ArticleEuropean journal of pediatrics2026
Neck circumference percentiles for obesity screening in Turkish children and adolescents: a cross-sectional study.
Article in European journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study aimed to establish neck circumference (NC) percentile values using the Lambda-Mu-Sigma (LMS) method among Turkish children and adolescents, to examine the relationship between NC and body mass index (BMI), and to identify optimal NC cut-off values for classifying IOTF-obesity and IOTF-overweight + obesity. This cross-sectional study included 4557 participants (2130 boys and 2427 girls) aged 6-18 years from Afyonkarahisar, Türkiye. Standard anthropometric measurements, including NC and BMI, were obtained. Age- and sex-specific smoothed NC percentile curves were generated using the LMS method. Age-adjusted partial correlation analysis was performed separately for boys and girls to examine the NC-BMI relationship. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal NC cut-off values for classifying IOTF-obesity and IOTF-overweight + obesity. A strong positive correlation was observed between NC and BMI in boys (r = 0.69, 95% CI 0.66-0.72; p < 0.001) and girls (r = 0.64, 95% CI 0.61-0.67; p < 0.001). NC values increased with age and exhibited significant sexual dimorphism, particularly during puberty. Age-stratified NC cut-off values for identifying obesity (IOTF-obesity) and overweight/obesity (IOTF-overweight + obesity) were determined for three age groups (< 10, 10-14, and 15-18 years) in boys and girls. AUC values ranged from 0.78 to 0.93, indicating acceptable to excellent discriminatory ability. Conclusion: This study provides age- and sex-specific NC reference values for Turkish children and adolescents. NC is a practical, reliable, and noninvasive anthropometric measure for obesity screening. The identified cut-off values might be useful in clinical and school-based settings for identifying children at risk of obesity. What is Known: • NC is a simple anthropometric measure associated with obesity and cardiometabolic risk in children and adolescents. • Population-specific percentile references are required because anthropometric indicators vary by ethnicity and region. What is New: • This study provides updated age- and sex-specific NC percentile reference values based on a large school-based sample from central Afyonkarahisar, Türkiye. • New NC cut-off values with acceptable to excellent discriminatory accuracy for obesity screening are proposed for clinical and school-based use.
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