{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:27:54Z","timestamp":1793046474177,"version":"4.5.0"},"reference-count":30,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,12,4]],"date-time":"2022-12-04T00:00:00Z","timestamp":1670112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health Department of the Government of Navarra","award":["61\/2015"],"award-info":[{"award-number":["61\/2015"]}]},{"name":"Health Department of the Government of Navarra","award":["201630.10"],"award-info":[{"award-number":["201630.10"]}]},{"name":"Health Department of the Government of Navarra","award":["CB12\/03\/3002"],"award-info":[{"award-number":["CB12\/03\/3002"]}]},{"name":"Fundaci\u00f3 La Marat\u00f3 de TV3","award":["61\/2015"],"award-info":[{"award-number":["61\/2015"]}]},{"name":"Fundaci\u00f3 La Marat\u00f3 de TV3","award":["201630.10"],"award-info":[{"award-number":["201630.10"]}]},{"name":"Fundaci\u00f3 La Marat\u00f3 de TV3","award":["CB12\/03\/3002"],"award-info":[{"award-number":["CB12\/03\/3002"]}]},{"DOI":"10.13039\/501100012514","name":"CIBERobn","doi-asserted-by":"publisher","award":["61\/2015"],"award-info":[{"award-number":["61\/2015"]}],"id":[{"id":"10.13039\/501100012514","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012514","name":"CIBERobn","doi-asserted-by":"publisher","award":["201630.10"],"award-info":[{"award-number":["201630.10"]}],"id":[{"id":"10.13039\/501100012514","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012514","name":"CIBERobn","doi-asserted-by":"publisher","award":["CB12\/03\/3002"],"award-info":[{"award-number":["CB12\/03\/3002"]}],"id":[{"id":"10.13039\/501100012514","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Neck circumference (NC) and its relationship to height (NHtR) and weight (NWtR) appear to be good candidates for the non-invasive management of non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the ability of routine variables to assess and manage NAFLD in 98 obese subjects with NAFLD included in a 2-year nutritional intervention program. Different measurements were performed at baseline, 6, 12 and 24 months. The nutritional intervention significantly improved the anthropometric, metabolic and imaging variables. NC was significantly associated with the steatosis degree at baseline (r = 0.29), 6 m (r = 0.22), 12 m (r = 0.25), and 24 m (r = 0.39) (all p &lt; 0.05). NC was also significantly associated with visceral adipose tissue at all the study time-points (basal r = 0.78; 6 m r = 0.65; 12 m r = 0.71; 24 m r = 0.77; all p &lt; 0.05). NC and neck ratios combined with ALT levels and HOMA-IR showed a good prediction ability for hepatic fat content and hepatic steatosis (at all time-points) in a ROC analysis. The model improved when weight loss was included in the panel (NC-ROC: 0.982 for steatosis degree). NC and ratios combined with ALT and HOMA-IR showed a good prediction ability for hepatic fat during the intervention. Thus, their application in clinical practice could improve the prevention and management of NAFLD.<\/jats:p>","DOI":"10.3390\/nu14235160","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T04:40:09Z","timestamp":1670215209000},"page":"5160","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Neck Circumference for NAFLD Assessment during a 2-Year Nutritional Intervention: The FLiO Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1580-3629","authenticated-orcid":false,"given":"Mariana","family":"Elorz","sequence":"first","affiliation":[{"name":"Department of Radiology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"},{"name":"Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Benito-Boilos","sequence":"additional","affiliation":[{"name":"Department of Radiology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"},{"name":"Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertha Araceli","family":"Marin","sequence":"additional","affiliation":[{"name":"Centre for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0479-8825","authenticated-orcid":false,"given":"Nuria","family":"P\u00e9rez D\u00edaz del Campo","sequence":"additional","affiliation":[{"name":"Centre for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Ignacio","family":"Herrero","sequence":"additional","affiliation":[{"name":"Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain"},{"name":"Liver Unit, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"},{"name":"Biomedical Research Centre Network in Hepatic and Digestive Diseases (CIBERehd), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Ignacio","family":"Monreal","sequence":"additional","affiliation":[{"name":"Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain"},{"name":"Clinical Chemistry Department, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep A.","family":"Tur","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122 Palma, Spain"},{"name":"Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Alfredo","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Centre for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3926-0892","authenticated-orcid":false,"given":"Maria Angeles","family":"Zulet","sequence":"additional","affiliation":[{"name":"Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain"},{"name":"Centre for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain"},{"name":"Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6475-5387","authenticated-orcid":false,"given":"Itziar","family":"Abete","sequence":"additional","affiliation":[{"name":"Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain"},{"name":"Centre for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain"},{"name":"Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,4]]},"reference":[{"key":"ref_1","first-page":"37","article-title":"Diagn\u00f3stico de esteatosis hep\u00e1tica por m\u00e9todos cl\u00ednicos, bioqu\u00edmicos y por im\u00e1genes","volume":"54","author":"Graffigna","year":"2017","journal-title":"Rev. Argent. Endocrinol. Metab."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.fmc.2017.03.001","article-title":"Esteatosis hep\u00e1tica: Diagn\u00f3stico y seguimiento","volume":"24","author":"Rovira","year":"2017","journal-title":"FMC Form. M\u00e9dica Contin En Atenci\u00f3n Primaria"},{"key":"ref_3","first-page":"29","article-title":"A 2012 clinical update for internists in adult nonalcoholic fatty liver disease","volume":"54","author":"Younossi","year":"2012","journal-title":"Panminerva Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Martinou, E., Pericleous, M., Stefanova, I., Kaur, V., and Angelidi, A.M. (2022). Diagnostic Modalities of Non-Alcoholic Fatty Liver Disease: From Biochemical Biomarkers to Multi-Omics Non-Invasive Approaches. Diagnostics, 12.","DOI":"10.3390\/diagnostics12020407"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1056\/NEJM200102153440706","article-title":"Liver biopsy","volume":"344","author":"Bravo","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_6","first-page":"508","article-title":"Non-invasive biomarkers in predicting non-alcoholic steatohepatitis and assessing liver fibrosis: Systematic review and meta-analysis","volume":"63","author":"Ismaiel","year":"2020","journal-title":"Panminerva Med."},{"key":"ref_7","first-page":"41","article-title":"The metabolic syndrome and nonalcoholic fatty liver disease","volume":"48","author":"Collantes","year":"2006","journal-title":"Panminerva Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1097\/RCT.0b013e318199d883","article-title":"Liver steatosis quantification using magnetic resonance imaging: A prospective comparative study with liver biopsy","volume":"33","author":"Mennesson","year":"2009","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"530","DOI":"10.4254\/wjh.v10.i8.530","article-title":"Current status of imaging in nonalcoholic fatty liver disease","volume":"10","author":"Li","year":"2018","journal-title":"World J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12986-015-0060-z","article-title":"Neck circumference as an independent indicator of non-alcoholic fatty liver disease in non-obese men","volume":"12","author":"Li","year":"2015","journal-title":"Nutr. Metab."},{"key":"ref_11","first-page":"7982107","article-title":"Neck Circumference is an Effective Supplement for Nonalcoholic Fatty Liver Disease Screening in a Community-Based Population","volume":"2020","author":"Jian","year":"2020","journal-title":"Int. J. Endrocrin."},{"key":"ref_12","first-page":"1532","article-title":"Effects of two personalized dietary strategies during a 2-year intervention in subjects with nonalcoholic fatty liver disease: A randomized trial","volume":"7","author":"Cantero","year":"2021","journal-title":"Liver Int."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Marin-Alejandre, B.A., Abete, I., Cantero, I., Monreal, J.I., Elorz, M., Herrero, J.I., Benito-Boillos, A., Quiroga, J., Martinez-Echeverria, A., and Uriz-Otano, J.I. (2019). The metabolic and hepatic impact of two personalized dietary strategies in subjects with obesity and nonalcoholic fatty liver disease: The fatty liver in obesity (FLiO) randomized controlled trial. Nutrients, 11.","DOI":"10.3390\/nu11102543"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.2337\/diacare.27.6.1487","article-title":"Use and abuse of HOMA modelling","volume":"27","author":"Wallace","year":"2004","journal-title":"Diabetes Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1007\/s10620-016-4037-1","article-title":"Quantitative Imaging Biomarkers of NAFLD","volume":"61","author":"Kinner","year":"2016","journal-title":"Dig Dis. Sci."},{"key":"ref_16","first-page":"71","article-title":"Model Search by Bootstrap \u201cBumping\u201d","volume":"8","author":"Tibshirani","year":"1999","journal-title":"J. Comput. Graph. Stat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1590\/s0004-2803.201900000-06","article-title":"The correlation of neck circumference and insulin resistance in NAFLD patients","volume":"56","author":"Boemeke","year":"2019","journal-title":"Arq. Gastroenterol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Huang, B.-X., Zhu, M.-F., Wu, T., Zhou, J.-Y., Liu, Y., Chen, X.-L., Zhou, R.-F., Wang, L.-J., Chen, Y.-M., and Zhu, H.-L. (2015). Neck circumference, along with other anthropometric indices, has an independent and additional contribution in predicting fatty liver disease. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0118071"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1093\/pubmed\/fdab197","article-title":"Neck circumference and the burden of metabolic syndrome disease: A population-based sample","volume":"44","author":"Zanuncio","year":"2021","journal-title":"J. Public Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"163","DOI":"10.5152\/tjg.2018.18004","article-title":"Evaluation of neck circumference as an easy and reliable predictor for non-alcoholic fatty liver disease","volume":"30","author":"Salmanroghani","year":"2019","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.pcd.2021.02.002","article-title":"Neck circumference and metabolic syndrome: A cross-sectional population-based study","volume":"15","author":"Ebrahimi","year":"2021","journal-title":"Prim. Care Diabetes"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12986-021-00562-3","article-title":"Neck circumference as an independent predictor for NAFLD among postmenopausal women with normal body mass index","volume":"18","author":"Shi","year":"2021","journal-title":"Nutr. Metab."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.3748\/wjg.v25.i11.1307","article-title":"Noninvasive evaluation of nonalcoholic fatty liver disease: Current evidence and practice","volume":"25","author":"Zhou","year":"2019","journal-title":"World J. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3701","DOI":"10.1210\/jc.2009-1779","article-title":"Neck circumference as a novel measure of cardiometabolic risk: The Framingham heart study","volume":"95","author":"Preis","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e026253","DOI":"10.1136\/bmjopen-2018-026253","article-title":"Association between neck circumference and cardiometabolic disease in Chinese adults: A community-based cross-sectional study","volume":"9","author":"Fu","year":"2019","journal-title":"BMJ Open"},{"key":"ref_26","first-page":"21","article-title":"Elastograf\u00eda hep\u00e1tica cuantitativa en la valoraci\u00f3n de sujetos normales y con esteatosis hep\u00e1tica no alcoh\u00f3lica. Correlaci\u00f3n interobservador","volume":"12","year":"2013","journal-title":"Radiol. M\u00e9xico"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13098-019-0445-7","article-title":"Neck circumference in relation to glycemic parameters: A systematic review and meta-analysis of observational studies","volume":"11","author":"Saneei","year":"2019","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"18565","DOI":"10.1038\/srep18565","article-title":"Neck Circumference and Incidence of Diabetes Mellitus over 10 Years in the Korean Genome and Epidemiology Study (KoGES)","volume":"5","author":"Cho","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"321","DOI":"10.2174\/1573399813666170621123227","article-title":"Socioeconomic Status: The Missing Link Between Obesity and Diabetes Mellitus?","volume":"14","author":"Volaco","year":"2018","journal-title":"Curr. Diabetes Rev."},{"key":"ref_30","first-page":"60","article-title":"To evaluate the association of neck circumference with metabolic syndrome and cardiovascular risk factors","volume":"67","author":"Bochaliya","year":"2019","journal-title":"J. Assoc. Physicians India"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/23\/5160\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:33:47Z","timestamp":1760146427000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/23\/5160"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,4]]},"references-count":30,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["nu14235160"],"URL":"https:\/\/doi.org\/10.3390\/nu14235160","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202211.0028.v1","asserted-by":"object"}]},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,4]]}}}