Neck Circumference: A Possible Predictor of Metabolic Disorders in the Hospital Setting

Document Type : Research Paper

Authors

1 Department of Community Nutrition, Faculty of Nutrition Tabriz University of Medical Sciences, Tabriz, I.R. Iran.

2 Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, I.R. Iran.

Abstract

Introduction: Malnutrition is considered to be a severe complication in hospitalized patients, which increases the length of hospital stay, treatment costs, and mortality. The present study aimed to evaluate neck circumference as a possible predictor of metabolic disorders in the hospital settings. Methods: This study was conducted on 300 hospitalized patients selected from the internal disease ward of Imam Reza Hospital in Tabriz, Iran. Data were recorded on their demographic characteristics, medical history, medication use, and anthropometric and biochemical parameters. Dietary supplementation use, nutritional support, and physical activity (PA) were also measured using the subjective global assessment tool, and neck circumference (NC) was measured by the researcher. Data analysis was performed in SPSS version 16.0. Results: In total, 61.8% of the male and 65.9% of the female patients had an NC of equal to or higher than normal. Chi-square was applied to assess the categorical variables, and one-way ANOVA was used for the continuous variables, indicating significant correlations between the NC and gender, body mass index, marital status, occupation status, PA, current nutritional status, and medical history such as diabetes mellitus (DM), hypertension (HTN), and renal disorders, as well as the use of some medications (p <0.05). Furthermore, significant correlations were denoted between the NC and levels of albumin (P=0.025), mean corpuscular volume (P=0.001), and total bilirubin (P=0.034). Systolic blood pressure was also significantly correlated with the NC (P=0.033). Conclusion: NC represents a relatively new anthropometric assessment, which is rarely used in clinical practice, while it is easy to perform and has excellent reproducibility. Our findings indicated that NC, DM, and HTN were correlated. Further studies are suggested to establish accurate associations between NC and metabolic disorders and confirm their correlations with biochemical factors.

Keywords

References

1.Weinsier RL, Hunker EM, Krumdieck CL, Butterworth CE, Jr. Hospital malnutrition a prospective evaluation of general medical patients during the course of hospitalization. The American Journal of Clinical Nutrition. 1979;32(2):418-26.
2.Corish CA, Kennedy NP. Protein-energy undernutrition in hospital in-patients. Br J Nutr. 2000;83(6):575-91.
3.Mullen JL, Gertner MH, Buzby GP, Goodhart GL, Rosato EF. Implications of malnutrition in the surgical patient. Arch Surg. 1979;114(2):121-5.
4.Lim SL, Ong KC, Chan YH, Loke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012;31(3):345-50.
5.Burgos R, Joaquin C, Blay C, Vaque C. Disease-related malnutrition in hospitalized chronic patients with complex needs. Clin Nutr. 2019.
6.Zaciragic A, Elezovic M, Avdagic N, Babic N, Dervisevic A, Lepara O, et al. Relationship between the Neck Circumference, Standard Anthropometric Measures, and Blood Pressure in Bosnian Young Adults. Eurasian J Med. 2019;51(2):150-3.
7.Pirlich M, Schutz T, Norman K, Gastell S, Lubke HJ, Bischoff SC, et al. The German hospital malnutrition study. Clin Nutr. 2006;25(4):563-72.
8.Amaral TF, Matos LC, Tavares MM, Subtil A, Martins R, Nazare M, et al. The economic impact of disease-related malnutrition at hospital admission. Clin Nutr. 2007;26(6):778-84.
9.Agarwal E, Ferguson M, Banks M, Batterham M, Bauer J, Capra S, et al. Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: results from the Nutrition Care Day Survey 2010. Clin Nutr. 2013;32(5):737-45.
10.Chima CS, Barco K, Dewitt ML, Maeda M, Teran JC, Mullen KD. Relationship of nutritional status to length of stay, hospital costs, and discharge status of patients hospitalized in the medicine service. J Am Diet Assoc. 1997;97(9):975-8; quiz 9-80.
11.Vague J. The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr. 1956;4(1):20-34.
12.Preis SR, Massaro JM, Hoffmann U, D'Agostino RB, Sr., Levy D, Robins SJ, et al. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J Clin Endocrinol Metab. 2010;95(8):3701-10.
13.Wakabayashi H, Sashika H. Malnutrition is associated with poor rehabilitation outcome in elderly inpatients with hospital-associated deconditioning a prospective cohort study. J Rehabil Med. 2014;46(3):277-82.
14.Stabe C, Vasques AC, Lima MM, Tambascia MA, Pareja JC, Yamanaka A, et al. Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian Metabolic Syndrome Study. Clin Endocrinol (Oxf). 2013;78(6):874-81.
15.Luo Y, Ma X, Shen Y, Xu Y, Xiong Q, Zhang X, et al. Neck circumference as an effective measure for identifying cardio-metabolic syndrome: a comparison with waist circumference. Endocrine. 2017;55(3):822-30.
16.Bochaliya RK, Sharma A, Saxena P, Ramchandani GD, Mathur G. To Evaluate the Association of Neck Circumference with Metabolic Syndrome and Cardiovascular Risk Factors. J Assoc Physicians India. 2019;67(3):60-2.
17.Taghizadeh S, Abbasalizad Farhangi M. A Review of Neck Circumference As a Potent Anthropometric Predictor of Cardiovascular Disease and Metabolic Syndrome. J Nutr Fast Health. 2019;7(2):70-5.
18.Boemeke L, Raimundo FV, Bopp M, Leonhardt LR, Fernandes SA, Marroni CA. The correlation of neck circumference and insulin resistance in nafld patients. Arq Gastroenterol. 2019.
19.Albassam RS, Lei KY, Alnaami AM, Al-Daghri NM. Correlations of neck circumference with body composition and cardiometabolic risk factors in Arab women. Eat Weight Disord. 2019.
20.Lin S, Hu L, Li P, Li X, Lin K, Zhu B, et al. Utility of neck circumference for identifying metabolic syndrome by different definitions in chinese subjects over 50 years old: A Community-Based Study. J Diabetes Res. 2018;2018:3708939.
21.De La Higuera L, Riva E, Djade CD, Mandelli S, Franchi C, Marengoni A, et al. Prognostic value of estimated glomerular filtration rate in hospitalized elderly patients. Intern Emerg Med. 2014;9(7):735-47.
22.Hingorjo MR, Qureshi MA, Mehdi A. Neck circumference as a useful marker of obesity: a comparison with body mass index and waist circumference. JPMA The Journal of the Pakistan Medical Association. 2012;62(1):36-40.
23.Wan H, Wang Y, Xiang Q, Fang S, Chen Y, Chen C, et al. Associations between abdominal obesity indices and diabetic complications: Chinese visceral adiposity index and neck circumference. Cardiovascular Diabetology. 2020;19(1):1-12.
24.Inoguchi T, Li P, Umeda F, Yu HY, Kakimoto M, Imamura M, et al. High glucose level and free fatty acid stimulate reactive oxygen species production through protein kinase C--dependent activation of NAD (P) H oxidase in cultured vascular cells. Diabetes. 2000;49(11):1939-45.
25.Cho NH, Oh TJ, Kim KM, Choi SH, Lee JH, Park KS, et al. Neck circumference and incidence of diabetes mellitus over 10 years in the korean genome and epidemiology study (KoGES). Sci Rep. 2015;5:18565.
26.Khalangot M, Gurianov V, Okhrimenko N, Luzanchuk I, Kravchenko V. Neck circumference as a risk factor of screen-detected diabetes mellitus: community-based study. Diabetology & metabolic syndrome. 2016;8(1):12.
27.Huang BX, Zhu MF, Wu T, Zhou JY, Liu Y, Chen XL, et al. Neck circumference, along with other anthropometric indices, has an independent and additional contribution in predicting fatty liver disease. PLoS One. 2015;10(2):e0118071.
28.Zhou JY, Ge H, Zhu MF, Wang LJ, Chen L, Tan YZ, et al. Neck circumference as an independent predictive contributor to cardio-metabolic syndrome. Cardiovasc Diabetol. 2013;12:76.
29.Hu Y, Chen J, Yang L, Chen P, Li J, Chen L, et al. The value of neck circumference (NC) as a predictor of non-alcoholic fatty liver disease (NAFLD). J Clin Transl Endocrinol. 2014;1(4):133-9.
30.Moradi S, Mohammadi H, Javaheri A, Ghavami A, Rouhani MH. Association between neck circumference and blood pressure: a systematic review and meta-analysis of observational studies. Hormone and metabolic research= Hormon-und Stoffwechselforschung= Hormones et metabolisme. 2019;51(8):495-502.
31.Castro-Piñero J, Delgado-Alfonso A, Gracia-Marco L, Gómez-Martínez S, Esteban-Cornejo I, Veiga OL, et al. Neck circumference and clustered cardiovascular risk factors in children and adolescents: cross-sectional study. BMJ open. 2017;7(9):e016048.
32.Ozkaya I, Yardimci B, Tunckale A. Appropriate neck circumference cut-off points for metabolic syndrome in Turkish patients with type 2 diabetes. Endocrinología, Diabetes y Nutrición. 2017;64(10):517-23.
33.Diogo LN, Pinto P, Bárbara C, Monteiro EC, Papoila AL. Neck circumference and body mass index as independent predictors of hypertension misclassification in patients suspected of having obstructive sleep apnea. Blood pressure monitoring. 2015;20(1):8-15.
34.Zhong P, Sun D, Wu D, Li T, Wu Y, Xu L. Neck circumference can be used as a valuable tool to screen the cardiovascular risk factors in Chinese elderly: a community based study. Int J Clin Exp Med. 2017;10(2):3685-91.
35.Piro S, Spampinato D, Spadaro L, Oliveri CE, Purrello F, Rabuazzo AM. Direct apoptotic effects of free fatty acids on human endothelial cells. Nutr Metab Cardiovasc Dis. 2008;18(2):96-104.
Journal of Nutrition,Fasting and Health
Volume 9, Issue 1
March 2021
Pages 35-42

Files

History

  • Receive Date: 06 July 2020
  • Revise Date: 14 September 2020
  • Accept Date: 28 September 2020

Share

How to cite

Statistics