Neck and Waist Circumference as Correlates of Coronary Artery Disease: A Case-Control Analysis in a South Asian Population

TL;DR

This study shows that neck and waist size are independent indicators of heart disease risk in South Asians, offering a simple way to assess cardiovascular health.

Contribution

The study demonstrates that neck and waist circumference are mutually independent and strong predictors of coronary artery disease in a South Asian population.

Findings

CAD cases had significantly higher neck and waist circumferences compared to controls.

Both NC and WC were independently associated with CAD in multivariate analysis.

NC and WC showed strong correlations with metabolic risk factors like blood pressure and cholesterol.

Abstract

Background: The anatomical distribution of body fat is a critical determinant of cardiovascular risk. Simple anthropometric measures like neck circumference (NC) and waist circumference (WC) serve as proxies for upper-body and central adiposity.

Objectives: This study aimed to determine if NC and WC are independently associated with coronary artery disease (CAD) in a South Asian Indian cohort.

Methods: We conducted a case-control study at a tertiary care hospital in Bengaluru, India, including 100 patients with established CAD and 100 controls. Detailed anthropometric, clinical, and biochemical data were collected. Pearson's correlation and multivariate logistic regression analyses were used to assess the association of NC and WC with CAD and its related risk factors.

Results: Cases with CAD had significantly higher mean NC and WC than controls (p<0.001). In correlation analysis, both NC and WC were significantly and positively correlated with systolic and diastolic blood pressure, low-density lipoprotein cholesterol, and triglycerides, and negatively correlated with high-density lipoprotein cholesterol (p<0.001 for all). In a multivariate logistic regression model that included both anthropometric measures simultaneously to adjust for each other's effects, a 1-SD increase in NC (adjusted OR (aOR): 1.78; 95%CI: 1.32-2.30; p<0.001) and a 1-SD increase in WC (aOR: 2.15; 95%CI: 1.56-2.90; p<0.001) remained strong and mutually independent factors associated with CAD.

Conclusion: In this South Asian population, NC and WC are simple, inexpensive, and powerful correlates of CAD and its associated metabolic risk factors. Their mutual independence in statistical models suggests they represent distinct aspects of pathogenic adiposity, and their routine measurement can enhance cardiovascular risk assessment.

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