CORRELATION OF NECK CIRCUMFERENCE WITH CONVENTIONAL ANTHROPOMETRIC RISK FACTORS AND CORONARY ANGIOGRAPHIC SEVERITY

Abstract

Adiposity is a risk factor for coronary artery disease  (CAD) and fat distribution is an effective modifier that mediates metabolic risk factors like diabetes, hypertension, and dyslipidemia. This study was conducted to determine the relationship between the neck circumference with metabolic risk factors and their correlation with coronary angiographic severity using Gensini scoring.

Aim

The aims of the study was to evaluate ischemic heart disease (IHD) patients -

• To compare novel metabolic risk factors of upper body adiposity such as neck circumference (NC)/ mid upper-arm circumference (MUAC) with traditional cardiovascular risk factors [waist circumference (WC), waist-hip ratio (WHR), Body- mass index (BMI)] .
• To correlate these risk factors with angiographic severity assessed by coronary angiogram with Gensini score.

Material and methods

A cross-sectional study was conducted in the cardiology department of our institute. Consecutive patients undergoing coronary angiography (CAG) were included in the study. Their anthropometric indices (conventional and novel) known to correlate with metabolic syndrome were measured and the degree of coronary stenosis in epicardial vessels was assessed by Gensini scoring system. The data analysis was done using multiple logistic regression using statistical package for social sciences (SPSS) software. The mean and standard deviation for each continuous variable were calculated. Correlation of neck circumference with metabolic risk factors was tested by Karl Pearson’s correlation coefficient method. Analytical statistics is given by correlation, regression. P-value<0.05 is considered to be significant.

Results

Our study included a total 41 patients who underwent CAG including 29 males and 12 females with mean age 55 (33-85) years. Study included >50% diabeticsand hypertensives, one-third smokers, ~40% dyslipidemics and consumers of alcohol and one-fifth had positive family history of CAD. MUAC, WC, WHR and BMI were more elevated in females while males had higher NC.

There was a significant linear relationship between NC and other anthropometric indices. As the NC increases by one cm, weight increases by 0.5kg, WC increases by 0.3cm, MUAC increases by 0.5cm which were significant (p-value <0.05). While Gensini score was higher in males compared to females, NC did not correlate with Gensini score in either gender.

Discussion & conclusions

It was interesting that WHR was abnormal in all patients while other parameters too were elevated in majority of patients, with preponderance showing gender variation. Women had higher MUAC, WC, WHR than men, while the latter had higher NC & coronary angiographic severity. Novel anthropometric parameter of Neck Circumference was seen to be a reliable upper-body adiposity indicator, with positive correlation with conventional parameters of metabolic syndrome, while not being predictive of CAD extent, based on angiographic scoring.