Sexual Dimorphism in the Association Between Neck Circumference and Handgrip Strength: A Population-Based Cross-sectional Study
Abstract
Background: Handgrip strength (HGS) is a well-validated proxy of overall muscle strength and nutritional status. Neck circumference (NC), an accessible and minimally invasive anthropometric measure, has emerged as a potential surrogate marker of upper-body composition. This study evaluated the predictive validity of NC for HGS in a mixed-sex population. Methods: This cross-sectional analysis included 450 participants (208 males, 242 females) aged 15-65 years. Anthropometric measurements included NC, HGS, height, weight, body mass index (BMI), and arm circumference. Bivariate associations were assessed using Pearson correlations, and multiple linear regression models were constructed to determine the independent contribution of NC to HGS, controlling for age, sex, BMI, height, and arm circumference. Sex-stratified analyses were conducted to examine differential effects. Results: Mean NC was 33.55 cm in males and 33.07 cm in females (P = .097). Handgrip strength was significantly higher in males (28.58 kg) than females (26.24 kg; P < .001). Overall, NC demonstrated a modest but significant correlation with HGS (r = 0.222, P < .001), though sex-stratified analyses revealed marked divergence: males showed a moderate correlation (r = 0.311, P < .001) while females showed none (r = 0.103, P = .109). In the fully adjusted model, NC independently predicted HGS (β = 0.372, 95% CI: 0.155 to 0.590, P = .001), contributing 2.26% unique variance. Sex-stratified regression confirmed NC as a significant predictor in males (β = 0.532, P < .001) but not females (β = 0.076, P = .643). Conclusion: Neck circumference independently predicts HGS in males but not females, suggesting sexspecific patterns in upper-body anthropometry and muscular function. Neck circumference may serve as a useful screening tool for muscle strength in male populations, particularly in resource-limited settings. Cite this article as: Adefisan IE, Oretan IG. Sexual dimorphism in the association between neck circumference and handgrip strength: apopulation-based cross-sectional study. Eurasian J Med. 2026, 58(4), 1507, doi: 10.5152/eurasianjmed.2026.261507