Neck circumference as a risk indicator for type 2 diabetes mellitus: a community based cross-sectional study

Balaji Arumugam, Aadarshna R., Suganya E.


Background: Diabetes mellitus is a metabolic syndrome due to insulin deficiency, characterized by hyperglycaemia. Indian diabetes risk score (IDRS) is the most commonly used one to determine the risk status. However there is lot of inconvenience and possible errors in measuring the waist circumference to determine the IDRS, hence the study was planned to evaluate if neck circumference could replace waist circumference in determining the diabetes risk.

Methods: This cross sectional study was conducted among 300 study participants fulfilling the eligible criteria. Socio-demographic variables, parameters required for determining the IDRS was assessed, in addition, neck circumference (NC) was measured using standard protocol. Another risk score was calculated by replacing waist circumference (WC) with neck circumference and scoring was named as IDRS-NC. Pearson correlation and Wilcoxan sign rank test was done to find out the relationship between WC and NC and also to determine if IDRS-NC could replace IDRS.

Results: Out of 300 study population, majority of the participants are in the age group of <35 years 129 (43%) and around 2/3rd of the participants were females. Among the study participants proportion of participants belonging to low risk, medium risk and high risk assessed using IDRS and IDRS-NC was 18.7%, 41%, 40.3% and 31.7%, 38%, 30.3% respectively. There was a strong positive correlation (r=0.837) between the neck circumference and waist circumference. Wilcoxan sign rank test was significant between the 2 scores having a p value of <0.05.

Conclusions: In our study there was a positive correlation between neck circumference and waist circumference.


Indian diabetes risk score, IDRS-NC, Wilcoxan sign rank test

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ICMR. Available at: diabetes/guide_diabetes.htm. Accessed

World Health Day 2016: Diabetes. Available at: /2016/en/. Accessed

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442.

Shashank RJ. Indian diabetes risk score. JAPI. 2005;53:755-7.

Mohan V, Deepa R, Deepa M, Sommanavar S, Dutta M. A simplified Indian diabetes risk score for screening for undiagnosed diabetic subjects. J Assoc Physicians India. 2005;53:755-63.

Verweij LM, Terwee CB, Proper KI, Hulshof CTJ, Mechelen W. Measurement error of waist circumference: gaps in knowledge. Public Health Nutr. 2013;16:281-8.

Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, et al. Neck circumference positively related with central obesity, overweight, and metabolic syndrome in Chinese subjects with type 2diabetes: Beijing community diabetes study. Diabetes Care. 2010;33:2465-7.

Karki BB, Bhattarai MD, Bajracharya MR, Karki S, Devkota AR. Correlation of neck and wrist circumference with waist circumference. J Adv Intern Med. 2014;3(2):47-51.

Hong XL, Fen Z, Dong Z, Zhong X, Shu Q, Shu M, et al. Neck circumference as a measure of neck fat and abdominal visceral fat in Chinese adults. BMC Public Health. 2014;14:311.

Verma M, Rajput M, Sahoo S, Kaur N. Neck Circumference: independent predictor for overweight and obesity in adult population. Indian J Community Med. 2017;42(4):209-13.

Mohan V, Deepa M, Anjana RM, Lanthorn H, Deepa R. Incidence of diabetes and prediabetes in a selected urban south Indian population (CUPS-19). J Assoc Physicians India. 2008;56:152-7.

Radha R, Srividya J. Assessment of risk of type 2 diabetes mellitus among rural population in Karnataka by using Indian diabetes risk score. Int J Community Med Public Health. 2017;4:1056-9.

Nagalingam S, Sundaramoorthy K, Arumugam B. Screening for diabetes using Indian diabetes risk score. Int J Adv Med. 2016;3(2):415-8.

Jacobsan BK, Aarbs NA. Changes in waist circumference and the prevalence of abdominal obesity during 1994-2008- cross-sectional and longitudinal results from two surveys: the Tromso study. BMC Obes. 2016;3:41.

Hu L, Huang X, You C, Li J, Hong K, Li P, et al. Prevalence of overweight, obesity, abdominal obesity and obesity-related risk factors in southern China. PLoS One. 2017;12(9):e0183934.

Lou DH, Yin FZ, Wang R, Ma CM, Liu XL, Lu Q. Neck circumference is an accurate and simple index for evaluating overweight and obesity in Han children. Ann Hum Biol. 2012;39(2):161-5.

Dimitrios P. Association of neck circumference with obesity in female college students. Maced J Med Sci. 2015;3(4):578-81.

Kumar S, Gupta A, Jain S. Neck circumference as a predictor of obesity and overweight among rural central India. Int J Med Public Health. 2012;2(1):62-6.

Aswathappa J, Garg S, Kutty K, Shankar V. Neck circumference as an anthropometric measure of obesity in diabetics. North Am J Medl Sci. 2013;5(1):28-31.

Zaciragic A, Elezovic M, Babic N, Avdagic N, Dervisevic A, Huskic J. Neck circumference as an indicator of central obesity in healthy young bosnian adults: cross-sectional study. Int J Prevent Med. 2018;9:42.