Abdominal Height Research Articles

Opportunistic measurement of sagittal abdominal diameter with bone densitometry predicts death and cardiovascular events

Abstract Supine sagittal abdominal diameter (SAD), also known as abdominal height, has been proposed as a simple measure for assessing abdominal adiposity. We aimed to determine whether SAD from dual-energy X-ray absorptiometry (DXA) performed for osteoporosis assessment predicts major adverse cardiovascular events (MACE) using the population-based DXA registry for the Province of Manitoba, Canada. The study population comprised 72,974 individuals aged 40 years and older with baseline DXA assessment between February 1999 and March 2018. Incident MACE (composite of all-cause mortality, acute myocardial infarction [MI], non-hemorrhagic stroke) was ascertained from linked healthcare databases. During mean 8.4 years follow-up (611,862 person-years), 14,457 (18.8%) individuals experienced incident MACE. Risk stratification was greatest with SAD/weight ratio, with area under the curve (AUC) for MACE and its components ranging from 0.582 for acute MI to 0.620 for death (all p<0.001), all significantly better than with body mass index (BMI) (p<0.001). In multivariable-adjusted models, each SD increase in SAD/weight was associated with increased risk for MACE (hazards ratio [HR] 1.20, 95% CI 1.18-1.22), death (HR 1.22, 95% CI 1.20-1.25), acute MI (HR 1.19, 95% CI 1.14- 1.24), and stroke (HR 1.17, 95% CI 1.12-1.22). A linear gradient was seen across SAD/weight quintiles (all p-trend<0.001), with adjusted HR for MACE 1.61 (95% CI 1.50-1.72) for highest versus lowest quintile. Results were similar when further adjusted for BMI, in non-obese and obese individuals (p-interaction for obesity = 0.141), and in both women and men (p-interaction for sex = 0.471). In conclusion, SAD measured opportunistically at the time of DXA testing is predictive of death and major cardiovascular events in individuals undergoing osteoporosis assessment.

Replacing the body mass index with the sagittal abdominal diameter (abdominal height).

The body mass index (BMI; weight/height2 ), providing no information about the relative size of any adipose tissue depots, may accordingly misclassify degrees of cardiometabolic risk. However, in supine persons the abdominal height above the exam table (the sagittal abdominal diameter, SAD) is associated preferentially with the accumulation of visceral fat. Since visceral fat is a marker of insulin resistance, type 2 diabetes, coronary heart disease, and hypertension, SAD could contribute to the estimation of generalized cardiometabolic risk. The SAD has been measured inexpensively by a sliding-beam caliper in small studies and in the US National Health and Nutrition Examination Survey (NHANES). Cross-sectional models found that the SAD/height ratio (SADHtR) is more strongly associated than the waist circumference/height ratio or BMI with intermediary predictors of cardiometabolic disease. Prospective studies are needed, however, to demonstrate how well SAD or SADHtR might predict major disease outcomes or all-cause mortality.

Association of obesity anthropometric indices with hypertension, diabetes mellitus and hypertriglyceridemia in apparently healthy adult Nigerian population.

BACKGROUNDHypertension, hyperglycemia and hypertriglyceridemia are chronic conditions associated with cardiometabolic diseases. Certain anthropometric indices are known to predict them.AIMTo investigate the association of anthropometric indices with these chronic diseases and which anthropometric index predicts them best. METHODSIn this study, 221 apparently healthy individuals who never received treatments for cardiovascular disease (CVD), diabetes or other chronic diseases participated. The age of the participants ranged from 20-75 years with mean age of 36.9 ± 11.4 years. The risk factors of these diseases namely systolic blood pressures (SBP) and diastolic blood pressures (DBP), fasting blood glucose (FBG) and triglycerides (TG) were determined for all the participants using standard clinical procedures. The obesity anthropometric indices, waist circumference, waist-to-height ratio, waist-to-hip ratio and body mass index as well as abdominal height (AH) and body surface index were determined. The association between each of them with the risk factors were determined by the Pearson correlation method.RESULTSFrom the results, it was found that AH showed superiority over the rest for SBP (r = 0.301, P < 0.01), DBP (r = 0.370, P < 0.01), FBG (r = 0.297, P < 0.01) and TG (r = 0.380, P < 0.01). Using the receiver operating characteristic curves, cut-off values of AH for SBP, DBP, FBG and TG were determined to be 24.75 cm, 24.75 cm, 25.25 cm and 24.75 cm respectively.CONCLUSIONThe indices of anthropometry used in this study correlated significantly with the studied CVD risk factors, with AH emerging as the most predictive.

Determination of some body measurements of camels with three-dimensional modeling method (3D).

In this study, the use of the three-dimensional modeling method was tested in taking some body measurements in camels with a practical method and was compared with other measurement methods. As the animal material of the study, 12 single-humped dromedary female camels and 14 double-humped Camelus dromedarius × Camelus bactrianus: F1 male camels, a total of 26 camels, were used in three camel farms in Incirliova district of Aydın province. The body measurements are taken from each animal by using different three methods, namely by the manual method (MM), by the photography method (PM), and by the three-dimensional modeling method (3D) were the withers height (WH), the back height (BH), the rump height (RH), the body length (BL), the brisket height (BRH), the abdominal height (AH), the shoulder width (SW), and the rump width (RW), and these values were compared with each other. As a result of this study, the mean values of MM and 3D measurement values were very close to each other and the difference between them was found to be statistically insignificant (P < 0.05). The difference between the means of PM and MM/3D measurement values was found to be significant (P < 0.05). In the measurements taken by MM, 3D, and PM methods in male camels, the values obtained by MM and 3D methods for WH, BH, RH, BRH, AH, BL, and SW were very close to each other and the differences between them were found insignificant statistically (p < 0.05). On the determined regression graph, a linear was found between MM and 3D measurement values. As a result of this study, it has been determined that the 3D modeling method can be used as a remote and more practical method in determining the morphological features of large-scale animals such as camels more reliably, more easily, and more practically.

Cardiovascular Anthropometry: What Is Best Suited for Large-Scale Population Screening in Sub-Saharan Africa?

Background : Body mass index (BMI) measures overweight/obesity. It, however, especially in sub-Saharan Africa (SSA), misclassifies cardiometabolic risk. Central obesity measures are superior. We therefore sought to compare BMI, waist-to-hip ratio (WHR) and abdominal height (AH) in predicting cardiovascular disease risk in sub-Saharan Africa.Methods : Subjects had blood pressures, BMI, and WHR determined. Blood pressure was taken, weight and height measured to generate BMI, and AH measured with a new locally fabricated abdominometer. The ability of the anthropometric indices in identifying abnormal individuals needing intervention was assessed with sensitivity, specificity, and area under the receiver operator characteristic curve.Results : Adults totaling 1,508 (728 M/780 F) adults were studied. For BMI, 985 (65.3%) were normal, while 375 (24.9%), consisting of 233 males and 142 females, had normal WHR. Blood pressure was normal in 525 (34.8%) and 317 (21.0%) for systolic and diastolic blood pressures, respectively. Using BMI as gold standard, sensitivity, specificity, positive, and negative predictive values for WHR in males were 80.7, 37.5, 62.5, and 19.3%, respectively. For females and in the same order, they were 62.0, 34.3, 65.7, and 38.0%. For AH, it was equal in both genders at 82.6, 39.2, 60.8, and 17.4%. By receiver operating curves comparing AH, WHR, and BMI against blood pressure detection, the area under the curve was 0.745, 0.604, and 0.554 for AH, BMI, and WHR, respectively.Conclusion : Abdominometer-derived AH has a better sensitivity and greater area under the receiver operator curve compared with BMI and WHR in this sub-Sahara African population; implying superiority as a cardiovascular anthropometric index.

ADDING A NEW TECHNIQUE TO ASSESS VISCERAL OBESITY TO YOUR REPERTOIRE

Apply It! After having read this article, the health and fitness professional will be able to • Measure sagittal abdominal diameter to estimate visceral obesity in adults • Discuss with clients and patients the relationship between visceral fat and chronic disease • Incorporate abdominal height into health screenings

Association of occupational stress with waking, diurnal, and bedtime cortisol response in police officers.

Police officers have higher rates of cardiovascular disease (CVD) morbidity and mortality than the U.S. general population. Officers are exposed to conventional and unexpected workplace stressors. The hypothalamic-pituitary-adrenal (HPA) axis plays a major role responding to stressor exposure by releasing cortisol. Prolonged release or excessive levels may result in disease. Our study investigated cross-sectional associations between self-reported work stress and various salivary cortisol parameters. A total of 285 police officers (76.5% male) from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (2004-2009) completed the Spielberger Police Stress Survey, reporting frequency and severity of work events during the past month and year to calculate stress indices. Officers provided saliva samples to measure levels of cortisol secretion. Linear regression assessed associations between stress indices and various cortisol parameters, adjusted for age, gender, race/ethnicity, abdominal height, and smoking status. Significant positive associations were observed between stress indices (overall stress, physical danger stress, and past-month lack of support) and diurnal cortisol (AUCg: total area under the curve). Administrative, overall, and physical danger stress in the past year were significantly associated with the diurnal slope. Overall, administrative, and physical danger stress were significantly associated with bedtime levels. There were no significant associations between the stress indices and the awakening cortisol parameters. Higher stress ratings were related to blunted diurnal decline in cortisol, suggesting conventional and unexpected police stressors may result in HPA axis dysfunction. Future studies investigating possible associations between elevated cortisol and subclinical CVD are needed.

Dose dependent effects of Spirulina Platensis on liver health in rats

Spirulina platensis which is an important microalgae is interested in both human and animal nutrition for health balance. This study’s aimed to evaluate the dose dependent effects of S.platensis on body weight, height, waist circumference (WC), body mass index (BMI), waist/height ratio (WHtR), abdominal fat weight, liver weight, serum liver enzymes and liver histopathology. 30 male Wistar albino rats’re used in groups; Control, SP-1(500mg/kgbw) and SP-2(1000mg/kgbw). S.platensis was administered by oral gavage daily. The body weight, height, WC, BMI, WHtR and abdominal lipid weight were calculated. Also, serum cholesterol, ALT and AST were measured. End of the study, liver tissue samples were taken and scaled and histopathologic changes were recorded. There were no differences in body conditions, but positively significant correlations were found among parameters. As the doses were considered, in groupSP-1, significant positively correlations were determined among abdominal fat, growth, height, BMI and WC statistically. Nevertheless, there were no significant changes in liver weight, serum and histopathologic analyzes. S.platensis with its high concentration of functional nutrients is called as an important alternative therapeutic food and it can be used safely.

Sub-clinical atherosclerosis in the common carotid artery in women with/without previous pre-eclampsia: A seven-year follow-up

Pre-eclampsia is associated with increased risk of cardiovascular disease and premature death. However, conventional common carotid artery intima-media thickness (CCA-IMT) measurement does not reflect this. In contrast, measurement of the individual CCA intima and media thicknesses clearly indicates increased vascular risk both at diagnosis and about one year after pre-eclampsia. This study examined whether individual CCA wall layers, risk factors for cardiovascular disease, and markers of endothelial dysfunction had normalized or remained unfavorable seven years after pre-eclampsia. The individual CCA intima and media thicknesses were measured using 22 MHz ultrasound. Conventional cardiovascular risk factors were recorded. A thick intima, thin media and high intima/media thickness ratio (I/M) are signs of sub-clinical atherosclerosis. The median age of women with previous pre-eclampsia (cases = 23) or normal pregnancies (controls = 35) was 39/37 years. At follow-up (median about seven years), the intima remained thicker and the I/M was higher in cases than in controls [all p < 0.0001; p < 0.001 after adjustment for time to follow-up, body mass index (BMI), and mean arterial pressure (MAP)], whereas the CCA-IMT was illogically thinner. Further, BMI, MAP, hip circumference, abdominal height, serum endostatin and apolipoprotein B levels were higher in cases (all p < 0.05). Intima and I/M measurements were correlated with age, MAP, endostatin and apolipoprotein B, whereas no logical correlations were found for CCA-IMT. The arteries in cases but not controls were still adversely affected after seven years. Measuring intima thickness and I/M appears preferable to measuring CCA-IMT for demonstrating vascular risk after pre-eclampsia.

Effect of maternal body size and socioeconomic status on the outcome of pregnancy

Background: The outcome of pregnancy is strongly influenced by the maternal biosocial factors, intrauterine age, and genetic and biological characters of the fetus. Aims and Objectives: Effect of maternal body size and socioeconomic status on the outcome of pregnancy. Materials and Methods: This was a hospital-based prospective study carried out at Dr. B.R. Ambedkar Medical College Hospital and K.C. General Hospital, Bengaluru, during the period of October 2001–September 2002. The subjects for the study were pregnant women delivering at full term. Majority of the pregnant women participated in the study were in the age group of 20–30 years. Results: Women (20–30 years) belonging to low- and lower middle-income groups gave birth to babies with relatively low birth weight. The placental size exhibited a demonstrable influence on the birth weight of male and female babies. The birth weight of the babies showed an increase with that of the abdominal circumference and fundal height. Conclusion: An attempt was made to establish influence maternal socioeconomic status and placental size on the outcome of pregnancy in the age group of 20–35 years.

Absenteeism and Associated Factors in Workers of a High-Level Educational Institution, Cartagena-Colombia

To analyze the sociodemographic characteristics, organizational factors and cardiovascular risk factors related to work absenteeism in a higher education institution in the city of Cartagena-Colombia. Cross-sectional analytical study with a probabilistic sample of 162 workers. We recorded sociodemographic data, personal and family history, in addition, we performed a physical examination that included: abdominal circumference, height, weight and blood pressure. Also, clinical laboratory tests were performed for the analysis of lipid profile (total cholesterol, HDL cholesterol and triglycerides) and fasting blood glucose, determined by enzymatic colorimetric and automated methods. A frequency of absenteeism of 24.7% was estimated, being more frequent in the age group of 40 to 49 years and with a statistically significant difference between women and men. All the organizational variables studied showed a statistical association with work absenteeism. In contrast, the only cardiovascular risk factors that showed statistical association were: abdominal obesity and personal history of arterial hypertension. The evidences found allow us to think about the need to implement, immediately, a program of lifestyle change and healthy work, which includes a motivational strategy of change that, together, reduce the occurrence of absenteeism and the prevalence of cardiovascular risk factors found in the study population.

COMPARISON OF ISOBARIC AND INSUFFLATED LAPAROSCOPY-ASSISTED OVARIOHYSTERECTOMY IN THE COMMON RABBIT (ORYCTOLAGUS CUNICULUS)

Abstract Surgical sterilization of female rabbits can be associated with a significant risk of postoperative morbidity. Laparoscopic ovariectomy has been reported previously to address this issue. The aim of the current study is to assess whether an isobaric (ISO) technique, utilizing an abdominal lifting technique, rather than insufflation (INS) technique, which involves pressurizing the abdomen, is feasible in this species. Four rabbit cadavers were used to subjectively compare the viability of the 2 techniques. Seven rabbit cadavers were used to assess the effects of ISO and insufflated pneumoperitoneum on the dimensions of the abdomen and the volume of the thorax at atmospheric and positive inspiratory pressures using CT imaging. There was a significantly higher (P = 0.006) difference between baseline and pneumoperitoneum thoracic volume in the ISO specimens versus the INS specimens. There was no significant difference in abdominal height in either technique and both afforded adequate working space. The implementation of ISO laparoscopy-assisted ovariohysterectomy was subjectively no more technically difficult than INS laparoscopy-assisted ovariohysterectomy in the rabbit. Based on this investigation, ISO laparoscopy is feasible and requires less specialized equipment compared with insufflated laparoscopy, making it more available in a general practice setting and for routine surgery. Use of ISO laparoscopy could potentially decrease ventilatory compromise compared with insufflated laparoscopy in rabbits.

Abdominometer: A novel instrument to determine the level of risk for cardiometabolic diseases

Background: The standard measure for classifying obesity, the body mass index (BMI) has been found to be deficient in some populations, Sub-Saharan Africans inclusive. Until recently, waist-to-height ratio (WHtR) was considered an improvement in this regard. Abdominal height (AH) measured with a novel appliance was recently found to be a superior cardiac anthropometric measure in our population; hence, there is a need to correlate it mathematically with the older indices. Objective: To determine a mathematical formula that permits computation of AH from BMI and WHtR. Methodology: A total of 200 randomly selected consenting young adult Nigerians (100 males and 100 females) between the ages 16 and 44 years who were undergoing preadmission medical examinations in a higher educational institution participated in this study. Height and weight were measured to determine BMI; waist and hip circumferences were measured and waist-to-hip ratio and WHtR computed. Results: Correlations between two anthropometric indices, BMI, and WHtR with AH were determined, and linear relationships were established using regression analysis to compute the AH using BMI and WHtR (P 32 cm and 30 cm by BMI and WHtR classifications, respectively. Conclusion: Where there is no abdominometer to measure AH, it is possible from BMI and WHtR to determine AH; which has been shown to predict cardiometabolic diseases better in our population.

Effect of central adiposity on lung function tests in adolescents

Objectives: The objectives of the study were to study the relation of total body adiposity and abdominal adiposity markers with forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in adolescents in Bengaluru. Methods: 125 healthy children from a school and 70 asthmatics from Ramaiah hospital between 10 and 15 years were included in the study. Anthropometry including weight, body mass index (BMI), waist and hip circumference, and abdominal height was done in all study adolescents. The subjects were categorized according to BMI. Pulmonary function tests (PFTs) were done by Knudson methodand FEV1, FVC, and peak expiratory flow (PEF) were measured. The patients were classified by their asthma severity according to GINA guidelines. Results: BMI, weight, waist and hip circumference correlated with abdominal height in male asthmatics and controls where they revealed significant correlations with FEV1/FVC% ratio. In females, abdominal height correlated with BMI, weight, waist and hip circumference in both the groups. PEF correlated with BMI, weight, waist circumference, and abdominal height in healthy females. FEV1/FVC correlated with BMI, abdominal height in female asthmatics, with weight in healthy females.Independent predictors of FEV1/FVC% ratio were hip circumference in males and abdominal height, and waist circumference in females. Conclusion: Increase in obesity is associated with reduced lung volumes and flows. The abdominal adiposity markers (waist and hip circumference, and abdominal height) are significant and effective predictors of obesity and the variations of PFT’s than total adiposity markers (BMI and weight).

Abdominal height measures and body mass index

Abdominal height measures and body mass index

Abdominal height measures cardiometabolic risk better than body mass index: result of a preliminary study

Background: Obesity is associated with substantial cardiovascular morbi-mortality. The long acclaimed standard for assessing it, the BMI does not appropriately identify subjects at risk for CVD across all races. Given the varying habitus of Africans compared with people of Asian and European ancestry, and the fact that BMI does not discriminate the contribution and distribution of fat to overall weight; the need to determine what is more accurate for each group became compelling. Aims and Objective: This is an attempt to pilot the use of a new concept, the Abdominometer, in our local population in comparison the age long BMI. Study Design: Cross-sectional Descriptive. Setting: Community Forum. Materials and Methods: A small population of 31 seen during a group cardiovascular health survey with BMI and Abdominal Height data had their blood pressure and glycosylated haemoglobin measured. Ability of BMI and Abdominal height respectively to predict hypertension and diabetes was compared. Statistics: We applied sensitivity, specificity, positive and negative predictive values, accuracy as well as false positive and negative rates on data relating to AH, BMI, Blood pressure and Glycosylated haemoglobin. Results: For hypertension screening, abdominal height performed better than BMI but not impressively so for diabetes. Regarding detection of hypertension with BMI and abdominal height measurements, true positive was 4/31 and 11/31 respectively with accuracy of 61.3% and 67.9% in same sequence. With detection of diabetes using BMI and abdominal height, true positive was 2/31 and 4/31 respectively with accuracy of 29% and 41.9% in same sequence. Conclusion: For our environment, abdominal height cut-off of 25 cm is better to screen for initiation of preventive and curative action for obesity than BMI and should be more widely used for validation and acceptance.

Sedation for Bronchoscopy and Complications in Obese Patients

Background: Bronchoscopy is a safe and minimally invasive diagnostic tool, but no studies have reported prospectively on sedation and outcomes in patients with objectively defined obesity. Objectives: The purpose of the study is to determine if obese patients require more sedation or had more procedural complications during bronchoscopy under moderate sedation than non-obese patients. Methods: We evaluated complications and sedation requirements in non-obese versus obese patients, defined by multiple criteria including body mass index (BMI), neck circumference, abdominal height, and Mallampati scores. Results: Data were collected prospectively in 258 patients undergoing bronchoscopy under moderate sedation. By varying criteria, there were the following proportions of obese patients: 30% by BMI >30, 39% by neck circumference >40 cm, and 35% by abdominal height >22 cm in males and >20 cm in females. Sedative and analgesic dosing was not clinically significantly higher in obese patients than in non-obese patients. There was no difference in complications or procedural success based on obesity criteria. Hemoglobin oxygen desaturations occurred more often during bronchoscopy in patients with increasing Mallampati scores (p = 0.04), but this had no effect on bronchoscopy time or successful completion of the procedure. A subset of patients with previous polysomnogram-proven obstructive sleep apnea were more likely to have earlier termination of their procedure (15.8%) than patients with no diagnosed sleep apnea (2.3%; p = 0.002). Conclusion: In this prospective assessment of patients with obesity, we found neither clinically significant differences in sedation needs nor increases in complications in obese versus non-obese patients using a variety of indices of obesity.

Reduction in Vigorous Physical Activity during Intermittent Fasting Under Free-Living Conditions

PURPOSE: To examine the effects of a short-term intermittent fasting diet on body weight whilst also evaluating its influence on fat distribution and physical activity under free-living conditions. METHODS: Six men and five women (mean ± SD; age 28 ± 14 years, mass 77.4 ± 14.6 kg, BMI 25.7 ± 2.0 kg·m2) undertook a three week intervention consisting of two phases; an initial one week control phase followed by a two week intervention phase. For the intervention, participants fasted on alternate days as defined by their sleep-wake cycles (approximately 30-32 hours) with only calorie-free beverages permitted during fasting periods. On the intervening days participants maintained their habitual diet. Physical activity was monitored throughout each phase using combined heart rate and accelerometry, whilst energy intake and body fat percentage were quantified using weighed diet records and skinfold measurements respectively. RESULTS: Adherence to the fasting intervention was 99.4% with no significant change seen in energy intake on feeding days compared to control days (p=0.45), indicating good compliance with the dietary protocol. A significant 2.1 ± 0.8 kg reduction in body mass (p<0.01) was seen during the intervention phase which correlated positively with energy deficit (r = 0.535; p<0.05). This was accompanied by significant reductions in BMI (-0.7 ± 0.2 kg·m2; P<0.01), body fat percentage (-1.52 ± 2.19 %; p<0.05), sagittal abdominal height (-1.3 ± 0.5 cm; p<0.01) and waist-to-hip ratio (0.02 ± 0.01; p<0.01), although fasting plasma glucose concentration remained unchanged (p=0.73). Furthermore, there were no significant differences in resting metabolic rate, respiratory exchange ratio or physical activity energy expenditure. However, a significant reduction was seen in the time spent performing vigorous physical activity (6.0-10.2 METs) on feeding days compared to control days (9 ± 8 min·day-1 vs. 18 ± 15 min·day-1; P<0.05). CONCLUSION: These results show that intermittent fasting can be effective in eliciting weight loss and may modify fat distribution in a manner consistent with improved metabolic health. However, the decline in vigorous physical activity during the intervention period may be indicative of an adaptive response to minimise the energy deficit in an attempt to preserve energy balance.

Obstetric predictors of hypertension: A cross-sectional study of women attending the postnatal clinic of Jos University Teaching Hospital.

Background:Hypertensive disease in pregnancy (HDP) accounts for high mother and child morbi-mortality and predict future cardiometabolic diseases. This study aimed to identify obstetric predictors of HDP needing preventive action to reduce its consequences; when women present to antenatal clinic (ANC).Materials and Methods:Cross-sectional descriptive this was an Interviewer-administered semi-structured questionnaire-based study of the anthropometric, and blood pressure measurementsin attendees at the postnatal clinic (PNC) of Jos University with ANC records.Setting:Six weeks postnatal clinic (PNC) of Jos University Teaching Hospital (JUTH).Results:The following indices proved predictive of HDP and subsequent hypertension: weight (P = 0.009), hip circumference (P = 0.018), parity (P = 0.043), waist circumference (P = 0.00), abdominal height (P = 0.040), waist/height (P = 0.020), history of developing hypertension in previous pregnancy (P = 0.000), birth weight of baby (P = 0.02), and mode of delivery (P = 0.05).Conclusion:To initiate preventive action on ANC registration in mitigating effects of or outrightly preventing HDP, careful check on anthropometry as well as history of hypertension or operative/preterm delivery in a previous pregnancy is necessary

Beyond Body Mass Index: Advantages of Abdominal Measurements for Recognizing Cardiometabolic Disorders

The clinical recognition of cardiometabolic disorders might be enhanced by anthropometry based on the sagittal abdominal diameter (SAD; also called "abdominal height") or waist circumference rather than on weight. Direct comparisons of body mass index (BMI, weight/height(2)) with SAD/height ratio (SADHtR) or waist circumference/height ratio (WHtR) have not previously been tested in nationally representative populations. Nonpregnant adults without diagnosed diabetes (ages 20-64 years; n= 3071) provided conventional anthropometry and supine SAD (by sliding-beam caliper) in the 2011-2012 US National Health and Nutrition Examination Survey. Population-weighted, logistic models estimated how strongly each anthropometric indicator was associated with 5 cardiometabolic disorders: Dysglycemia (glycated hemoglobin ≥5.7%), HyperNonHDLc (non-high-density-lipoprotein [HDL] cholesterol ≥4.14 mmol/L, or taking anticholesteremic medications), Hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg, or taking antihypertensive medications), HyperALT (alanine transaminase ≥p75 [75th percentile, sex-specific]), and HyperGGT (gamma-glutamyltransferase ≥p75 [sex-specific]). After scaling each indicator, adjusted odds ratios (aORs) tended to be highest for SADHtR and lowest for BMI when identifying each disorder except dysglycemia. When SADHtR entered models simultaneously with BMI, the aORs for BMI no longer directly identified any condition, whereas SADHtR identified persons with HyperNonHDLc by aOR 2.78 (95% confidence interval [CI], 1.71-4.51), Hypertension by aOR 2.51 (95% CI, 1.22-5.15), HyperALT by aOR 2.89 (95% CI, 1.56-5.37), and HyperGGT by aOR 5.43 (95% CI, 3.01-9.79). WHtR competed successfully against BMI with regard to Dysglycemia, HyperNonHDLc, and HyperGGT. c-Statistics of SADHtR and WHtR were higher than those of BMI (P <.001) for identifying HyperNonHDLc and HyperGGT. Among nonelderly adults, SADHtR or WHtR recognized cardiometabolic disorders better than did the BMI.