Abstract 1469: Neck Circumference and Development of Cardiovascular Disease Risk Factors in the Framingham Heart Study
BACKGROUND: Upper-body subcutaneous adipose tissue, measured by neck circumference, may be a unique fat depot that confers additional cardiovascular (CVD) risk above and beyond central adiposity. Neck circumference is significantly correlated with CVD risk factors in cross-sectional studies, but data from prospective studies are lacking. Our objective was to examine the association between neck circumference and the development of CVD risk factors.
METHODS: Participants from the Framingham Heart Study (n=2,732; 54% women; mean age 57 years) were followed for 10 years for the development of hypertension [HTN], low HDL cholesterol [low-HDL (<40 mg/dL, men; <50 mg/dL, women], high triglycerides [high-TG (≥150 mg/dL or lipid treatment)], diabetes [DM], and impaired fasting glucose [IFG]. Logistic regression models, adjusted for age, sex, and smoking, were used to assess the association between neck circumference and incidence of CVD risk factors.
RESULTS: Neck circumference (per standard deviation increment) was significantly associated with the development of all CVD risk factors: HTN (OR=1.4, p<0.001), low-HDL (OR=1.2, p=0.02), high-TG (OR=1.3, p<0.001), DM (OR=2.1, p<0.001), and IFG (OR=1.4, p<0.001). After further adjustment for body mass index (BMI), neck circumference remained significantly associated with high-TG (OR=1.2, p<0.001), DM (OR=1.7, p<0.001), and IFG (OR=1.2, p<0.01). In models that included waist circumference instead of BMI, neck circumference was significantly associated with the development of DM (OR=1.6, p<0.001) and IFG (OR=1.3, p<0.001). Addition of neck circumference to the models resulted in a significant change in the C-statistic only for DM (see table⇓).
CONCLUSION: Neck circumference is associated with the development of multiple CVD risk factors. Measurement of neck circumference may improve prediction of incident DM over traditional adiposity measures such as BMI and waist circumference.