Sagittal abdominal diameter is more predictive of cardiovascular risk than abdominal fat compartments in severe obesity.

Abstract

To compare the predictive role of abdominal fat distribution by computed tomography (CT) with that of total abdominal fat by sagittal abdominal diameter (SAD) on cardiovascular risk in severe obesity. A cross-sectional, clinical study. 64 males and 64 females, aged 42+/-15 years (mean+/-s.d.; range 18-75 years), BMI (kg/m(2)) 41.7+/-5.3 (30.2-57.6). Blood glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides (TGLs), insulin (IRI), insulin resistance (HOMA-IR), slice areas (cm(2)) of total (tSAT), superficial (sSAT) and deep subcutaneous adipose tissue (dSAT), visceral adipose tissue (VAT) and SAD (mm) by CT. The sSAT depot was negatively associated with blood glucose, HOMA-IR, LDL cholesterol and TGLs, whereas dSAT was negatively associated with HDL cholesterol. VAT was associated with blood glucose and HOMA-IR, whereas SAD was associated with all variables evaluated. In males, VAT was associated with blood glucose (r(2)=0.12, P<0.01), SAD was associated with blood glucose (r(2)=0.67, P<0.01), IRI (r(2)=0.65, P<0.05), and HOMA-IR (r(2)=0.67, P<0.01). In females, sSAT was negatively associated with blood glucose (r(2)=0.63, P<0.05), whereas VAT was associated positively with blood glucose (r(2)=0.21, P< 0.001), total cholesterol (r(2)=0.16, P<0.01), LDL cholesterol (r(2)=0.20, P<0.001) and TGLs (r(2)=0.12, P<0.01). SAD was associated positively with IRI (r(2)=0.52, P<0.05), HOMA-IR (r(2)=0.53, P<0.05), total cholesterol (r(2)=0.52, P<0.05), LDL cholesterol (r(2)=0.54, P<0.01), TGLs (r(2)=0.52, P<0.05) and negatively to HDL cholesterol (r(2)=0.51, P<0.001). When compared with CT-based measures of abdominal fat compartments, SAD is a more predictive indicator of cardiovascular risk in severe obesity.