The relationship between neck circumference and cardiometabolic risk factors in children and adolescents with obesity

the aim of our study was to evaluate the association between neck circumference (NC) and cardiometabolic risk factors in children and adolescents with obesity.

a cross-sectional study was conducted from October to December 2024, involving 364 children and adolescents with obesity (aged 5 to 17.9 years). Participants were categorized as metabolic syndrome (MetS) or non-MetS according to the International Diabetes Federation criteria. Subjects were further divided into pre-pubertal, mid-pubertal, and post-pubertal groups.

the cohort comprised 188 females and 176 males, with a median age of 12.7 years and a median BMI of 29.37 kg/m². MetS was diagnosed in 111 participants (30.5 %), with a prevalence of 19.8 % in pre-pubertal, 34.8 % in mid-pubertal, and 38.1 % in post-pubertal individuals. Participants with MetS had higher NC and NC z-scores, BMI, waist circumference (WC), hip circumference (HC), waist-to-height ratio (WHtR), and systolic and diastolic blood pressure. They also had higher fasting triglycerides, uric acid, fasting plasma glucose, insulin levels, and HOMA-IR. NC demonstrated significant correlations with age, BMI, WC, HC, and metabolic parameters. In multivariate logistic regression analysis, NC emerged as an independent predictor of MetS. Threshold NC values indicative of MetS were identified as 32.75 cm (pre-pubertal), 35.50 cm (mid-pubertal), and 36.25 cm (post-pubertal).

this study shows that NC is markedly increased in children and adolescents with MetS and independently predicts MetS. Moreover, our findings indicate that associations between NC and cardiometabolic risk factors, supporting NC as a practical marker for cardiometabolic risk stratification in pediatric obesity.