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Du MF, Zhang X, Hu GL, Mu JJ, Chu C, Liao YY, Chen C, Wang D, Ma Q, Yan Y, Jia H, Wang KK, Sun Y, Niu ZJ, Man ZY, Wang L, Zhang XY, Luo WJ, Gao WH, Li H, Wu GJ, Gao K, Zhang J, Wang Y. Associations of lipid accumulation product, visceral adiposity index, and triglyceride-glucose index with subclinical organ damage in healthy Chinese adults. Front Endocrinol (Lausanne) 2023; 14:1164592. [PMID: 37795361 PMCID: PMC10546403 DOI: 10.3389/fendo.2023.1164592] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/28/2023] [Indexed: 10/06/2023] Open
Abstract
Background and aims Obesity is an independent risk factor for cardiovascular disease development. Here, we aimed to examine and compare the predictive values of three novel obesity indices, lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose (TyG) index, for cardiovascular subclinical organ damage. Methods A total of 1,773 healthy individuals from the Hanzhong Adolescent Hypertension Study cohort were enrolled. Anthropometric, biochemical, urinary albumin-to-creatinine ratio (uACR), brachial-ankle pulse wave velocity (baPWV), and Cornell voltage-duration product data were collected. Furthermore, the potential risk factors for subclinical organ damage were investigated, with particular emphasis on examining the predictive value of the LAP, VAI, and TyG index for detecting subclinical organ damage. Results LAP, VAI, and TyG index exhibited a significant positive association with baPWV and uACR. However, only LAP and VAI were found to have a positive correlation with Cornell product. While the three indices did not show an association with electrocardiographic left ventricular hypertrophy, higher values of LAP and TyG index were significantly associated with an increased risk of arterial stiffness and albuminuria. Furthermore, after dividing the population into quartiles, the fourth quartiles of LAP and TyG index showed a significant association with arterial stiffness and albuminuria when compared with the first quartiles, in both unadjusted and fully adjusted models. Additionally, the concordance index (C-index) values for LAP, VAI, and TyG index were reasonably high for arterial stiffness (0.856, 0.856, and 0.857, respectively) and albuminuria (0.739, 0.737, and 0.746, respectively). Lastly, the analyses of continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) demonstrated that the TyG index exhibited significantly higher predictive values for arterial stiffness and albuminuria compared with LAP and VAI. Conclusion LAP, VAI, and, especially, TyG index demonstrated utility in screening cardiovascular subclinical organ damage among Chinese adults in this community-based sample. These indices have the potential to function as markers for early detection of cardiovascular disease in otherwise healthy individuals.
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Affiliation(s)
- Ming-Fei Du
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xi Zhang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Gui-Lin Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jian-Jun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yue-Yuan Liao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Chen Chen
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Dan Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qiong Ma
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Hao Jia
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ke-Ke Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yue Sun
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ze-Jiaxin Niu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zi-Yue Man
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Lan Wang
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, China
| | - Xiao-Yu Zhang
- Department of Cardiology, Northwest Women’s and Children’s Hospital of Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Wen-Jing Luo
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wei-Hua Gao
- Department of Cardiology, Xi’an No.1 Hospital, Xi’an, China
| | - Hao Li
- Department of Critical Care Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Guan-Ji Wu
- Department of Cardiology, Xi’an Central Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ke Gao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jie Zhang
- Department of Cardiology, Xi’an People’s Hospital, Xi’an, China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Oliveira RFD, Daniele TMDC, Façanha CFS, Forti ACE, Bruin PFCD, Bruin VMSD. Adiponectin levels and sleep deprivation in patients with endocrine metabolic disorders. ACTA ACUST UNITED AC 2018; 64:1122-1128. [PMID: 30569989 DOI: 10.1590/1806-9282.64.12.1122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/27/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sleep abnormalities are frequent in patients with endocrine metabolic disorders (EMD) such as arterial hypertension, diabetes and obesity. Adiponectin is a peptide largely secreted by adipocytes and has various properties e.g. anti-inflammatory, antioxidant, antiatherogenic, pro-angiogenic, vasoprotective and insulin-sensitizing. Adiponectin inversely relates to body weight and when its concentration decreases, the resistin concentration increases resulting in greater insulin resistance. OBJECTIVE The objective of this study is to examine factors influencing adiponectin levels in a population with EMD. METHODS This was a cross-sectional evaluation of 332 patients (18 to 80y) presenting arterial hypertension, pre-diabetes, diabetes, and/or obesity. Investigation included clinical evaluation of comorbidities, general blood tests and adiponectin measures (ELISA). Chronic sleep deprivation was determined if habitual sleep was <6 hours >4 days/week. RESULTS Arterial hypertension (78.5%), type-2 diabetes (82.3%), and overweight (45.0%)/obesity (38.8%) were frequent. Patients with type-2 diabetes tended to have more chronic sleep deprivation (p=0.05). Adiponectin levels increased with age and were inversely correlated with sagittal abdominal diameter (p=0.04) and fasting insulin (p=0.001). Chronic sleep deprivation was associated with higher adiponectin concentration [OR=1.34; CI=1.13-1.58; p<0.005] and this was maintained after adjustment for gender, age, body mass index, menopause, arterial hypertension, American Diabetes Association classification and physical exercise levels [OR=1.38; 0=1.14-1.66: p=0.001]. CONCLUSION In patients with EMD, adiponectin is influenced not only by obesity but also by age and sleep deprivation. The latter finding may be explained by a compensatory effect or a counter regulation to minimize the harmful effects of sleep deprivation.
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Affiliation(s)
- Roseane Feitosa de Oliveira
- School of Medicine, Universidade Federal do Ceará (UFC). Postgraduate Program in Medical Sciences, UFC, Fortaleza, CE, Brasil
| | - Thiago Medeiros da Costa Daniele
- School of Medicine, Universidade Federal do Ceará (UFC). Postgraduate Program in Medical Sciences, UFC, Fortaleza, CE, Brasil.,Sleep Lab and Biological Rhythms, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brasil
| | - Cristina Figueiredo Sampaio Façanha
- School of Medicine, Universidade Federal do Ceará (UFC). Postgraduate Program in Medical Sciences, UFC, Fortaleza, CE, Brasil.,Sleep Lab and Biological Rhythms, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brasil
| | - Adriana Costa E Forti
- School of Medicine, Universidade Federal do Ceará (UFC). Postgraduate Program in Medical Sciences, UFC, Fortaleza, CE, Brasil
| | - Pedro Felipe Carvalhedo de Bruin
- School of Medicine, Universidade Federal do Ceará (UFC). Postgraduate Program in Medical Sciences, UFC, Fortaleza, CE, Brasil.,Sleep Lab and Biological Rhythms, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brasil
| | - Veralice Meireles Sales de Bruin
- School of Medicine, Universidade Federal do Ceará (UFC). Postgraduate Program in Medical Sciences, UFC, Fortaleza, CE, Brasil.,Sleep Lab and Biological Rhythms, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brasil
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Rao G, Powell-Wiley TM, Ancheta I, Hairston K, Kirley K, Lear SA, North KE, Palaniappan L, Rosal MC. Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations: A Scientific Statement From the American Heart Association. Circulation 2015; 132:457-72. [PMID: 26149446 DOI: 10.1161/cir.0000000000000223] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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4
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Bal Z, Uyar ME, Tutal E, Guliyev O, Colak T, Sezer S, Haberal M. Sagittal abdominal diameter as an anthropometric measure of cardiovascular and graft loss risk in renal transplant recipients. Transplant Proc 2015; 47:1162-4. [PMID: 26036544 DOI: 10.1016/j.transproceed.2015.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/29/2014] [Accepted: 01/28/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sagittal abdominal diameter (SAD) has been presented as a stronger prognostic factor for all-cause and cardiovascular mortality in the general population. The aim of this study was to evaluate the relationship between SAD and its associated parameters in renal transplant recipients. METHODS One hundred eighty-one renal transplant recipients were enrolled in the study. All patients were evaluated according to standard clinical and biochemical parameters. Anthropometric measurements were performed for all patients. Pulse-wave velocity (PWV) was determined from pressure tracing over carotid and femoral arteries with the use of the Sphygmocor system. RESULTS Patients were divided into 2 groups according to SAD measurements. Group 1 (n = 127) was defined as SAD <24.3 cm, and group 2 (n = 54) was defined as SAD ≥ 24.3 cm. Patients in group 2 had significantly higher triglycerides, C-reactive protein (CRP), uric acid, systolic blood pressure, PWV, and body mass index measurements compared with group 1 (P < .05 for all). In group 2, estimated glomerular filtration rate (eGFR) was significantly lower than group 1 (P = .022). SAD had positive correlation with PWV, systolic and diastolic blood pressure, body mass index, triglycerides, fasting glucose, CRP, and uric acid (P < .05 for all). On stepwise linear regression analyses, proteinuria (P = .005), SAD (P = .001), and CRP (P = .015) independently predicted the degree of percentage change of eGFR. CONCLUSIONS Considering the significant association of visceral fat with inflammation and cardiovascular disease, estimating visceral fat by means of SAD could be a useful tool to stratify cardiovascular risk as well as graft function in renal transplant recipients.
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Affiliation(s)
- Z Bal
- Department of Nephrology, Baskent University Medical School, Ankara, Turkey.
| | - M E Uyar
- Department of Nephrology, Baskent University Medical School, Ankara, Turkey
| | - E Tutal
- Department of Nephrology, Baskent University Medical School, Ankara, Turkey
| | - O Guliyev
- Department of Nephrology, Baskent University Medical School, Ankara, Turkey
| | - T Colak
- Department of Nephrology, Baskent University Medical School, Ankara, Turkey
| | - S Sezer
- Department of Nephrology, Baskent University Medical School, Ankara, Turkey
| | - M Haberal
- Department of General Surgery, Baskent University Medical School, Ankara, Turkey
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5
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Kahn HS, Gu Q, Bullard KM, Freedman DS, Ahluwalia N, Ogden CL. Population distribution of the sagittal abdominal diameter (SAD) from a representative sample of US adults: comparison of SAD, waist circumference and body mass index for identifying dysglycemia. PLoS One 2014; 9:e108707. [PMID: 25272003 PMCID: PMC4182731 DOI: 10.1371/journal.pone.0108707] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 08/26/2014] [Indexed: 01/14/2023] Open
Abstract
Background The sagittal abdominal diameter (SAD) measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD’s distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, provide the first, national estimates of the SAD distribution among US adults, and test associations of SAD and other adiposity indicators with prevalent dysglycemia. Methods and Findings In the 2011–2012 National Health and Nutrition Examination Survey, supine SAD was measured (“abdominal height”) between arms of a sliding-beam caliper at the level of the iliac crests. From 4817 non-pregnant adults (age ≥20; response rate 88%) we used sample weights to estimate SAD’s population distribution by sex and age groups. SAD’s population mean was 22.5 cm [95% confidence interval 22.2–22.8]; median was 21.9 cm [21.6–22.4]. The mean and median values of SAD were greater for men than women. For the subpopulation without diagnosed diabetes, we compared the abilities of SAD, waist circumference (WC), and body mass index (BMI, kg/m2) to identify prevalent dysglycemia (HbA1c ≥5.7%). For age-adjusted, logistic-regression models in which sex-specific quartiles of SAD were considered simultaneously with quartiles of either WC or BMI, only SAD quartiles 3 (p<0.05 vs quartile 1) and 4 (p<0.001 vs quartile 1) remained associated with increased dysglycemia. Based on continuous adiposity indicators, analyses of the area under the receiver operating characteristic curve (AUC) indicated that the dysglycemia model fit for SAD (age-adjusted) was 0.734 for men (greater than the AUC for WC, p<0.001) and 0.764 for women (greater than the AUC for WC or BMI, p<0.001). Conclusions Measured inexpensively by bedside caliper, SAD was associated with dysglycemia independently of WC or BMI. Standardized SAD measurements may enhance assessment of dysfunctional adiposity.
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Affiliation(s)
- Henry S. Kahn
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Qiuping Gu
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, United States of America
| | - Kai McKeever Bullard
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - David S. Freedman
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Namanjeet Ahluwalia
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, United States of America
| | - Cynthia L. Ogden
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, United States of America
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Koren D, Marcus CL, Kim C, Gallagher PR, Schwab R, Bradford RM, Zemel BS. Anthropometric predictors of visceral adiposity in normal-weight and obese adolescents. Pediatr Diabetes 2013; 14:575-84. [PMID: 23710887 PMCID: PMC4565510 DOI: 10.1111/pedi.12042] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 03/11/2013] [Accepted: 03/26/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Obesity and fat distribution patterns [subcutaneous vs. visceral adipose tissue (VAT)] are important predictors of future cardiometabolic risk. As accurate VAT measurement entails imaging, surrogate anthropometric measurements that would be cheaper and quicker to obtain would be highly desirable. Sagittal abdominal diameter (SAD) may be better than other VAT surrogate measures in adults, but the value of SAD to predict magnetic resonance imaging (MRI)-determined VAT in adolescents of different races, sexes, and pubertal stages has not been determined. AIM To test the hypothesis that SAD correlates more strongly with volumetric VAT than other anthropometric measurements, independent of age, sex, race, and Tanner stage. SUBJECTS AND METHODS Twenty-eight normal-weight and 44 obese adolescents underwent Tanner staging, anthropometric examinations, and abdominal MRI for volumetric partitioned fat calculation. RESULTS VAT increased exponentially in the body mass index (BMI) > 97th percentile range. SAD, waist circumference (WC), BMI, and BMI Z-score correlated strongly with VAT (correlation coefficients of 0.85-0.86, all p-values < 0.0005); waist-hip ratio was less predictive of VAT (r = 0.68, p < 0.0005). On hierarchical regression, the strongest predictors of VAT in obese subjects were BMI Z-score and SAD (R(2) = 0.34 vs. 0.31, respectively, p < 0.0005); in normal-weight subjects, most anthropometric measures predicted VAT equally (R(2) = 0.16-0.18, p-values = 0.018-0.026). CONCLUSIONS Unlike adults, in obese adolescents, SAD is not the strongest predictor of visceral adiposity. BMI Z-score is equivalently predictive and, together with BMI, provides sufficient information to assess visceral adiposity; more specialized anthropometric measurements (e.g., SAD and WC) do not add additional predictive value.
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Affiliation(s)
- Dorit Koren
- Pediatrics – Section of Adult and Pediatric Endocrinology Diabetes, and Metabolism, The University of Chicago, Chicago, IL 60637, USA
| | - Carole L Marcus
- Pediatrics – Sleep Center, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christopher Kim
- Research – Center for Sleep & Respiratory Neurobiology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA
| | - Paul R Gallagher
- Biostatistics Core, Clinical and Translational Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Richard Schwab
- Medicine – Division of Pulmonology, Allergy and Critical Care Medicine, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA
| | - Ruth M Bradford
- Pediatrics – Sleep Center, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Babette S Zemel
- Pediatrics – Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
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Flodmark CE, Shen W, Punyanitya M, Leander P, Lanke J, Pietrobelli A. Laser beam measurement of abdominal sagittal diameter in obese children: a validation study. Pediatr Obes 2013; 8:112-7. [PMID: 23002010 PMCID: PMC4494674 DOI: 10.1111/j.2047-6310.2012.00095.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Revised: 07/05/2012] [Accepted: 07/17/2012] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Sagittal diameter (SAD) has been reported to correlate to visceral fat and cardiovascular risk factors. SAD is measured with the individual lying down, halfway between the lower rib margin and the iliac crest; it represents the mid-height of the abdomen. The aim of this study was to validate SAD measured using a recently-developed laser beam device (SAD(LDB) ) against SAD measured using MRI (SAD(MRI)). METHODS Of 48 obese children (25 boys, 23 girls) aged 9-11 years on the waiting list for obesity treatment, 34 agreed to a baseline measurement, which was followed by repeated measurements 6 and 12 months later in 31 and 22 children respectively. MRI was used to examine SAD(MRI) at 5 cm above (SAD(MRI,cra) ) and below (SAD(MRI,cau)) the mid plane of the L4-5 intervertebral disc. RESULTS Each of the differences SAD(LBD) - SAD(MRI, cau) and SAD(LBD) - SAD(MRI,cra) was subjected to a repeated-measurements ANOVA; the visit did not have a statistically significant effect in either case (p = 0.19 and p = 0.72, respectively). The difference SAD(LBD) - SAD(MRI, cau) was 1.50 on average (p < 0.0001; CI 1.26-1.74) while the corresponding figure for SAD(LBD) -SAD(MRI, cra) was 1.26 (p < 0.0001; CI 1.04-1.49). Regression of the difference on the mean gave slopes of -0.09 (p = 0.25) and -0.04 (p = 0.57) respectively. Prediction of SAD(MRI) from SAD(LDB) can be performed in different ways: by means of linear regression or by means of an additive correction. CONCLUSIONS Thus, this laser device can be used instead of MRI to estimate SAD by using a simple correction.
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Affiliation(s)
- C.-E. Flodmark
- Childhood Obesity Unit, Childhood Centre Malmö, Skåne University Hospital, Malmö, Sweden
| | - W. Shen
- Obesity Nutrition Research Centre, St Luke’s–Roosevelt Hospital, New York City, New York, USA,Institute of Human Nutrition, Columbia University, New York, NY, USA
| | - M. Punyanitya
- Institute of Human Nutrition, Columbia University, New York, NY, USA
| | - P. Leander
- Department of Radiology Diagnostic Centre, Skåne University Hospital, Malmö, Sweden
| | - J. Lanke
- Department of Statistics, Lund University, Lund, Sweden
| | - A. Pietrobelli
- Pediatric Unit, Verona University Medical School, Verona, Italy,Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Pajunen P, Rissanen H, Laaksonen MA, Heliövaara M, Reunanen A, Knekt P. Sagittal abdominal diameter as a new predictor for incident diabetes. Diabetes Care 2013; 36:283-8. [PMID: 22961578 PMCID: PMC3554316 DOI: 10.2337/dc11-2451] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Obesity, particularly visceral adiposity, is a major risk factor for type 2 diabetes. The commonly used obesity indicators, BMI, waist girth, and waist-to-hip ratio (WHR), have limited ability to measure the visceral adipose tissue. Sagittal abdominal diameter (SAD) has been shown to predict the amount of visceral fat. So far no study has been published on its ability to predict diabetes occurrence. RESEARCH DESIGN AND METHODS We assessed and compared the prediction of the four obesity indicators for diabetes incidence in a prospective study based on 5,168 participants from the nationally representative Health 2000 study. RESULTS During a mean follow-up lasting 8.1 years, 222 incident diabetes cases occurred. In multivariate models adjusted for lifestyle factors, BMI, waist girth, WHR, and SAD were significant predictors of diabetes incidence. The relative risks (95% CI) between high and low levels were 15.0 (6.94-32.6), 11.4 (5.39-23.8), 12.5 (6.47-24.2), and 14.7 (6.89-31.2), respectively. Pairwise interaction analysis showed that the co-occurrence of high BMI and high SAD was associated with the highest diabetes incidence, with a relative risk of 37.0 (11.2-122). After adjustment for waist girth and the components of the metabolic syndrome, the relative risk was 9.88 (2.81-34.7). The corresponding population-attributable fraction estimate was 84% (49-95). CONCLUSIONS The combination of SAD and BMI measurements yields a new predictor of diabetes incidence.
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Affiliation(s)
- Pia Pajunen
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, Division of Welfare and Health Promotion, National Institute for Health and Welfare, Helsinki, Finland
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Marques-Lopes I. Diámetro abdominal sagital: un indicador de grasa visceral que se debe tener en cuenta en la práctica clínica. REVISTA ESPAÑOLA DE NUTRICIÓN HUMANA Y DIETÉTICA 2012. [DOI: 10.1016/s2173-1292(12)70085-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Diámetro abdominal sagital: aplicaciones en la práctica clínica. REVISTA ESPAÑOLA DE NUTRICIÓN HUMANA Y DIETÉTICA 2012. [DOI: 10.1016/s2173-1292(12)70088-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Al-Attas OS, Al-Daghri NM, Alokail MS, Alkharfy KM, Draz H, Yakout S, Sabico S, Chrousos G. Association of body mass index, sagittal abdominal diameter and waist-hip ratio with cardiometabolic risk factors and adipocytokines in Arab children and adolescents. BMC Pediatr 2012; 12:119. [PMID: 22871266 PMCID: PMC3470957 DOI: 10.1186/1471-2431-12-119] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 07/31/2012] [Indexed: 01/26/2023] Open
Abstract
Background Sagittal abdominal diameter (SAD) is a novel anthropometric measure hypothesized to be a surrogate measure of visceral abdominal obesity in adults. This study aims to determine whether SAD is superior to other anthropometric measures such as body mass index (BMI) and waist to hip ratio (WHR) in terms of association to cardiometabolic risk and circulating adipocytokine concentrations in a cohort of Saudi children and adolescents. Methods A total of 948 (495 boys and 453 girls) apparently healthy children with varying BMI, aged 10–17 years, were included in this cross sectional study. Fasting glucose, lipid profile, leptin, adiponectin, resistin, insulin, TNF-α and aPAI-1 were measured in serum and HOMA-IR was calculated. MetS components were defined according to the International Diabetes Federation (IDF) criteria. Results BMI was superior to SAD as well as WHR, and had the highest number of significant associations to MetS components and adipocytokines even after adjustment for age and gender, including blood pressure, lipids, glucose and leptin. Conclusion In conclusion, while SAD is significantly associated with components of MetS among children and adolescents, it is not superior to BMI. The use of SAD therefore may not be practical for use in the pediatric clinical setting. Follow-up studies are needed to determine whether SAD has clinical significance in terms of harder outcomes such as predicting diabetes mellitus or cardiovascular diseases.
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Affiliation(s)
- Omar S Al-Attas
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Measurement of waist circumference at different sites affects the detection of abdominal obesity and metabolic syndrome among psychiatric patients. Psychiatry Res 2012; 197:322-6. [PMID: 22370155 DOI: 10.1016/j.psychres.2011.09.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 06/27/2011] [Accepted: 09/17/2011] [Indexed: 11/23/2022]
Abstract
There is a lack of understanding about the impact of different waist circumference (WC) measurements on the detection of abdominal obesity and metabolic syndrome in psychiatric patients. This cross-sectional study included a total of 382 inpatients with schizophrenia-related disorders to assess each component of metabolic syndrome. WC was measured at the lowest rib, midpoint between the iliac crest and lowest rib, iliac crest, minimal waist, and umbilicus. Logistic regression analysis was performed to examine the ability of WC at each site to predict the presence of metabolic risk clustering. The mean WC values for all sites were significantly different from each other. The measurement site had an influence on the prevalence of abdominal obesity (30-38.2% in men and 53.9-86.3% in women). The influence on the prevalence of metabolic syndrome was greater with the International Diabetes Federation (IDF) criteria (19.3-23.9% in men and 29.4-43.1% in women) than with the Adult Treatment Panel III (ATP III) criteria (26.1-28.6% in men and 37.3-44.1% in women). The areas under the receiver operating characteristic curve for metabolic risk clustering were highest at the umbilicus and midpoint. Given that the WC measurement protocol has substantial influence on the prevalence of abdominal obesity and metabolic syndrome, a predefined measurement site is required for all psychiatric studies.
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Cornier MA, Després JP, Davis N, Grossniklaus DA, Klein S, Lamarche B, Lopez-Jimenez F, Rao G, St-Onge MP, Towfighi A, Poirier P. Assessing Adiposity. Circulation 2011; 124:1996-2019. [DOI: 10.1161/cir.0b013e318233bc6a] [Citation(s) in RCA: 578] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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