The Distance between the Lower Edge of the Xiphisternum and the Center of the Umbilicus as an Indicator of Abdominal Obesity and Cardiovascular Disease Risk

Abstract

Objective: Abdominal obesity is considered an independent risk factor for cardiovascular disease (CVD). Aim: To compare the distance between the lower edge of xiphisternum and the center of the umbilicus (XUD) with other anthropometric measurements in predicting risk factors for CVD. Methods: A random sample of 4,485 (males 1,772, females 2,713) nationally representative noninstitutionalized adults aged ≥18 years were included in the analysis. XUD, BMI, waist circumference (WC), waisttohip ratio (WHR), systolic and diastolic blood pressure were measured and fasting venous blood samples were collected to determine glucose, total cholesterol, lowdensity lipoprotein (LDL) cholesterol, highdensity lipoprotein cholesterol and triacylglyceride levels. Oral glucose tolerance test (OGTT) was also preformed. Results: The mean XUD (± SD) was 17.4 ± 3.2 cm and 17.0 ± 3.0 cm for males (M) and females (F) respectively (M vs. F; p < 0.001). XUD had significant correlations with the cardiovascular risk factors analyzed as continuous variables (p < 0.001), except LDL cholesterol for women. However, the strengths of associations were weak for all associations (<0.3). The correlations of BMI, WC and WHR with XUD were significant (p < 0.001). The area under the curve (AUC) in the receiver operating characteristic (ROC) curve analysis for XUD in predicting the presence of two or more CVD risk factors was 0.62 (95%CI 0.61– 0.64); the corresponding AUC values for BMI (0.71, 95% CI 0.69–0.72), WC (0.71 95% CI, 0.70–0.73), and WHR (0.67 95% CI, 0.65–0.68) were higher than that for XUD. Conclusion: The XUD showed significant correlations with the cardiovascular risk factors among Sriii Lankan adults. However, in predicting CVD risk XUD was inferior to BMI, WC, and WHR.