Neck circumference as an independent predictor for NAFLD among postmenopausal women with normal body mass index

Abstract Background: Neck circumference, a proxy for upper-body subcutaneous fat, is a unique and pathogenic fat depot that confers additional metabolic risk. The purpose of present study was to determine whether neck circumference associates with nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with normal body mass index.Methods: A cross-sectional survey (n=2,492) and a 3.1-year follow-up investigation (n=1,354) were conducted among Chinese postmenopausal women with normal BMI (18.5 to <25 kg/m2). Neck circumference was measured horizontally at the lower margin of the laryngeal prominence.Results: In the cross-sectional analysis, large neck circumference was associated with the presence of NAFLD (odds ratio 2.28; 95% CI 1.74-2.98; highest tertile versus lowest tertile) after adjustment for confounding factors. Among 1,354 subjects without the NAFLD at baseline, 429 (31.7 %) incident NAFLD cases occurred at 3.1 years. Neck circumference was positively associated with triglycerides, homeostasis model assessment of insulin resistance, C-reactive protein, and negatively associated with high-density lipoprotein cholesterol and adiponectin. Individuals with large baseline neck circumference had a significantly higher risk of NAFLD than those with small neck circumference. The multivariable adjusted hazard ratio was 1.42 (95% CI 1.15-1.97; p for trend =0.004) for the highest versus the lowest tertile of neck circumference, and was 1.22 (95% CI 1.10-1.41; p =0.006) per 1-standard deviation increment in neck circumference.Conclusions: Among postmenopausal women with normal BMI, relatively large neck circumference levels are associated with an increased risk of NAFLD.