Neck Circumference as an Indicator of Cardiometabolic Health

Neck circumference has emerged as a pragmatic anthropometric measure for assessing upper-body adiposity, reflecting fat distribution that often eludes traditional indices such as body mass index and waist circumference. As a surrogate for both white and thermogenic brown adipose deposits in the cervical region, a larger neck circumference correlates with a greater burden of visceral fat and is linked to insulin resistance, dyslipidaemia, hypertension and systemic inflammation. Owing to its simplicity, reproducibility and minimal invasiveness, measurement of neck circumference is increasingly adopted in clinical and epidemiological settings worldwide. Its predictive value spans from paediatric hypertension screening to adult cardiovascular risk profiling, facilitating early identification of individuals at heightened risk of type 2 diabetes, metabolic syndrome and cerebro-cardiovascular events. Research advances have refined measurement protocols and explored sex-specific and ethnic variations in cut-off values, underscoring the global applicability of neck circumference in cardiometabolic risk stratification.

Research from Nature Portfolio

In a decade-long prospective cohort study involving a middle-aged Asian population, participants were categorised into quartiles based on baseline neck circumference. After comprehensive adjustment for traditional risk factors—including age, adiposity, sleep quality metrics and snoring habit—the highest neck circumference quartile exhibited a marked increase in the incidence of type 2 diabetes. The risk escalated progressively across quartiles, indicating that cervical adiposity independently predicts future glycaemic deterioration beyond established metrics. These findings substantiate neck circumference as a valuable, easily obtainable marker for long-term diabetes risk in high-risk cohorts.

Neck Circumference as an Indicator of Cardiometabolic Health publication trend

The graph below shows the total number of articles in neck circumference as an indicator of cardiometabolic health across all publications each year (not limited to Nature Index journals).

Technical terms

Cardiometabolic risk: the likelihood of developing cardiovascular disease, type 2 diabetes and related metabolic disorders.

Neck circumference (NC): the linear measurement encircling the neck below the laryngeal prominence, used as a proxy for cervical adiposity.

Dual X-ray absorptiometry (DEXA): an imaging modality that quantifies body composition, including fat and lean mass.

Homeostatic Model Assessment of Insulin Resistance (HOMA-IR): an index derived from fasting glucose and insulin levels to estimate insulin sensitivity.

High-sensitivity C-reactive protein (hsCRP): a biomarker of systemic inflammation used to assess cardiovascular risk.

Meta-analysis: a statistical approach that synthesises data from multiple independent studies to derive pooled estimates.

Cross-sectional study: an observational design analysing data from a population at a single point in time to explore associations.

References

1. Neck Circumference and Incidence of Diabetes Mellitus over 10 Years in the Korean Genome and Epidemiology Study (KoGES). Scientific Reports (2015).
2. Association between neck circumference and diabetes mellitus: a systematic review and meta-analysis. Diabetology & Metabolic Syndrome (2023).
3. Associations between Neck Circumference, Mid-Upper Arm Circumference, Wrist Circumference, and High Blood Pressure among Lithuanian Children and Adolescents: A Cross-Sectional Study. Nutrients (2024).