Neck circumference: An upcoming tool of adiposity indices

Lawan Hassan Adamu; Abdullahi Yusuf Asuku; Magaji Garba Taura; Idris Abdu Tela; Sa'adu Datti; Aminu Imam

doi:10.4103/0331-8540.122766

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ORIGINAL ARTICLE

Year : 2013 | Volume : 10 | Issue : 2 | Page : 82-85

Neck circumference: An upcoming tool of adiposity indices

Lawan Hassan Adamu¹, Abdullahi Yusuf Asuku¹, Magaji Garba Taura¹, Idris Abdu Tela¹, Sa'adu Datti¹, Aminu Imam²
¹ Department of Anatomy, Faculty of Medicine, Bayero University, Kano, Nigeria
² Department of Anatomy, Faculty of Basic Medical Sciences, University of Ilorin, Ilorin, Kwara, Nigeria

Date of Web Publication

7-Dec-2013

Correspondence Address:
Lawan Hassan Adamu
Department of Anatomy, Faculty of Medicine, Bayero University, Kano, P M B-3011 Kano
Nigeria

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/0331-8540.122766

Abstract

Context: Obesity is one of the most significant contributors to ill health competing with under-nutrition and infectious diseases. Aims: The aims of the study were to determine the presence and level of sexual dimorphism in adiposity indices, correlation of neck circumference (NC) and body mass index (BMI) with other adiposity indices such as waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR) and also to encourage the uses of neck circumferences as valuable tool in assessing upper body central adiposity index. Settings and Design: The study population included 71 undergraduate participants (41 Males and 30 Females) with mean age of 22.68 ΁ 4.23 years. Subjects and Methods: Anthropometric measurements of height, weight, NC, WC and HC were obtained following standard protocols. Statistical Analysis Used: Independent t-test and Pearson's correlation were employed to compare and find the relationship between the variables, using SPSS version 17. Significance level was considered at P ≤ 0.05. Results: The result shows that there was statistically significant (P < 0.05) sexual dimorphism in mean WC, WHR and NC between the sexes. BMI showed strongest correlation with WHtR (r = 0.8, P < 0.001) followed by HC (r = 0.7, P < 0.001), WC (r = 0.7, P < 0.001). On the other hand the NC shows a significant correlation (P < 0.05) with all the variables. Conclusions: Despite the low level of correlation of NC with other adiposity indices compared to the BMI, the NC may serve as an important tool for the assessment of upper body adiposity.

Keywords: Adiposity indices, anthropometry, neck circumferences, Nigeria, obesity

How to cite this article:
Adamu LH, Asuku AY, Taura MG, Tela IA, Datti S, Imam A. Neck circumference: An upcoming tool of adiposity indices. Niger J Basic Clin Sci 2013;10:82-5

How to cite this URL:
Adamu LH, Asuku AY, Taura MG, Tela IA, Datti S, Imam A. Neck circumference: An upcoming tool of adiposity indices. Niger J Basic Clin Sci [serial online] 2013 [cited 2023 Jun 10];10:82-5. Available from: https://www.njbcs.net/text.asp?2013/10/2/82/122766

Introduction

Obesity is characterised by increased adipose tissue mass which results both from increased fat-cell number (hyperplasia) and increased fat-cell size. ^[1] Obesity is now very common in the world's population, and is competing with under-nutrition and infectious diseases as one of the major significant contributor to ill health. ^[2] Many studies have confirmed association between body mass index (BMI), waist circumference (WC), body fat mass, ^[3] abdominal fat content, ^[4] neck circumferences (NC), ^{[5],[6],[7],[8],[9]} and other obesity markers.

However, when considered the non-invasive and inexpensive nature of NC measurement, it applications will be of paramount importance in a given population. Furthermore, there is a paucity of literature on the adiposity indices of Africans, particularly in the Northern part of Nigeria. Based on this, the present study aims to determine among the students of Bayero University Kano, Nigeria (1). The level of sexual dimorphism in NC, BMI, WC, waist-hip ratio (WHR), hip circumference (HC) and waist to height ratio (WHtR), (2). How NC and BMI correlate with other adiposity indices such as WC, WHR and WHtR, (3). The level of correlation between BMI and NC, (4). The possibility of introducing NC as a useful tool in assessing upper body central adiposity index.

Subjects and Methods

The participants were randomly selected using simple random technique from the Medical students of Hausa ethnic group. The population included 71 participants (41 Males and 30 Females) who were apparently healthy with no congenital malformation or history of surgical operation on the neck or trunk. Prior to the commencement of the study, informed consent was obtained from the participants and all the procedures were explained to them.

The waist, hip and neck circumferences were measured using inelastic tape (Butterfly model - made in China), graduated in cm (0-150). The waist circumference was measured midway between the lowest rib and the iliac crest, with the participant in the upright position. ^[10] Hip circumference was measured at the level of the greater trochanter, with the participant standing erect and the medial borders of the feet in contact. ^[11] The neck circumference (cm) was measured in a horizontal plane with subject in standing position, at the level of inferior border of the thyroid cartilage and perpendicular to the vertical axis of the neck in anatomical position. While taking this reading the subject was asked to look straight ahead, with shoulders down, but not hunched. ^[12] For height and weight measurement, a vertical wooden bar calibrated in centimeters (0-200 cm) with a movable horizontal bar which could be adjusted to touch the vertex of the participant's head was used to measure the height of the participants. A portable bathroom weighing scale (Camry, BR9015A, Zhongshan, China) was used to measure body weight to the nearest kilogram. The participants' weights and heights were used to calculate the BMI as kilograms per meter square (kg/m ² ), WC was then divided by HC and height to obtain WHR and WHtR respectively. The mean and standard deviations were calculated for all variables, while independent t-test was used to compare values obtained for the male and female participants. Pearson's correlation was used to find the relationship of WC, HC, WHR, and WHtR to BMI and NC. Significance level was considered at P ≤ 0.05. SPSS version 17 was used for the statistical analyses.

Results

The age range of the study population was 16-39 years, with a mean age of 22.68 ± 4.23 years.

In [Table 1], there was no significant sexual dimorphism between genders for BMI and WHtR. However, the mean Weight, Height, WC, WHR and NC shows statistically significantly differences, with higher value (P < 0.05, P < 0.001) in males (62.59 ± 9.10 cm, 173.70 ± 5.88 cm, 75.08 ± 8.82 cm, 0.84 ± 0.07 cm and 35.15 ± 1.78 cm) than females (56.42 ± 8.16 cm, 161.17 ± 6.00 cm, 70.69 ± 8.50 cm, 0.74 ± 0.05 cm and 31.53 ± 2.41cm), respectively. But for HC, females had higher value (94.90 ± 8.22 cm) then males (89.65 ± 8.47 cm).

Table 1: t test showing difference in mean statistic between male and female for the measured variables

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[Table 2] shows Pearson's correlation coefficients of WC, HC, WHR, and WHtR with BMI and NC. BMI showed the strongest significant (r = 0.815; P < 0.001) correlation with WHtR, followed by HC and WC. BMI has no significant correlation with WHR. On the other hand the NC shows a significant correlation with all the variables with HC and WHR showing strongest correlation (r = 0.642, P < 0.001; r = 0.555, P < 0.001 respectively) and WC and WHtR showing weakest correlation (r = 0.242, P < 0.05; r = 0.434, P < 0.05 respectively).

Table 2: Pearson's correlation coefficients of WC, HC, WHR, and WHtR with BMI and NC

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The linear relationship between NC and BMI was shown in [Figure 1] with r = 0.36 P = 0.002.

Figure 1: Scatter plot showing correlation of neck circumference (NC; cm) with body mass index (BMI; kilograms per meter square) in the study population

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Discussion

Body mass index has been identified by most health professionals as the most useful epidemiological measure of obesity. ^[13] In the assessment of obesity, the central distribution of body fat cannot be overlooked, hence, the use of other anthropometric indices such as WC, WHR, ^[14] and WHtR ^{[15],[16],[17],[18]} as measures of adiposity. Another anthropometric index of interest is NC, which has recently been used to identify overweight and obesity and is observed to have good correlation with age, weight, WC, HC, WHR, and BMI for both sexes. ^[19] Furthermore, NC is also considered as an index of upper body obesity and correlates positively with changes in systolic and diastolic blood pressure and other components of the metabolic syndrome. ^[20]

The present study used the BMI, WC, HC, WC, WHR, WHtR and NC as anthropometric measurements of adiposity. The general characteristic of the population shows that the mean values of these variables fall within the expected value for healthy population as seen in other studies. ^[9],[21] In the present study males showed significantly higher values in height, body weight, WC, WHR and NC when compared to females. This is in agreement with previous studies. ^{[9],[22],[23],[24]} Among Turkish children, Mazicioglu et al.,^[24] also found the percentiles and mean values for NC to be greater in boys as compared to girls, both before and after puberty. For the females only HC shows statistically significant differences. This also agreed with previous works, ^{[22],[23],[24],[25]} with the exception of BMI ^[22],[23] which show significant higher value in male. Although the difference is not statistically significant, but the reverse trend seen in this study may be linked to different life style in females which vary from one population to another.

The comparative correlation between NC and BMI with other adiposity indices, show that BMI strongly associate with WC, HC and WHtR with no significant correlation with WHR, whereas the NC strongly correlated with HC and WHR and weakly with WHtR and WC in the study population. This indicates that the BMI is still stronger then the NC but one advantage of NC over BMI is its stronger correlation with WHR. This implies that NC may serve as a measure to determine overweight and obesity with level of accuracy of 91-95% for men and 97-98% for female. ^[19] Moreover, WHR and WC have also been shown to have significant role in identification of obese and overweight individuals. ^[26] In another study ^[27],[28] BMI and WC have been identified as diagnostic for fatness. The NC and BMI also show a significant correlation in the present study. This agrees with previous studies which observed the relationship of NC with conventional anthropometric parameters of obesity ^[5],[7],[9] including BMI. Similarly Yang et al., ^[6] found relationships between NC and BMI, WC, and metabolic syndrome among Chinese population. As it is always more desirable to have the simplest and inexpensive measure for use in the field situation and for emergency clinical diagnosis, the NC in this study proves to be one of such non-invasive and inexpensive methods that may become useful tools for adiposity indices in Nigeria.

Conclusions

This study showed a significant linear trend between BMI and NC. The two variables also show statistically significant relationship with all the adiposity indices considered in the study except for WHR which does not correlate well with BMI. Hence, despite the low level of correlation of NC with other adiposity indices considered in the study compared to the BMI, the NC may serve as an important upper body adiposity index among the students population which participated in this study.

References

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Figures

[Figure 1]

Tables

[Table 1], [Table 2]

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