_______________________________________________________________________________________________________________________________ Open Access Maced J Med Sci. 2016 Sep 15; 4(3):319-323. 319 ID Design 2012/DOOEL Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2016 Sep 15; 4(3):319-323. http://dx.doi.org/10.3889/oamjms.2016.072 eISSN: 1857-9655 Basic Science Neck Circumference in Overweight/Obese Subjects who Visited the Binjai Supermall in Indonesia Dharma Lindarto * , Shierly, Santi Syafril Department of Internal Medicine, Faculty of Medicine, North Sumatra University - H. Adam Malik Hospital, Jalan Bunga Lau No 17, Medan 20136, Indonesia Citation: Lindarto D, Shierly, Syafril S. Neck Circumference in Overweight/Obese Subjects who Visited the Binjai Supermall in Indonesia. Open Access Maced J Med Sci. 2016 Sep 15; 4(3):319-323. http://dx.doi.org/10.3889/oamjms.2016.072 Keywords: obesity; neck circumference; cutoff point; overweight; BMI. *Correspondence: Dharma Lindarto. Department of Internal Medicine, Faculty of Medicine, North Sumatra University - H. Adam Malik Hospital, Jalan Bunga Lau No 17, Medan 20136, Indonesia. Phone +62811631514. E- mail: dharmalindarto22@gmail.com Received: 13-May-2016; Revised: 25-Jun-2016; Accepted: 26-Jun-2016; Online first: 16-Jul-2016 Copyright: © 2016 Dharma Lindarto, Shierly, Santi Syafril. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Competing Interests: The authors have declared that no competing interests exist. Abstract BACKGROUND: Neck circumference (NC) is a simple screening measure for identifying overweight and obesity, it reflects upper-body fat distribution and central obesity. AIM: To determine whether a single measure of NC might be used to identify overweight/obesity. MATERIAL AND METHODS: An observational, analytical, cross-sectional study was done. The subjects consisted of all consecutive subjects who visited Binjai Supermall (North Sumatera Province, Indonesia) between 23rd and 29th September 2015 and agreed to participate in the study. NC, weight, height, body mass index (BMI), and waist circumference (WC) were measured. Overweight and obesity were defined as BMIs of 23.0–24.9 and ≥ 25 kg/m 2 , respectively. RESULTS: In total, 1554 subjects participated. Of these, 1238 (79.7%) were overweight/obese. NC correlated significantly with weight, height, BMI, and WC. Receiver operating characteristic (ROC) analysis showed that for all men and women, the area under the curve of overweight/obesity for NC was 0.83 and 0.79, respectively. The best NC cutoff points for males and females that indicated overweight/obesity were ≥ 37 cm (sensitivity, 78.3% and specificity, 75.5%) and ≥ 33.5 cm (sensitivity, 76.6% and specificity, 66.7%), respectively. CONCLUSION: The NC cutoffs that were identified may be useful for screening for overweight/obesity and related co-morbidities. Introduction Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass [1]. Current estimates; in the US, are that 69% of adults are either overweight or obese, with approximately 35% being obese [2]. Obesity raises the risk of hypertension, dyslipidemia, type 2 diabetes mellitus (T2DM), coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and some cancers [3]. In developing countries, people with a high socioeconomic status are most likely to be obese. This may be due to their occupation, education level, physical activity, and tendency to smoke [4]. In 2013, the prevalence of obesity in North Sumatra Province, Indonesia was about 27%. This is markedly greater than the national prevalence of obesity (20%) [5]. When assessing obesity, various techniques are used. These include measuring BMI, the waist circumference (WC), waist/hip ratio, mid-upper arm circumference, subscapular/triceps ratio, and neck circumference (NC) [6]. NC is a particularly simple and rapidly obtained anthropometric measurement that can be used to screen for overweight/obese people because it reflects upper-body fat distribution and central obesity [7, 8]. The Framingham Heart Study showed that NC is an index of central obesity as it associates independently with visceral adiposity and body mass index (BMI). Moreover, NC associates independently with cardiometabolic risk factors (e.g., systolic and diastolic blood pressure) even after adjusting for visceral adiposity or BMI and WC [9]. Similarly, NC with metabolic syndrome correlated better among females than males. The cross - sectional study was conducted in a tertiary care hospital in South India, showed that men with NC >37