDL-cholesterol, IDL-cholesterol, VLDL3-cholesterol and TG/HDL ratio increased significantly, while HDL2-cholesterol and HDL3-cholesterol decreased across NC quartiles. In linear regression models, a direct association [β(95% CI)] of NC with leptin [(0.155 (0.068–0.242); 0.147 (0.075–0.220)], E-selectin [(0.105 (0.032–0.177); 0.073 (0.006 to 0.140)] and small-dense LDL [(1.866 (0.641–3.091); 2.372 (1.391–3.353)] and an inverse association with HDL2-cholesterol [(− 0.519 (− 0.773 to − 0.266); − 0.815 (− 1.115 to 0.515)] adjusted for age were detected for men and women, respectively.ConclusionOur findings indicate that measurement of NC may be useful for an earlier identification of unfavorable atherogenic metabolic profile in middle-aged individuals at lower cardiovascular risk level.
Highlights
Cardiovascular disease (CVD) is the leading cause of disability adjusted life years (DALYs) worldwide, in developing countries [1]
high-density lipoprotein (HDL)-C levels were inversely associated with Neck circumference (NC) quartiles in both sexes with borderline significance
E-selectin, small dense low-density lipoprotein (LDL)-C, IDL-C, V LDL3-C and TG/HDL ratio increased, and HDL2-C and H DL3-C decreased, while adiponectin, large LDL and log LDL-DR did not differ across the quartiles
Summary
Cardiovascular disease (CVD) is the leading cause of disability adjusted life years (DALYs) worldwide, in developing countries [1]. Earlier identification of at-risk individuals using novel risk markers could anticipate the implementation of preventive strategies. Beyond the usefulness of body mass index (BMI) and waist circumference (WC), there is some evidence that neck circumference (NC) could reflect upper-body fat deposition, enhancing the identification of high-risk individuals [2]. How NC could help predicting cardiometabolic risk earlier has not been adequately investigated in large studies. The relationship between NC and non-traditional cardiovascular biomarkers in non-obese individuals without overt CVD warrants further investigation. Neck circumference (NC) is associated with traditional cardiovascular risk factors (CVRF), but its usefulness to identify earlier atherogenic risk has been scarcely examined. Associations of NC with non-traditional CVRF were investigated in participants at low-to-moderate risk from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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