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Table 3 Characteristics of the included studies on correlation between neck circumference and cardiometabolic risk factors

From: Neck circumference and its association with cardiometabolic risk factors: a systematic review and meta-analysis

Study Country Type of study Population n Male/femal e Agey Age group Confounde r Outcome Measure of effect Measure of associati on Quality score
Kurtoglu et al. [24] Turkey Case–contr ol Healthy 581 259/322 5–18 Prepubertal boys   BMI r = 0.759; P <  0.001 Pearson correlatio n; P-value 7
SBP r =  0.502; P <  0.001
DBP r =  0.335; P <  0.001
WC r = 0.820; P <  0.001
FBS r = 0.172; P = 0.046
Insulin r = 0.609; P <  0.001
TC r = 0.302; P <  0.001
TG r = 0.409; P <  0.001
HDL-C r =− 0.166; P = 0.056
HOMA-IR r = 0.619; P <  0.001
Pubertal boys BMI r = 0.774; P <  0.001
SBP r = 0.452; P <  0.001
DBP r = 0.472; P <  0.001
WC r = 0.833; P <  0.001
FBS r = 0.047; P = 0.650
Insulin r = 0.325; P <  0.001
TC r = 0.467; P <  0.001
TG r = 0.380; P <  0.001
HDL-C r = − 0.304; P <  0.001
HOMA-IR r = 0.336; P = 0.001
Prepubertal girls BMI r = 0.783; P <  0.001
SBP r = 0.396; P <  0.001
DBP r = 0.317; P <  0.001
WC r = 0.853; P <  0.001
FBS r = 0.210; P = 0.031
Insulin r = 0.416; P <  0.001
TC r = 0.272; P = 0.005
TG r = 0.208; P = 0.032
HDL-C r = − 0.349; P <  0.001
HOMA-IR r = 0.409; P <  0.001
Pubertal Girls BMI r = 0.778; P <  0.001
SBP r = 0.268; P <  0.001
DBP r = 0.193; P = 0.008
WC r = 0.781; P <  0.001
FBS r = 0.131; P = 0.074
Insulin r = 0.455; P <  0.001
TC r = 0.101; P = 0.170
TG r = 0.201; P = 0.006
HDL-C r =− 0.189; P = 0.010
HOMA-IR r = 0.449; P <  0.001
Silva et al. [15] Brazil Cross-sectio nal Healthy 388 169/219 10–19 Male Body fat percentage and puberty BMI Z score 0.58; P <  0.001 Adjusted Pearson correlatio n; P-value 6
WC 0.79; P <  0.001
SBP 0.47; P <  0.001
DBP 0.37; P <  0.001
        Female stage FBS − 0.08; P <  0.001   
Fasting insulin 0.29; P <  0.001
HOMA1-IR 0.29; P <  0.001
TC 0.08
LDL-C 0.14
HDL-C − 0.34; P <  0.001
TG 0.23; P <  0.01
BMI Z score 0.48; P <  0.001
WC 0.64; P <  0.001
SBP 0.28; P <  0.001
DBP 0.18; P <  0.01
FBS 0.08;
Fasting insulin 0.43; P <  0.001
HOMA1-IR 0.41; P <  0.001
TC 0.04;
LDL-C 0.09;
HDL-C − 0.24; P <  0.001
TG 0.25; P <  0.001
Goncalves et al. [12] Brazil Cross sectio nal Healthy 260 129/131 10–14 Total   Body fat 0.51; P <  0.001 Pearson correlatio n; P-value 6
WC 0.74; P <  0.001
Weight 0.75; P <  0.001
BMI 0.88; P <  0.001
Waist to height ratio 0.41; P <  0.001
WHR 0.14; P <  0.05
HOMA-IR 0.35; P <  0.001
Fasting insulin 0.36; P <  0.001
SBP 0.62; P <  0.001
DBP 0.29; P <  0.001
TC − 0.27; P <  0.001
LDL-C − 0.18; P <  0.05
HDL-C − 0.27; P <  0.001
TG 0.06; P <  0.001
Gomez-Arbelaez et al. [16] Colombia Cross-sectio nal Healthy 669 351/318 8–14 Total Age, gender and Tanner stage FBS 0.815 ±0.244; P = 0.001 Adjusted Beta ± SE 7
HDL-C − 1.333 ± 0.384; P = 0.001
TG 3.887 ± 1.014; P <  0.001
SBP 1.719 ±0.205; P <  0.001
DBP 1.305 ±0.173;
           P <  0.001   
Insulin 0.362 ±0.051; P <  0.001
HOMA-IR 0.085 ±0.011; P <  0.001
Atwa et al. [42] Egypt Cross-sectio nal Healthy 2762 1327/1435 12–15 Male   Weight r = 0.68; P <  0.001 Pearson correlation coefficient; p-value 8
BMI r = 0.67; P <  0.001
WC r=0.72; P <  0.001
Female Weight r =  0.68; P <  0.001
BMI r = 0.65; P <  0.001
WC r = 0.63; P <  0.001
Pillai et al. [27] India Prospective observational cross-sectional Women with PCOS 121 0/121 12–41 Female   WC r = 0.758; p < 0.001 Pearson correlation coefficients 6
Vallianou et al. [44] Greece Cross-sectio nal Consecutive adults who had visited the ‘Polykliniki’ GeneralHos pital for a health check-up 490 194/296 18–89   Age, gender, years of school, smoking, physical activity, diet, alcohol intake SBP 0.97 (0.41–1.54); p =  0.001 Adjusted Beta (95% CI) 7
DBP 0.66 (0.31–1.01); P <  0.0001
FBS 0.003 (0.001–0.005); p =  0.003
HDL-C _1.37 (_1.77–0.97); p <  0.0001
LDL-C 1.15 (_0.05–2.34); p = 0.06
TC 1.01 (_0.33–2.35); p = 0.14
TG 0.02 (0.01–0.03); p <  0.0001
Zepeda et al. [39] USA Cross-sectional Healthy 1058 561/497 6–18 Male   WC r =  0.78; P <  0.001 Pearson correlation coefficients; p-value 8
BMI r = 0.72; P <  0.001
SBP r =  0.44; P <  0.001
DBP r = 0.23; P <  0.001
WHtR r = 0.25; P <  0.001
Female WC r = 0.83; P <  0.001
BMI r = 0.71; P <  0.001
SBP r = 0.41; P <  0.001
DBP r = 0.28; P <  0.001
WHtR r =  0.49; P <  0.001
Luo et al. [11] China Cross- Healthy 1943 783/1160 58 ±7 Male Several Trunk FM 0.444; P <  0.001 Adjusted 8
   sectional       metabolic and body fat parameter s visceral fat area 0.138; P <  0.001 Beta; p-value  
Subcutaneous fat area 0.208; P <  0.001
SBP 0.052; P =  0.039
Female Trunk FM 0.519; P <  0.001
visceral fat area 0.144; P <  0.001
Subcutaneous fat area 0.053; P =  0.032
SBP 0.098; P <  0.001
Lou et al. [41] China Cross-sectional Healthy 2847 1475/1372 7–12 Male   Weight r =  0.841; P <  0.001 Pearson correlation coefficient; p-value 8
BMI r =  0.800; P <  0.001
WC r =  0.809; P <  0.001
Female Weight r =  0.785; P <  0.001
BMI r =  0.736; P <  0.001
WC r =  0.739; P <  0.001
Selvan et al. [13] India Cross-sectio nal Healthy 451 258/193 30–80 Male Age WC r =  0.742; P <  0.001 Adjusted Pearson correlation coefficient; p-value
BMI r =  0.744; P <  0.001
SBP r =  0.106
DBP r =  0.113
FBS r =  0.025
TC r =  0211; P <  0.05
TG r =  0.365; P <  0.001
LDL-C r =  0.185
HDL-C r =  = − 0.319; P <  0.01
Female WC r =  0.713; P <  0.001
BMI r =  0.682; P <  0.01
SBP r =  0.172
DBP r =  0.028
FBS r =  0.221
TC r= 0.003
TG r =  0.112
LDL-C r =  =  0.092
HDL-C r = -0.327; P <  0.01
Katz et al. [40] Canada Cross-sectional Healthy 1913 977/936 6–17 Healthy-weight male Age BMI 0.75 (0.62–0.88) Adjusted Beta (95% CI) 8
Overweight/ob ese male BMI 0.46 (0.38–0.54)
Healthy-weight male WC 0.24 (0.18–0.3)
Overweight/ob ese male WC 0.16 (0.13–0.18)
Healthy-weight BMI 0.42 (0.37–0.47)
        female      
Overweight/ob ese female BMI 0.37 (0.26–0.48)
Healthy-weight female WC 0.15 (0.12–0.17)
Overweight/ob ese female WC 0.15 (0.13–0.17)
Formisano et al. [23] Italy, Belgium, Cyprus, Estonia, Germany, Hungary, Spain and Sweden Cross-sectional Healthy 15673 7962/7711 3–10 Boys BMI z-score and country of origin WC z-score 0.318; P <  0.001 Adjusted Pearson correlation coefficient; p-value 8
SBPz-score 0.030
DBP z-score − 0.017
HDL-C z-score − 0.060; P <  0.001
TG z-score 0.056; P <  0.001
HOMA index z-score 0.068; P <  0.001
Girls WC z-score 0.357; P <  0.001
SBPz-score 0.050; P <  0.005
DBP z-score − 0.011
HDL-C z-score − 0.056; P <  0.005
TG z-score 0.063; P <  0.001
HOMA index z-score 0.111; P <  0.001
Cizza et al. [38] USA Cross-sectional Obese 120 28/92 18–50 Total   MetS score r =  0.458; p <  0.001 Pearson correlation coefficient; p-value 6
Fasting insulin r =  0.476; P  <  0.001
HOMA index r =  0.461; P <  0.001
Visceral fat r =  0.674, P <  0.001
Subcutaneous fat r =  0.125, P  =  0.20
Total
abdominal
fat%
r =  0.482, P <  0.001
Yang et al. [10] China Cross-sectional Type 2 diabetic patients 3182 1294/1888 20–80 Male Female   BMI r =  0.41; P < 0.0001 r = 0.84; P < 0.0001 Pearson correlation coefficient; p-value 8
Male Female   WC r =  0.47; P <  0.0001 r = 0.47; P <  0.0001
Kumar et al. [26] India Cross-sectional Patients who attended medicine 431 250/181 Males  >  35 and females  > 40 Total   BMI 0.492; P  < 0.001 Pearson correlation coefficient; 7
WC 0.453; P < 0.001
Hip 0.458; P < 0.001
W/H RATIO − 0.005; P  =  0.912
    Clinic in a tertiary care KMC hospital       SBP 0.243; P  < 0.001 p-value  
DBP 0.107; P=0.027
FBS 0.166; P < 0.001
TC 0.266; P < 0.001
LDL 0.344; P < 0.001
HDL − 0.173; P < 0.001
TG 0.280; P  < 0.001
Rao et al. [46] India Cross-sectional Patients who visited medicine OPD of a tertiary care teaching hospital 250 180/70 40–100 Total   SBP 0.194056; P  =  0.002 Pearson correlation coefficient; p-value 6
DBP 0.176716; P =  0.005
Li et al. [47] China Cross sectional Patients who took lower abdomen and neck CT examination s 177 87/90 35–75 Men
Women
Age Visceral adipose tissue (VAT) r  =  0.49, p < 0.00 r  =  0.25, p  =  0.012 Adjusted Pearson correlation coefficient; p-value 6
Men
Women
Subcutaneous adipose tissue (SAT) r  =  0.59, p <  0.001
r  =  0.41, p <  0.001
Zhou et al. [18] China Cross sectional from the Examination Centre 4201 2508/1693 20–85 Male Age SBP r =  0.250; p <  0.01 Adjusted Pearson correlation coefficient; p-value 8
DBP r =  0.261; p <  0.01
FBG r =  0.177; p <  0.01
TG r =  0.240; p <  0.01
HDL-C r =  − 0.202; p<0.01
TC r = 0.143; p <  0.01
LDL-C r =  0.088; p <  0.01
Female SBP r =  0.255; p <  0.01
DBP r =  0.189; p <  0.01
FBG r= 0.180; p <  0.01
TG r =  0.199; p <  0.01
HDL-C r =  − 0.234; p<0.01
TC r =  0.039
LDL-C r =  0.075; p <  0.01
Saka et al. [48] Turkey Cross-sectional Healthy 411 174/237 20–60 Men
Women
  Body weight r = 0.576; p=0.000 Pearson correlation coefficient 7
r = 0.702; p = 0.000
Men
Women
WC r = 0.593; p = 0.000
r = 0.667; p = 0.000
        *Men
Women
  Hip circumferences r = 0.568; p=0.000 r = 0.617; p = 0.000   
Men Women BMI r=0.58; p = 0.000 r = 0.688; p = 0.000
Androutsos et al. [28] Greece. Cross-sectional Healthy 324 167/157 9–13 Total Age, gender, Tanner stage, physical activity, and protein-, carbohydrate- and fat-dietary intake TC − 0.200 ± 0.777 Adjusted (β ± SE) 7
HDL − 1.713 ± 0.376
LDL 1.016 ±0.669
Fasting glucose 0.285 ±0.217
SBP 2.082 ±0.273
DBP 0.465 ±0.234
TG 0.037 ±0.009
Insulin 0.064 ±0.014
HOMA-IR 0.067 ±0.014
Male   TC r = − 0.11 Pearson’s correlation coefficient
HDL r = − 0.32, p<0.001
LDL r = 0.04
FBS r=0.10
SBP r = 0.43, p < 0.001
DBP r = 0.02
TG r = 0.12
Insulin r=0.23, p < 0.001
HOMA-IR r = 0.23, p < 0.001
Female TC r = − 0.11
HDL r = − 0.23, p<0.001
LDL r = 0.05
FBS r = 0.11
SBP r=0.43, p < 0.001
DBP r = 0.20,p < 0.05
TG r=0.22, p < 0.05
Insulin r = 0.35, p < 0.001
HOMA-IR r = 0.36, p < 0.001
Total TC r =  = − 0.10
HDL r = − 0.27, p<0.001
LDL r =  = 0.01
FBS r = 0.11
SBP r = 0.43, p < 0.001
DBP r = 0.09
TG r = 0.15, p < 0.001
          Insulin r = 0.26, p < 0.001   
HOMA-IR r = 0.26, p < 0.001
Joshipura et al. [49] San Juan, USA Cross-sectional Overweight/ obese, nondiabetic Hispanics 1206 54.6% male 40–65 Total Age, gender, smoking status, physical activity BMI R = 0.66; p < 0.001 Adjusted Pearson correlation coefficient; p-value 8
WC R = 0.64; p < 0.001
% body fat R = 0.45; p < 0.001
HOMA-IR R = 0.45; p < 0.05
FBS R = 0.10; p < 0.001
HbAlc R = 0.28; p < 0.001
SBP R = 0.18; p < 0.001
HDL-C R = − 0.23; p<0.001
DBP R = 0.23;p < 0.001
TG R = 0.12; p < 0.05
Hs-CRP R = 0.30; p <0.001
Hassan et al. [29] Egypt Cross-sectional case control 50 healthy, 50 obese children 100 52/48 7–12 Metabolic subjects   Weight 0.631;P = 0.001 Pearson correlation coefficient; p-value 6
BMI 0.239; P = 0.240
WC 0.465; P = 0.017
Waist/Hip − 0.113; P = 0.582
SBP 0.289; P = 0.152
DBP 0.445; P = 0.023
LDL 0.122; P = 0.551
HDL − 0.120; P = 0.559
TC 0.056;P =  0.787
TG − 0.253; P = 0.212
FBS − 0.377; P = 0.058
Fasting Insulin 0.219; P = 0.283
HOMA-IR 0.113;P =  0.583
Non metabolic subjects Weight 0.619; P =  0.001
BMI 0.535;P =  0.007
WC 0.605; P =  0.002
Waist/Hip − 0.203; P =  0.340
SBP 0.048; P =  0.823
DBP 0.186; P =  0.384
LDL − 0.444; P =  0.030
HDL − 0.139; P =  0.516
TC − 0.221; P =  0.299
TG 0.314; P =  0.135
FBS − 0.137; P =  0.524
Fasting Insulin 0.119; P =  0.580  
HOMA-IR 0.116; P =  0.591
Cho et al.[19] South Conor Healthy 3521 1784/1737 42–71 Male   SBP 0.170; P < 0.001 Pearson 8
  Korea t        DBP 0.200; P < 0.001 Correlation coefficient; p-value  
BMI 0.801; P < 0.001
WC 0.740; P < 0.001
Body fat (%) 0.547; P < 0.001
FPG 0.159; P <  0.001
HOMA-IR 0.317; P <  0.001
TG 0.240; P <  0.001
HDL-C − 0.246; P <  0.001
Female SBP 0.203; P <  0.001
DBP 0.199; P <  0.001
BMI 0.744; P <  0.001
WC 0.706; P <  0.001
Body fat (%) 0.510; P <  0.001
FPG 0.122; P <  0.001
HOMA-IR 0.234; P <  0.001
TG 0.256; P <  0.001
HDL-C − 0.223; P <  0.001
Guo et al. [43] China Cross-sectio nal Normal 6802 3631/3171 5–18 Normal weight Age, gender, BMI, WC BMI r = 0.226; P <  0.001 Adjusted Pearson correlation coefficient; p-value 8
WC r = 0.339; P <  0.001
SBP r = 0.449; P <  0.001
DBP r = 0.328; P <  0.001
Overweight BMI r = 0.137; P <  0.001
WC r = 0.348; P <  0.001
SBP r = 0.459; P <  0.001
DBP r = 0.344; P <  0.001
Obese BMI r = − 0.004;P =  0.932
WC r = 0.635; P <  0.001
SBP r = 0.477; P <  0.001
DBP r = 0.325; P <  0.001
Hatipoglu et al. [25] Turkey Case–control Overweight/ obese children and healthy ones as control 967 475/492 6–18 Boys prepubertal pubertal
Girls prepubertal pubertal
  BMI r =  0.700; P < 0.001 r =  0.821; P < 0.001
r =  0.727; P < 0.001 r =  0.848; P<0.001
Pearson correlation coefficient; p-value 8
Boys
Prepubertal
Pubertal
Girls
Prepubertal
Pubertal
WC r =  0.733; P < 0.001 r =  0.839; P < 0.001
r =  0.776; P < 0.001 r =  0.854; P<0.001
 
Kelishadi et al. [21] Iran Cross- School 23043 11708/113 6–18 Male Age, sex Weight r =  0.546; p <  0.001 Adjusted 7
   sectional students   35    and living area BMI r =  0.389; p < 0.001 Pearson correlation coefficient; p-value  
WC r =  0.491; p <  0.001
Waist/Hip r =  0.035; p <  0.001
Waist/Height r =  0.156; p <  0.001
Hip r =  0.505; p <  0.001
Female Weight r =  0.481; p <  0.001
BMI r =  0.387; p <  0.001
WC r =  0.456; p <  0.001
Waist/Hip r = − 0.020; p <  0.001
Waist/Height r =  0.222; p <  0.001
Hip r =  0.464; p <  0.001
Total Weight r =  0.519; p <  0.001
BMI r =  0.384; p <  0.001
WC r =  0.479; p <  0.001
Waist/Hip r =  0.023; p <  0.001
Waist/Height r =  0.188; p <  0.001
Hip r =  0.478; p <  0.001