Neck Circumference and the Heart: Unveiling a New Anthropometric Marker for LVH Risk in Type 2 Diabetes—The TESEO Study

Aim: Left ventricular hypertrophy (LVH) is highly prevalent among individuals with type 2 diabetes (T2DM) and is a predictor of adverse cardiovascular outcomes. Visceral and ectopic fat accumulation contributes to cardiometabolic risk. Neck circumference (NC) and the neck circumference-to-height index (NCI) have emerged as potential markers of ectopic adiposity, yet their association with LVH remains unexplored. The aim of this study was to evaluate the relationship between NC and NCI with the presence of LVH in a contemporary cohort of T2DM patients. Materials and Methods: T2DM patients were consecutively enroled in the TESEO study. Participants underwent comprehensive clinical, biochemical, bioimpedance and echocardiographic evaluations. Multivariable logistic regression models were used to examine the independent associations between NC/NCI and LVH, adjusting for age, sex, mean arterial blood pressure, HbA1c, triglycerides, estimated glomerular filtration rate, urinary albumin-to-creatinine ratio and treatments. Results: 29% of participants had LVH. NC and NCI were higher among individuals with LVH. After full adjustment, NC and NCI were independently associated with 26% and 57% higher odds of LVH, respectively. Stratified analyses revealed a stronger association in men (OR 1.65, 95% CI: 1.25–2.18) than in women (OR 1.49, 95% CI: 1.19–1.87). NC and NCI outperformed BMI and waist circumference in their association with LVH. ROC curve analyses confirmed that NCI has good discriminatory power for identifying individuals with and without LVH. Conclusions: NC and NCI are independently associated with LVH in T2DM patients and they may represent practical, non-invasive markers to enhance cardiovascular risk stratification in clinical settings.