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Original Article
Gender-specific associations among neck circumference, the rs9939609 FTO gene polymorphism, and the 14-year risk of metabolic syndrome in the Korean adult population
Inkyung Baik
Epidemiol Health. 2024;46:e2024072.   Published online August 23, 2024
DOI: https://doi.org/10.4178/epih.e2024072
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Limited data exist on the relation between neck circumference (NC) and the risk of developing metabolic syndrome (MS). This study investigated gender-specific associations between NC and the 14-year risk of MS and explored the impact of the FTO rs9939609 polymorphism on these associations.
METHODS
This population-based prospective cohort study involved 2,666 participants (1,301 men and 1,365 women), who were free of MS at baseline (2005-2006). Incident MS cases, defined by the presence of 3 or more criteria regarding blood pressure and blood levels of glucose, triglycerides, and high-density lipoprotein cholesterol, were identified through biennial examinations until 2020. NC measurements taken at baseline and between 2013 and 2014 were analyzed using Cox proportional hazard regression to determine gender-specific associations with MS risk.
RESULTS
Controlling for potential confounders such as waist circumference (WC), significant associations were observed in both genders. Individuals in the highest NC quartile exhibited more than a 2-fold higher MS risk than those in the lowest quartile; with hazard ratios of 2.37 (95% confidence interval [CI], 1.74 to 3.22) for men and 2.65 (95% CI, 1.89 to 3.72) for women (p for trend <0.001). No significant interaction was found between the <i>FTO</i> polymorphism and NC. In diagnostic test analyses, NC and WC demonstrated comparable area under the curve values in both genders.
CONCLUSIONS
The findings suggest that NC is as effective as WC for predicting the incidence of MS.
Summary
Korean summary
허리둘레는 고혈압, 고혈당, 고지혈증의 위험과 밀접한 관련성을 나타내므로, 대사증후군의 구성 요소로 사용되어 왔다. 하지만 허리둘레 측정 시 피험자의 복장, 자세, 공복 및 식후 상태, 호흡 상태에 따라 측정 오차가 발생한다고 알려졌다. 본 연구는 한국 성인을 대상으로 14년간 진행된 전향적 코호트 연구 자료를 분석하여 목둘레가 허리둘레를 대신해서 대사증후군 위험을 예측할 수 있다는 결과를 확인하였다.
Key Message
Waist circumference has served as an anthropometric component of metabolic syndrome based on data regarding close associations with high blood pressure, hyperglycemia, and dyslipidemia. However, measurement errors of waist circumference due to the subject’s clothing, posture, fasting or postprandial state, and respiratory phase have been pointed out. This 14-year prospective cohort study including Korean adults has revealed that neck circumference can serve as a comparative indicator to waist circumference for predicting metabolic syndrome risk.

Epidemiol Health : Epidemiology and Health
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