Neck Circumference as a Possible Indicator of Cardiometabolic Risk among Nigerian Adults with Type 2 Diabetes

Abstract

Background and Aim: Neck circumference (NC) has been associated with cardiovascular risk factors. Type 2 diabetes mellitus (T2DM) is a chronic disorder that is driven by insulin resistance. This study aimed to evaluate the relationship between NC and insulin resistance with cardiometabolic factors among persons with T2DM. Methods: The study was a comparative cross-sectional study with a total sample size of 180, which included 120 patients with T2DM attending the medical outpatient clinic of a tertiary health facility in Nigeria and 60 healthy controls. Neck circumference of subjects with T2DM and controls was measured, and parameters such as waist circumference, waist-hip ratio and body mass index were estimated. Insulin resistance was determined using the homeostasis model assessment of insulin resistance (HOMA-IR). Data obtained was analyzed with Statistical Package for Social Sciences (SPSS), version 22. Results: There was no statistical difference in the mean neck circumference of the subjects with T2DM and controls (34.30 ± 3.09 cm vs 34.81 ± 2.61 cm; P>0.05). Neck circumference of male subjects with T2DM was higher than their female counterparts and this was statistically significant (37.46±2.97 cm vs 33.05±2.09 cm; P=0.01). Significant correlation was observed between NC and HOMA-IR among controls (rho = 0.34; P = 0.01) but not among patients with T2DM (rho = 0.13; P=0.16). There was significant positive correlation between NC and body mass index (rho = 0.30; P = 0.001), waist circumference (rho = 0.48; P<0.001) and waist-hip ratio (rho = 0.26; P = 0.004) amongst patients with T2DM. Conclusion: Neck circumference correlated positively with some cardiometabolic risk factors among subjects with T2DM in the study population. This may possibly indicate  that simple measurement such as neck circumference could serve as a supplementary or surrogate marker of central obesity, which might have implications for development of cardiovascular diseases.