Elevated Neck Circumference as an Indicator of Obesity Among Indian Adolescents

Overweight/ obesity among adolescents are most commonly determined by BMI percentiles but it involves time consuming computations for obesity diagnosis. Neck circumference (NC) is a marker of subcutaneous fat distribution in the adipose tissue in the upper body. NC has been positively correlated with components of metabolic syndrome and affects cardiometabolic risk profile of an individual. Therefore, the aim of the study was to develop age-specific, gender-specific and age- plus gender- specific NC reference threshold for estimating both overweight and obesity among Indian adolescents. Receiver Operating Characteristic (ROC) curve analysis was done to find cut-off values for NC for identification of overweight and obese adolescents. The best cut-off values for adolescents were determined by Youden index. Mann-Whitney test was used for comparing the variables between boys and girls. The median (IQR) NC for boys and girls were 32.0 (3.5) and 29.5 (2.1) cm, respectively. A statistically significant difference (p < 0.001) was seen in NC for adolescent boys and girls. The optimal NC cut-off value for overweight were ≥33 cm and ≥30 cm for boys and girls, respectively. The optimal NC cut-off value for obesity were ≥34 cm and ≥31 cm for boys and girls, respectively. The proposed cut-off for obesity was having 81 and 88 per cent chance to correctly distinguish obese adolescents from healthy adolescents. It can be concluded that NC is a simple technique that has good reliability and could be used for screening overweight/ obesity in adolescents.