Performance of Neck Circumference for Screening Overweight and Obesity among Adults Aged 18-64 Years in Agaro Town, Oromia Region, Southwestern Ethiopia, 2025.

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.