Abstract Background Neck circumference (NC) is a practical anthropometric measure for assessing obesity in youth, but its association with metabolic syndrome (MetS) components remains underexplored. This study evaluated the relationship between NC and MetS parameters in adolescents with obesity, using both standard International Diabetes Federation (IDF) criteria and expanded definitions incorporating insulin resistance. Methods In this cross-sectional study, 48 adolescents with obesity and 41 age- and sex-matched controls were recruited from a tertiary pediatric clinic. Anthropometric data (BMI, waist circumference, NC) and fasting blood samples (glucose, insulin, HDL cholesterol, triglycerides) were collected. MetS was diagnosed using IDF criteria and an expanded definition including hyperinsulinemia or elevated HOMA-IR. The Pediatric siMS (PsiMS) score quantified metabolic risk. Results NC was significantly greater in the obesity group than in controls (mean ± SD: 37.95 ± 3.03 cm vs. 31.86 ± 3.30 cm, p < .001). MetS prevalence was 14.6% by IDF criteria, rising to 43.8% with expanded criteria. In adolescents with obesity, NC positively correlated with fasting insulin, HOMA-IR, triglycerides, systolic blood pressure, and PsiMS score ( p < .05 for all). NC was also associated with the total number of MetS criteria met under both diagnostic approaches. Conclusions NC is a reliable, non-invasive marker correlated with key metabolic risk factors in adolescents with obesity. Its routine use could aid early detection of metabolic risk, particularly in resource-limited settings. Longitudinal research is needed to define NC thresholds and its predictive value for long-term outcomes.
Mehmet Cengiz (Wed,) studied this question.