Neck circumference can be a better predictor of cardiometabolic syndrome among body shape indexes and other anthropometry parameters – A cross‐sectional study from Mashhad Persian Cohort

Cardiometabolic syndrome (CMS) is a global health issue that is commonly associated with obesity. This study aimed to assess the utility of neck circumference for predicting cardiometabolic risk in the Iranian population. A cross-sectional study with 6789 participants was conducted using face-to-face interviews, clinical evaluations, body composition measurements using Inbody 770 device, laboratory tests and anthropometric measurements. The anthropometric measurements included height, weight, body mass index, neck, waist, hip and wrist circumference, while laboratory measures included complete blood count, fasting blood glucose, lipid profile and lipid accumulation product. The results revealed that 22.4% of the population had CMS, with a higher prevalence in males (29.8%) than in females (16%). Waist circumference was the most prevalent indicator of CMS (75.8%), particularly in males (86%), while low high-density lipoprotein (HDL) levels were the least common (found in only 349 males). Neck circumference was significantly related to all CMS indicators. Univariate logistic regression analysis indicated that every unit increase in neck circumference led to a twofold increase in the probability of CMS (OR (95% CI) = 1.24 (1.21, 1.26), p < 0.001). Neck circumference had a higher predictive value (AUC = 0.7, sensitivity = 0.71, specificity = 0.6, validity = 0.63) for CMS risk than weight and body mass index (BMI). The cut-off points for neck circumference in diagnosing CMS among the males and females were 38.6 and 36.9 cm, respectively. Neck and waist circumference are better predictors of cardiovascular risk factors than BMI or waist-to-hip ratio. Monitoring changes in these measurements can help predict CMS.