Mediterranean Journal of Nutrition and Metabolism

, Volume 2, Issue 3, pp 187–195

Sagittal abdominal diameter: comparison with waist circumference and its prediction of metabolic syndrome

  • Lorenzo M. Donini
  • Luciano Scavone
  • Claudia Savina
  • Cecilia Coletti
  • Maddalena Paolini
  • Settimio Tempera
  • Barbara Neri
  • Maria Rosaria De Felice
  • Alessandro Pinto
  • Carlo Cannella
Original Article

Abstract

Background

For an “in the field” estimate of visceral adiposity, simple, inexpensive, non-invasive and highly repetitive methods are needed. The anthropometric measurement most commonly used as an indicator for visceral fat deposits is waist circumference (W). Nevertheless, there are some doubts with regard to the anatomic landmark points where the evaluation needs to be carried out. Sagittal abdominal diameter (SAD) is another anthropometric measurement that has been proposed for the estimation of visceral fat.

Objective

The aims of the study are to evaluate intra- and inter-operator variability of the estimation of the SAD compared to W; correlate SAD to other anthropometric parameters and to factors involved in the metabolic syndrome (MS); and identify the values for the estimation of the SAD able to classify different risk levels with respect to the MS.

Methods

Ninety-five subjects at the Metabolic and Nutritional Rehabilitation Unit “Villa delle Querce” in Nemi were selected. Anthropometric and biochemical parameters were collected. The presence of a MS was detected. Intra- and inter-operator variability in the measurement of W and SAD and the predictive capacity of SAD in the estimation of the risk for MS were calculated.

Results

The main results achieved were reduced intra- and inter-operator variability in the measurement of SAD compared to W; confirmation of the correlations between SAD and the anthropometric parameters as indicators of a higher fat mass; and good predictive capacity of SAD towards MS (cut-off points: 22.2 cm for men and 19.5 cm for women).

Keywords

Nutritional status Metabolic syndrome Sagittal abdominal caliper Waist circumference 

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References

  1. 1.
    World Health Organization (2000) The Asia-Pacific Perspective: redefining obesity and its treatment. Introduction. WHO, Sydney, p 8Google Scholar
  2. 2.
    Friedman JM (2000) Obesity in the new millennium. Nature 404:632–634Google Scholar
  3. 3.
    Feinleib M (1985) Epidemiology of obesity in relation to health hazards. Ann Intern Med 103:1019–1024Google Scholar
  4. 4.
    Keys A (1980) Overweight, obesity, coronary heart disease and mortality. Nutr Rev 38:297–307CrossRefGoogle Scholar
  5. 5.
    Wajchenberg BL (2000) Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 21:697–738CrossRefGoogle Scholar
  6. 6.
    Marin P, Andersson B, Ottosson M et al (1992) The morphology and metabolism of intraabdominal adipose tissue in men. Metabolism 41:1242–1248CrossRefGoogle Scholar
  7. 7.
    Bjorntorp P (1991) Metabolic implications of body fat distribution. Diabetes Care 14:1132–1143CrossRefGoogle Scholar
  8. 8.
    Chowdhury B, Sjostrom L, Alpsten M et al (1994) A multicom-partment body composition technique based on computerized tomography. Int J Obes Relat Metab Disord 18:219–234Google Scholar
  9. 9.
    Sjostrom L (1996) A multicompartment body composition technique based on computerized tomography. Progr Obes Res 7:321–324Google Scholar
  10. 10.
    Despres JP, Ross R, Lemieux S (1996) Imaging techniques applied to the measurement of human body composition. In: Roche AF, Heymsfield SB, Lohman TG (eds) Human body composition. Human Kinetics, Champaign, IL, pp 149–166Google Scholar
  11. 11.
    Kvist H, Badrul C, Grangard U et al (1988) Total and visceral adipose-tissue volumes derived from measurements with computed tomography in adult men and woman: predictive equations. Am J Clin Nutr 48:1351–1361Google Scholar
  12. 12.
    Rasmussen MH, Andersen T, Breum L et al (1993) Observer variation in measurements of waist-hip ratio and the sagittal abdominal diameter. Int J Obes 17:323–327Google Scholar
  13. 13.
    Molarius A, Seidell JC (1998) Selection of anthropometric indicators for classification of abdominal fatness — a critical review. Int J Obes 22:719–727CrossRefGoogle Scholar
  14. 14.
    World Health Organization Expert Committee (1995) Physical status: the use and interpretation of anthropometry. Technical Report Series no. 854, WHO, GenevaGoogle Scholar
  15. 15.
    Wang Y, Rimm EB, Stampfer MJ et al (2005) Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr 81:555–563Google Scholar
  16. 16.
    Hu FB, Willet WC, Li T et al (2004) Adiposity as compared with physical activity in predicting mortality among woman. N Engl J Med 351:2694–2703CrossRefGoogle Scholar
  17. 17.
    Onat A, Avci GS, Barlan MM et al (2004) Measures of abdominal obesity assessed for visceral adiposity and relation to coronary risk. Int J Obes 28:1018–1025CrossRefGoogle Scholar
  18. 18.
    Janssen I, Katzmarzyk PT, Ross R (2004) Waist circumference and not body mass index explains obesity-ralated health risk. Am J Clin Nutr 79:379–384Google Scholar
  19. 19.
    Klein S, Allison DB, Heymsfield SB et al (2007) Waist circumference and cardiometabolic risk: a consensus statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society, the American Society for Nutrition, and The American Diabetes Association. Am J Clin Nutr 85:1197–1202Google Scholar
  20. 20.
    Wang J, Thornton JC, Williamson B et al (2003) Comparison of waist circumference measured at 4 sites. Am J Clin Nutr 77:379–384Google Scholar
  21. 21.
    Han TS, van Leer EM, Seidell JC et al (1995) Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 311:1401–1405Google Scholar
  22. 22.
    Ferland M, Despres J-P, Tremblay A et al (1989) Assessment of adipose tissue distribution by computed axial tomography in obese women: association with body density and anthropometric measurements. Br J Nutr 61:139–148CrossRefGoogle Scholar
  23. 23.
    Pouliot MC, Despres JP, Lemieux S et al (1994) Waist circumference and abdominal sagittal diameter: best simple anthropometric indices of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 73:460–468CrossRefGoogle Scholar
  24. 24.
    Despres JP, Pouliot MC, Bouchard C et al (1991) Estimation of deep abdominal adipose-tissue accumulation from simple anthropometric measurements in men. Am J Clin Nutr 54:471–477Google Scholar
  25. 25.
    Van der Kooy K, Seidell JC (1993) Techniques for the measurement of visceral fat: a practical guide. Int J Obes Relat Disord 17:187–196Google Scholar
  26. 26.
    Kullberg J, Von Below C, Lonn L et al (2007) Practical approach for estimation of subcutaneous and visceral adipose tissue. Clin Physiol Funct Imaging 27:148–153CrossRefGoogle Scholar
  27. 27.
    Zamboni M, Turcato E, Armellini F et al (1998) Sagittal abdominal diameter as a practical predictor of visceral fat. Int J Relat Metab Disord 22:655–660CrossRefGoogle Scholar
  28. 28.
    Sjostrom L, Lonn L, Chowdhury B et al (1996) The sagittal diameter is a valid marker of the visceral adipose tissue volume. Progr Obes Res 7:309–319Google Scholar
  29. 29.
    Han JH, Park HS, Kim SM et al (2007) Visceral adipose tissue as a predictor for metabolic risk factors in the Korean population. Diabet Med 25:106–110Google Scholar
  30. 30.
    Brundavani V, Murthy SR, Kurpad AV (2006) Estimation of deep-abdominal-adipose tissue (DAAT) accumulation from simple anthropometric measurements in Indian men and women. Eur J Clin Nutr 60:658–666CrossRefGoogle Scholar
  31. 31.
    Iribarren C, Darbirian JA, Lo JC et al (2006) Value of the sagittal abdominal diameter in coronary heart disease risk assessment: color study in a large multiethnic population. Am J Epidemiol 164:1150–1159CrossRefGoogle Scholar
  32. 32.
    Gustat J, Elkasabany A, Srinivasan S et al (2000) Relation of abdominal height to cardiovascular risk factors in young adults, The Bogalusa Heart Study. Am J Epidemiol 151:885–891Google Scholar
  33. 33.
    Empana JP, Ducimetiere P, Charles MA et al (2004) Sagittal abdominal diameter and risk of sudden death in asymptomatic Middle-aged men, The Paris Prospective Study I. Circulation 2:2781–2786CrossRefGoogle Scholar
  34. 34.
    Kahn HS, Austin H, Williamson DF et al (1996) Simple anthropometric indices associated with ischemic heart disease. J Clin Epidemiol 49:1017–1024CrossRefGoogle Scholar
  35. 35.
    Ohrvall M, Berglund L, Vessby B (2000) Sagittal abdominal diameter compared with other anthropometric measurements in relation to cardiovascular risk. Int J Obes 24:497–501CrossRefGoogle Scholar
  36. 36.
    Riserus U, Arnlov J, Brismar K et al (2004) Sagittal abdominal diameter is a strong anthropometric marker of insulin resistance and hyperproinsulinemia in obese men. Diabetes Care 27:2041–2046CrossRefGoogle Scholar
  37. 37.
    Mukuddem-Petersen J, Snijder MB, van Dam RM et al (2006) Sagittal abdominal diameter: no advantage compared with other anthropometric measures as a correlate of components of the metabolic syndrome in elderly from the Hoorn Study. Am J Clin Nutr 84:995–1002Google Scholar
  38. 38.
    Lohman T, Roche AF, Martorell R (1992) Manuale di riferimento per la standardizzazione antropometrica. EDRAGoogle Scholar
  39. 39.
    Durnin JV, Womersley J (1974) Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and woman aged from 16 to 72 years. Br J Nutr 32:77–97CrossRefGoogle Scholar
  40. 40.
    Siri WE (1963) Body composition, from fluid spaces and density. Analysis of methods. In: Techniques for measuring body composition. National Academy of Sciences — National Research Council, Washington, DCGoogle Scholar
  41. 41.
    Belfiore F, Iannello S, Volpicelli G (1998) Insulin sensitivity indices. Mal Gen Metab 63:134–141CrossRefGoogle Scholar
  42. 42.
    Turner RC, Levy JC, Rudesnki AS et al (1993) Measurement of insulin resistance and beta-cell function: the HOMA and CIGMA approach. In: Belfiore F, Bergman R, Molinatti G (eds) Current topics in diabetes research. Front Diabetes, Vol.12. Karger, Basel, pp 66–75Google Scholar
  43. 43.
    Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) (2001) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285:2486–2497CrossRefGoogle Scholar
  44. 44.
    Sampaio LR, Simões EJ, Assis AM, Ramos LR (2007) Validity and reliability of the sagittal abdominal diameter as a predictor of visceral abdominal fat. Arq Bras Endocrinol Metab 51:980–986Google Scholar
  45. 45.
    Lemieux S, Prud’homme D, Bouchard C et al (1996) A single threshold value of waist girth identifies normal-weight and overweight subjects with excess visceral adipose tissue. Am J Clin Nutr 64:685–693Google Scholar
  46. 46.
    Valsamakis G, Chetty R, Anwart A et al (2004) Association of simple anthropometric measures of obesity with visceral fat and the metabolic syndrome in male Caucasian and Indo-Asian subjects. Diabet Med 21:1339–1345CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Lorenzo M. Donini
    • 1
  • Luciano Scavone
    • 2
  • Claudia Savina
    • 2
  • Cecilia Coletti
    • 2
  • Maddalena Paolini
    • 2
  • Settimio Tempera
    • 1
  • Barbara Neri
    • 1
  • Maria Rosaria De Felice
    • 2
  • Alessandro Pinto
    • 1
  • Carlo Cannella
    • 1
  1. 1.Department of Medical Physiopathology (Food Science Laboratory)“Sapienza” University of RomeRomeItaly
  2. 2.Rehabilitation Clinical Institute “Villa delle Querce”Nemi, RomeItaly

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