Abstract
BackgroundSagittal abdominal diameter (SAD) is an anthropometric index associated with visceral adiposity. It remains unclear whether SAD and its socio-economic correlates differ in women and men, which limits the epidemiological and clinical applications of the SAD measurement. The aims of this study are to examine the sex differences in SAD and its socio-economic correlates.MethodsA complex stratified multistage clustered sampling design was used to select 6975 men and 7079 women aged 18 years or more from the National Health Nutrition and Examination Survey 2011–2016, representative of the US civilian non-institutionalized population. SAD was measured in accordance to the standard protocols using a two-arm abdominal caliper. The sex differences in SAD and its socio-economic correlates were evaluated by performing weighted independent t tests and weighted multiple regression.ResultsSAD was lower in women than in men in the entire sample, as well as in all the subgroups characterized by age, race, birth place, household income, and body mass index except for non-Hispanic blacks and those with household income < $20,000. Adjusted for other characteristics, age, birth place, household income, and body mass index were associated with SAD in both women and men. Black women were associated with higher SAD then white women (p < .0001), and Hispanic and Asian men were associated with lower SAD than white men (both p < .01). Women born in other countries were more likely to have lower SAD than women born in the US (p < .0001), and so were men (p = .0118). Both women and men with a household income of <$75,000 had higher SAD than those with an income of over $75,000. The associations of age, race, and household income with SAD differed in women and men.ConclusionSAD is lower in women than in men, in the general population as well as in the most socio-economic subgroups. While socio-economic correlates of SAD are similar in women and men, the associations of age, race, and household income with SAD vary across sex.
Highlights
Sagittal abdominal diameter (SAD) is an anthropometric index associated with visceral adiposity
Analysis of sex difference in SAD by characteristics shows that compared to men, women had lower SAD for all subgroups defined by age, race/ethnicity, education, birth place, household income, and body mass index (BMI) except for non-Hispanic blacks and those with household income less than $20,000 in which men and women have comparable SAD
Stratification analysis by sex shows that adjusted for other characteristics, age, birth place, household income, and body mass index were associated with SAD in both women and men (Table 3)
Summary
Sagittal abdominal diameter (SAD) is an anthropometric index associated with visceral adiposity It remains unclear whether SAD and its socio-economic correlates differ in women and men, which limits the epidemiological and clinical applications of the SAD measurement. Sagittal abdominal diameter (SAD) is a simple inexpensive anthropometric measure of visceral adiposity [3], and in some studies, has been shown more useful than other anthropometric measurements, including WC and body mass index (BMI), in assessing health risk [4, 5]. Women are reported to have lower intra-abdominal/ visceral adiposity than men while the difference is diminished and not consistently seen in the elderly [10,11,12] It remains relatively unknown whether SAD, as a manifest measure of visceral adiposity, differs by sex in the general population and in the subgroups defined by socio-economic characteristics. Identification of the sex difference in SAD is crucial for better understanding heath disparities in cardiometabolic outcomes among men and women and improving health care for both sexes
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