Abstract:
Background. NC measurement is a simple and time-saving screening measure that can be used to
identify overweight and obese individuals. Neck circumference (NC) is a relatively new method of
differentiating between normal and abnormal fat distribution. It is a marker of upper body
subcutaneous (SC) adipose tissue distribution. Body mass index (BMI) is a tool used to quantify
obesity generally; however, it is unable to distinguish between accumulations of muscle and fat.
For this reason, using BMI alone may yield inaccurate results.
Objective: To evaluate the performance of neck circumference method in determining nutritional
status of adults aged 18-64 years in Agaro Town Oromia region, Southwestern Ethiopia, from july
5 to December 5, 2024
Methods: A Community-based cross-sectional study was employed on Adult 18 to 64 years in
Agaro town from November 5 to December 5, 2024. Study participants were selected using a
simple random sampling technique. Data were collected using the structured questionnaires.
Analysis was performed using SPSS version 26. The correlation between NC, weight, and height
was examined. Diagnostic ability and cut-off values of NC was calculated by receiver operating
characteristic (ROC) curve analysis. Then the NC cutoffs was compared to the BMI score cutoff
using sensitivity, specificity, predictive values, and AUC with 95%CI.
Results; The mean and standard deviation age of the study participants were 35.9 ± 10.90 with
minimum and maximum age of 18 and 64 years respectively Out of 1200 study participants
aged 18-64 years enrolled in this study, 16.1%) and 5.4% were overweight and obese,
respectively. NC was moderately correlated with BMI (r = 0.413). The ROC analyses
demonstrated excellent performance of NC for detecting overweight and obesity among study
participants aged 18-64 years. The optimal NC cut-off for identifying adults with overweight
was 31.96 cm [AUC = 0.71 (95%CI; (0.67-0.75)), sensitivity = 82.9%, and specificity =
54.5%] for females and 33.5 cm [AUC = 0.57 (95%CI; 0.51-0.63), Sensitivity = 70.7%, and
specificity = 44.6%] for males. As well, the optimal cut-off for detecting adults with obesity
was 34.16 cm [AUC = 0.86 (95%CI; 0.82, 0.90), sensitivity = 73.5%, and specificity = 88.0%]
for females and 36.5 cm [AUC = 0.83 (95% CI; 0.74, 0.93), sensitivity = 68.8%, and specificity
= 83.3%] for girls.
Conclusion and recommendations; Neck circumference demonstrated good performance in
identifying overweight and obesity among adults, showing strong correlations with both body
mass index (BMI). The predictive ability of NC was particularly higher for detecting obesity
than overweight. Should consider incorporating neck circumference measurement into routine
anthropometric screening programs to help identify adults at risk of overweight and obesity
early.
