The Association Between Abdominal Sagittal Diameter And Cardio-metabolic Risk In Obese Women Undergoing Weight Loss

Abstract

Visceral adiposity has been reported to be related to an increased prevalence of the metabolic syndrome. Sagittal diameter may be a low-cost, safe method to assess central adiposity that may be related to metabolic disregulation. PURPOSE: To explore relationships between abdominal sagittal diameter and serum lipids that are known to be associated with cardio-metabolic risk. METHODS: 117 overweight and obese women took part in a 16 week behavioral weight loss intervention with a strong emphasis on increasing physical activity. Weight, sagittal diameter, and serum lipids were assessed at baseline and at week-16. Sagittal diameter was measured while participants were in the supine position, measured as the distance between the umbilicus and the small of the back. Measurements were taken to the nearest half centimeter using an aluminum sliding broad blade anthropometer. RESULTS: At baseline, participants averaged 45.7±9 yrs, 78.4±9 kg and BMI was 29.9±3 kg/m2. Weight was reduced significantly (p<.001) to 71.3±9 kg at week-16. Sagittal diameter averaged 23.3±2.5 cm at baseline and reduced significantly (p<.01) to 20.9±2.5 cm at week-16. At baseline, sagittal diameter was significantly (all p's <.01) related to triglycerides (.27), high-density lipoproteins (HDL) cholesterol (-.30), free-fatty acids (.27), and systolic blood pressure (.25). Changes in sagittal diameter over 16 weeks were also significantly (p<.01) associated with changes in low-density lipoproteins (LDL) cholesterol (.22) and free-fatty acids (.16). An ANCOVA was used to compare variables of interest adjusting for body weight whereby patients were collapsed into thirds of sagittal diameter. Patients with the lowest sagittal diameter had more favorable (p<.05) systolic blood pressure, triglycerides, HDL cholesterol, cholesterol:HDL ratio, fasting glucose, and fasting insulin than those in the highest group. CONCLUSIONS: Sagittal diameter may offer health care professionals a quick, safe, and low-cost method to estimate central adiposity, which has been shown to be linked to the metabolic syndrome.