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

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