Open Access

Eike A. Strathmann, Ilka Ratjen, Klara Willrodt, Janna Enderle, Sabrina Schlesinger, Beate Fischer, Katharina S. Weber, Cara Övermöhle, Karin H. Greiser, Anja M. Sedlmeier, Margit Heier, Anna Köttgen, Kathrin Günther, Matthias Nauck, Wolfgang Lieb

• Context: Neck circumference (NC) was proposed as promising marker to assess body fat distribution and cardiometabolic risk. Objective: We aimed to assess associations of NC with anthropometric traits, cardiometabolic risk markers, and self-reported cardiometabolic diseases. Methods: NC was measured in a subsample (5865 participants) of the German National Cohort (NAKO Gesundheitsstudie, NAKO), study region Kiel. Linear and logistic regression models were applied to assess associations of NC with anthropometric and cardiometabolic risk markers and self-reported cardiometabolic diseases, including diabetes, heart failure, gout, and a composite end point "clinical CVD" (cardiovascular disease; combining history of angina pectoris, stroke, myocardial infarction, and peripheral artery disease). Models were adjusted for sex and age, CV risk factors (systolic blood pressure, diabetes, low-density lipoprotein [LDL] cholesterol, use of lipid-lowering and antihypertensive medication, smokingContext: Neck circumference (NC) was proposed as promising marker to assess body fat distribution and cardiometabolic risk. Objective: We aimed to assess associations of NC with anthropometric traits, cardiometabolic risk markers, and self-reported cardiometabolic diseases. Methods: NC was measured in a subsample (5865 participants) of the German National Cohort (NAKO Gesundheitsstudie, NAKO), study region Kiel. Linear and logistic regression models were applied to assess associations of NC with anthropometric and cardiometabolic risk markers and self-reported cardiometabolic diseases, including diabetes, heart failure, gout, and a composite end point "clinical CVD" (cardiovascular disease; combining history of angina pectoris, stroke, myocardial infarction, and peripheral artery disease). Models were adjusted for sex and age, CV risk factors (systolic blood pressure, diabetes, low-density lipoprotein [LDL] cholesterol, use of lipid-lowering and antihypertensive medication, smoking status), and body mass index (BMI). Results: Mean NC values (±SD) were 39.5 ± 3.0 in men and 33.6 ± 2.7 cm in women. NC was positively associated with anthropometric traits, visceral adipose tissue (cm) (β = 1.45 [95% CI, 0.88-2.02]), systolic (β = .37 [0.19-0.56]) and diastolic (β = .17 [0.05-0.29]) blood pressure, glycated hemoglobin A1c (β = .02 [0.01-0.02]), nonfasting glucose (β = .57 [0.31-0.83]), and inversely associated with high-density lipoprotein cholesterol (β = -.73 [-0.91; -0.54]). Furthermore, NC showed associations with diabetes (odds ratio [OR] = 1.08 [1.02-1.15]), heart failure (OR = 1.12 [1.02-1.23]), and gout (OR = 1.09 [1.01-1.17]). Association with "clinical CVD" did not remain statistically significant after BMI adjustment. Conclusion: NC was associated with several cardiometabolic risk factors, including glycemic and lipid traits and self-reported cardiometabolic diseases. These observations suggest that NC may be a useful surrogate marker for cardiometabolic risk.…