1 Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.

3 Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex BN1 9PH, UK.

5 Chinese and Complementary Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.


Background: Metabolic syndrome (MetS) is complicated condition especially in pediatrics. For better MetS definition, marker discovery are interested. More accurate simple indices may be of value, such as neck circumference (NC). We investigated accuracy of NC for the diagnosis of MetS in adolescent girls.  
Materials and Methods: This cross-sectional study was conducted on schoolgirl who live in Mashhad and Sabzevar cities, Razavi Khorasan, Iran at 2018. The study sample comprised 988 girls with mean age 14.56 ±1.53 years old. The NC measured in site between mid-cervical spine and mid-anterior neck and enzymatic commercial kits measured biochemical analysis. The definitions of MetS included: IDF, NCEP-ATP III, and two modified NCEPs.
Results: Often subjects are non-smoker, menstruated, and reside in Mashhad. The age, living location, and dwelling type showed the very weak association with NC. NC was significantly associated with WC and elevated TG. The highest (r= 0.275 (P= 0.0001), and lowest (r= 0.155 (p < 0.001) association were between NC and the DeFerranti's and IDF definitions, respectively. The odd ratios (CI 95%) estimated for the different definitions were as follows: IDF: 1.41 (1.18- 1.69), NCEP: 1.54 (1.31- 1.79), Cook's: 1.68 (1.37- 2.07), and DeFerranti's: 1.59 (1.40- 1.80). ROC analysis showed that the specificity ranged between 78.57 – 100.00% and sensitivity ranged between 62.10 – 78.22% of NC for the different definitions of MetS definitions. A NC of >31 cm estimated as cutoff for all studied definitions except Cook's definition.
Conclusion: Besed on the results, NC should be considered as marker for central obesity and fat distribution in the diagnosis of MetS.