Objectives. The study aims to determine the cut off level of neck circumference that would correlate with abdominal obesity, using waist circumference as the gold standard; and determine its relationship with metabolic syndrome among high risk filipino patients. Methods. A total of 425 high risk Filipino patients who sought consult at Makati Medical Center from the period of March to October 2010 were qualified to participate in the study. Pertinent history, including blood pressure measurement

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... and anthropometric measurements such as height, weight, neck circumference and waist circumference were recorded; after an 8 hour overnight fast, blood samples were sent for fasting plasma glucose, HDL cholesterol and triglyceride levels. Results. Neck circumference cut off levels of ≥ 40cm for males and ≥ 33.8cm for females showed a low sensitivity and moderately high specificity for determining patients with abdominal obesity; 62.07% and 90.09% for males, 67.59% and 85.56% for females, respectively. In terms of determining patients with metabolic syndrome, it has a low sensitivity and specificity. However, obese by neck circumference cut off levels showed significant association (p value <0.001) with the component risk factors of metabolic syndrome, except for hypertriglyceridemia. Likewise, neck circumference also showed a strong positive linear relationship with waist circumference. Conclusion. Neck circumference showed a strong correlation with abdominal obesity, as well as with the component risk factors of metabolic syndrome, and therefore with risk of cardiovascular disease. Above the NC cut off levels, its predictive value for abdominal obesity is high; however, it has a poor ability to detect patients with abdominal obesity in the general population and therefore, cannot be used as a screening test.