https://www.ncbi.nlm.nih.gov/pubmed/31846425 NAFLD

J Pediatr Endocrinol Metab. 2019 Dec 16. pii: /j/jpem.ahead-of-print/jpem-2019-0204/jpem-2019-0204.xml. doi: 10.1515/jpem-2019-0204. [Epub ahead of print]

Association between neck circumference and non-alcoholic fatty liver disease in Mexican children and adolescents with obesity.

Peña-Vélez R1,2, Garibay-Nieto N1,2,3, Cal-Y-Mayor-Villalobos M4, Laresgoiti-Servitje E5, Pedraza-Escudero K1,2, García-Blanco MDC4, Heredia-Nieto OA6, Villanueva-Ortega E1,2.

Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic hepatic disorder in the pediatric population and has grown along with the obesity pandemic in which we live today. Adipose tissue storage in the upper body segment has been positively correlated with visceral adiposity and metabolic disease, which suggests that neck circumference could represent an easily accessible and replicable anthropometric measurement to identify patients with a higher risk of developing NAFLD. The main purpose of this study is to determine if there is an association between neck circumference and NAFLD. The secondary objectives are to establish cutoff values based on gender and puberty staging. Methods We included a sample pediatric population of 112 patients diagnosed with obesity aged between 6 and 18 years. We performed anthropometric and metabolic measurements on every patient, and NAFLD diagnosis was determined with hepatic ultrasound. Results The neck circumference was larger in NAFLD pediatric patients compared to those without NAFLD (p = 0.001). In a multivariate analysis, the neck circumference was associated with NAFLD as an independent risk factor (odds ratio [OR] = 1.172; 95% CI = 1.008-1.362; p = 0.038). Tanner 2-3 = 35 cm and Tanner 4-5 = 38 cm were established as risk cutoff values to develop NAFLD in the male adolescent population. Conclusions There is an association between the neck circumference and NAFLD in pediatric patients with obesity, particularly in the male population.