Neck Circumference and 10-Year Cardiovascular Risk at the Baseline of the ELSA-Brasil Study: Difference by Sex

Abstract Background: Neck circumference (NC), an indirect measure of upper-body subcutaneous adipose tissue, has been pointed out as an independent predictor of cardiometabolic diseases. Objectives: To assess the association between NC and 10-year cardiovascular risk in men and in women. Methods: Cross-sectional analysis of 13,920 participants of the (baseline) Longitudinal Study of Adult Health (ELSA-Brasil). The association between NC (used as continuous variable and grouped into quartiles) and the 10-year cardiovascular risk was estimated by the Framingham Global Risk Score and analyzed by generalized linear models after adjustments for sociodemographic characteristics, health behaviors, body mass index and waist circumference. The significance level adopted was 5%. Results: Mean NC was 39.5 cm (SD± 3.6) in men and 34.0 cm (SD±2.9) in women. After adjustments, a one-centimeter increase in NC was associated with an increment of 3% (95%CI1.02-1.03) and 5% (95% 1.04-1.05) in the arithmetic mean of the 10-year CVD risk in men and women, respectively. Men and women in the last quartile showed an increment of 18% (95%CI 1.13-1.24) and 35% (95%CI 1.28-1.43), respectively in the arithmetic mean of the 10-year CVD risk, after adjustments. Conclusions: We found a positive, independent association between NC and the 10-year cardiovascular disease risk. NC may contribute to the prediction of cardiovascular risk, over and above traditional anthropometric measures.

摘要：
背景：颈围（Neck circumference, NC）作为间接反映上半身皮下脂肪组织的指标，已被证实为心血管代谢疾病的独立预测因子。
目的：评估颈围与男、女性群体10年心血管疾病风险之间的关联。
方法：本研究对巴西成人健康纵向研究（Longitudinal Study of Adult Health, ELSA-Brasil）基线队列的13920名参与者开展横断面分析。将颈围作为连续变量及四分位分组变量，采用弗雷明汉全球风险评分（Framingham Global Risk Score）估算颈围与10年心血管疾病风险的关联，并在校正社会人口学特征、健康行为、体质量指数及腰围后，通过广义线性模型进行分析，检验水准设定为5%。
结果：男性受试者的平均颈围为39.5 cm（标准差±3.6），女性受试者为34.0 cm（标准差±2.9）。校正混杂因素后，男性颈围每增加1 cm，其10年心血管疾病风险的算术均值升高3%（95%置信区间1.02~1.03），女性则升高5%（95%置信区间1.04~1.05）。处于最高四分位组的男性与女性，其10年心血管疾病风险的算术均值经校正后分别升高18%（95%置信区间1.13~1.24）与35%（95%置信区间1.28~1.43）。
结论：本研究发现颈围与10年心血管疾病风险存在正向独立关联。相较于传统人体测量学指标，颈围可额外为心血管疾病风险预测提供辅助价值。