Neck circumference predicts development of carotid intima-media thickness and carotid plaque: A community-based longitudinal study

Background and aims: Carotid intima-media thickness (C-IMT) is an important index for evaluating subclinical atherosclerosis. Neck circumference (NC), a new anthropometric index of the upper body fat, is closely related to cardiovascular disease (CVD) and CVD risk factors. This study investigated the relationship between NC, C-IMT, and carotid plaque in a community based cohort. Methods and results: Participants recruited from Shanghai communities were followed up for 1.1-2.9 years. All participants underwent anthropometric and biochemical measurements. Elevated NC was defined as NC > 38.5 cm and NC > 34.5 cm in men and women, respectively. Elevated CIMT, determined by ultrasound, was defined as a level higher than the 75th percentile in the study population (>0.75 mm). In total, 1189 participants without carotid plaque at baseline were included, with an average age of 59.6 +/- 7.3 years. After a mean follow-up of 2.1 +/- 0.2 years, 203 participants developed carotid plaques. After adjusting for various atherosclerosis risk factors, the logistic regression showed that the higher NC group had a significantly greater risk of developing carotid plaque than the lower NC group (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.12-2.14; P = 0.008). Of those without carotid plaque at follow-up, 495 participants developed elevated C-IMT. Compared to the lower NC group, the higher NC group had a significantly increased risk of elevated C-IMT (OR, 1.49; 95% CI, 1.14-1.95; P = 0.003). Conclusion: Higher NC was significantly positively correlated with the risk of carotid plaque and elevated C-IMT. (c) 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.