Gait Seed and Sagittal Abdominal Diameter: The Results from the Handan Eye Study

Background The sagittal abdominal diameter (SAD) is more precise than body mass index (BMI) for predicting adverse events in elderly. While physical function and BMI is related, the relationship is uncertain. BMI and gait speed (GS) is related and have a U-shaped distribution. The objective was to examine the relationship between GS and SAD in men and women aged 50 years and older. Methods This was a cross-sectional analysis. Data from the Handan Eye Study (HES), a Chinese prospective longitudinal study with participants randomly selected from the Yongnian county. Usual GS was measured over a 4 meters-track. SAD was categorized by interquartile: <18.0cm; 18.0-19.79cm; 19.8-21.89cm; ≥21.9cm. Unadjusted and adjusted analyses of covariance were performed to estimate the gender-specific means (and 95% CI) of GS (in m/s) according to SAD categories. Results The current analyses were performed in 2852 participants. Mean age was 56.16 years for women and 56.54 years for men. The unadjusted means of GS were 0.995 (95% CI 0.972-1.019) m/s in SAD Q1 participants, 0.991 (95% CI 0.968-1.014) m/s in SAD Q2, 0.986 (95% CI 0.964-1.007) m/s in SAD Q3 and 0.961 (95% CI 0.937-0.985) m/s in SAD Q4 individuals in women. The similar trend presented in men [Q1: 0.993 (95%CI 0.969-1.016) m/s; Q2: 0.980 (95%CI 0.956-1.004); Q3: 0.944 (95%CI 0.918-0.970); Q4: 0.948 (95%CI 0.923-0.973)]. After adjustment for age, the reported trends between GS and SAD in categories were largely confirmed in women, but not in men. Conclusions Age and gender should be considered when we explore the relationship between GS and SAD in elderly.

Anthropometric Measurements and Correlations to Glucometabolic and Cardiovascular Risk in Obese Patients Undergoing Gastric Bypass Surgery

Abdominal obesity is associated with hypertension, increased fasting glucose, HbA1c, and cholesterol. Body mass index (BMI) is frequently used to measure and define obesity and as inclusion criteria for bariatric surgery. Sagittal abdominal diameter (SAD) has been suggested to predict the amount of visceral fat, metabolic traits, and cardiometabolic risk superior to BMI. The aim was to test whether SAD has stronger correlations to glucometabolic traits compared to BMI. One hundred and fifty-five (108 women, 47 men) morbidly obese patients undergoing bariatric surgery were evaluated before (baseline), 6 and 12 months after Roux-en-Y gastric bypass (RYGBP). BMI was reduced from 43.7 kg/m2 (baseline) to 31.3 kg/m2 (12 months) and SAD from 32.6 to 23.2 cm (both p <0 .001 ). SAD correlated with CRP ( p = 0.04 ), fasting glucose ( p = 0.008 ), HbA1c ( p = 0.016 ), triglycerides ( p = 0.017 ), systolic blood pressure ( p = 0.032 ), and vitamin D ( p = 0.027 ). BMI correlated with CRP ( p = 0.006 ), triglycerides ( p = 0.016 ), vitamin D ( p = 0.002 ), and magnesium ( p = 0.037 ). Despite RYGBP surgery, vitamin D was significantly increased. Liver enzymes were significantly lowered after RYGBP and the change over time in SAD correlated with gamma-glutamyltransferase. SAD was superior to BMI to predict glucose disturbance and dyslipidemia implying increased use of SAD as it is cost effective and simple to perform in the clinic and could be of value when considering patients for bariatric surgery.

Milk-Fat Intake and Differences in Abdominal Adiposity and BMI: Evidence Based on 13,544 Randomly-Selected Adults

The primary purpose of this investigation was to evaluate the relationship between milk-fat intake and obesity, particularly abdominal obesity, in 13,544 U.S. adults. A lesser objective was to measure the degree to which the association was influenced by multiple potential confounding variables. This cross-sectional study used data from the 2011–2016 National Health and Nutrition Examination Survey (NHANES). Quantity of milk-fat regularly consumed was the exposure variable. Sagittal abdominal diameter (SAD), a measure of abdominal obesity, and body mass index (BMI) were the outcome variables. Sagittal abdominal diameter is a strong predictor of visceral abdominal fat, when measured by computed tomography, and has been shown to predict cardiometabolic disorders better than BMI. After controlling for age, race, gender, physical activity, leisure computer use and gaming, alcohol habits, and cigarette use, significantly lower BMIs were associated with consistent non-fat and full-fat milk consumption (F = 4.1, p = 0.0063). A significantly lower SAD was associated only with regular consumption of non-fat milk (F = 5.0, p = 0.0019). No significant differences were detected between the other milk-fat groups or milk abstainers. In this nationally representative sample, only 19.6% of adults regularly consumed low-fat milk. In conclusion, consistent non-fat milk intake was predictive of lower levels of abdominal adiposity compared to consumption of higher levels of milk-fat.

Work, physical activity, and metabolic health: Understanding insulin sensitivity of long-haul truck drivers

BACKGROUND: Long-haul truck drivers are disproportionately exposed to metabolic risk; however, little is known about their metabolic health and the role of physical activity and other risk factors in metabolic outcomes. OBJECTIVE: This study compares truck drivers’ insulin sensitivity, and associations between metabolic risk factors and insulin sensitivity, with those of the general population. METHODS: Survey, anthropometric, and biometric data were collected from 115 long-haul truckers, which were then compared to the general population data using the National Health and Nutrition Examination Survey (NHANES) dataset. The quantitative insulin sensitivity check index (QUICKI) was used to estimate insulin sensitivity. RESULTS: Truck drivers had lower QUICKI scores than the general population cohort. Sagittal abdominal diameter and exercise were predictive for QUICKI among combined cohorts. Waist circumference and perceived health were more predictive for QUICKI among truck drivers, and sagittal abdominal diameter and income were more predictive for QUICKI among the general population. CONCLUSIONS: Long-haul truckers appear to represent a subset of the general population regarding the impact of physical activity and other metabolic risk factors on QUICKI. Accordingly, comprehensive efforts which target these factors are needed to improve truckers’ physical activity levels and other metabolic risks.

Correlation of Computed Tomography Guided Visceral Adiposity & Sagittal Abdominal Diameter with Atherogenic Index of Plasma in Type 2 Diabetic Patients

BACKGROUND Type 2 diabetic patients are at high risk for many cardiovascular diseases which are associated with obesity and abdominal fat that includes visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Visceral adiposity contributes to impairment of insulin resistance which is a prerequisite for diabetes and dyslipidaemia. Computed tomography (CT) scan is the gold standard for measurement of VAT but due to its limitations, sagittal abdominal diameter (SAD) is considered which also has a strong correlation with VAT. There is a good relation between VAT and isolated lipid parameters. However, lipid ratios, such as Atherogenic Index of Plasma (AIP) are of higher predictive value for cardiovascular risk. The present study is focused on exploring the relationship between CT guided visceral adiposity and sagittal abdominal diameter with AIP in type 2 diabetic patients. METHODS This study was carried out with a study group of 53 type 2 diabetes patients aged between 25 to 65 years, incorporating appropriate inclusion and exclusion criteria in a tertiary care hospital. The biochemical assays done include triglycerides, HDLcholesterol and blood glucose by standard techniques. AIP was calculated by taking the logarithmic ratio of triglyceride and HDL-cholesterol levels. Measurement of visceral adiposity was done by SAD and CT scan. RESULTS A total of 53 patients with type II diabetes mellitus (DM) were recruited for the study comprising of 35 males and 18 females. Mean age of the patients was 41.717 ± 11.658 years. Mean value of SAD was 22.755 ± 2.70. Mean value of AIP was 0.164 + 0.15. Mean value of CT measured visceral adiposity was - 77.875 ± 24.54 HU. Pearson’s correlation coefficient for the relationship between SAD and AIP was 0.741 and Pvalue was less than 0.0001 indicating a positive correlation. Pearson’s correlation coefficient for the relationship between CT measured visceral adiposity and AIP was 0.765 and P-value was less than 0.0001 which also shows a positive correlation. CONCLUSIONS In our study we demonstrated that SAD and CT guided visceral adiposity was correlating with AIP in patients with type 2 diabetes mellitus. KEY WORDS Visceral Adiposity, Sagittal Abdominal Diameter, Atherogenic Index of Plasma, Diabetes Mellitus, Computed Tomography Scan

Relationship between maternal bone biomarkers and fetal adiposity through normal pregnancy

Purpose To examine the association of maternal bone markers (sclerostin, sRANKL, osteocalcin, 25OHD3) with fetal intra-abdominal and subcutaneous adipose tissue deposition and birthweight during normal pregnancy. Methods One hundred pregnant women (aged 30.4±5.6 years, mean±SD) with pre-pregnancy BMI=24.1±4.6 kg/m² were seen prospectively during each trimester. At each visit they were submitted to anthropometric measurements, a fasting blood sampling, a 75gr oral glucose tolerance test (OGTT) and a fetal ultrasonogram. At birth, neonates had birth weight measurement. Results In the 2 nd trimester maternal sclerostin concentrations correlated positively with fetal abdominal circumference and birth weight; maternal sRANKL concentrations correlated positively with fetal abdominal subcutaneous fat thickness, sagittal abdominal diameter and abdominal circumference. Fetuses born to mothers with greater (&gt;254 ng/mL) compared to fetuses born to mothers with lower (≤254 ng/mL) sRANKL concentrations had greater abdominal circumference, sagittal diameter and abdominal subcutaneous fat thickness. Maternal serum sclerostin concentrations were the best positive predictors of birth weight. In the 3 rd trimester maternal sclerostin concentrations correlated positively with fetal sagittal abdominal diameter; maternal sRANKL concentrations positively correlated with fetal abdominal circumference and fetal abdominal sagittal diameter. Conclusions Maternal bone markers sclerostin and sRANKL may relate with fetal intra-abdominal adipose tissue deposition through direct or indirect unknown as yet mechanisms contributing thus, to birthweight.

Sagittal abdominal diameter and its socioeconomic correlates: perspective of sex differences

Background Sagittal abdominal diameter (SAD) is an anthropometric index associated with visceral adiposity. It remains unclear whether SAD and its socio-economic correlates differ in women and men, which limits the epidemiological and clinical applications of the SAD measurement. The aims of this study are to examine the sex differences in SAD and its socio-economic correlates. Methods A complex stratified multistage clustered sampling design was used to select 6975 men and 7079 women aged 18 years or more from the National Health Nutrition and Examination Survey 2011–2016, representative of the US civilian non-institutionalized population. SAD was measured in accordance to the standard protocols using a two-arm abdominal caliper. The sex differences in SAD and its socio-economic correlates were evaluated by performing weighted independent t tests and weighted multiple regression. Results SAD was lower in women than in men in the entire sample, as well as in all the subgroups characterized by age, race, birth place, household income, and body mass index except for non-Hispanic blacks and those with household income < $20,000. Adjusted for other characteristics, age, birth place, household income, and body mass index were associated with SAD in both women and men. Black women were associated with higher SAD then white women (p < .0001), and Hispanic and Asian men were associated with lower SAD than white men (both p < .01). Women born in other countries were more likely to have lower SAD than women born in the US (p < .0001), and so were men (p = .0118). Both women and men with a household income of <$75,000 had higher SAD than those with an income of over $75,000. The associations of age, race, and household income with SAD differed in women and men. Conclusion SAD is lower in women than in men, in the general population as well as in the most socio-economic subgroups. While socio-economic correlates of SAD are similar in women and men, the associations of age, race, and household income with SAD vary across sex.

Proposed cut-off points for anthropometric and bioelectrical measures based on overweight and obesity criteria in Spanish institutionalised elderly people

The increasing prevalence of obesity among the institutionalised elderly population and its severe consequences on health requires an early and accurate diagnosis that can be easily achieved in any clinical setting. This study aimed to determine new cut-off values for anthropometric and bioelectrical impedance measures that are superior to body mass index criteria for overweight and obesity status in a sample of Spanish institutionalised elderly population. A total of 211 institutionalised older adults (132 women, aged 84.3±7.3 years; 79 men, aged 81.5±7.3 years) were enrolled in the current cross-sectional study. Anthropometric and bioelectrical impedance measures included the body mass index, waist circumference, gluteal circumference, waist-hip ratio, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio. In women, the waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat index presented strongly significant specificity and sensitivity (area under the curve [AUC], p<0.0001) and elevated discriminative values (receiver operating characteristic [ROC] curves: 0.827 to 0.867) for overweight and obesity status. In men, the waist-hip ratio, waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio were strongly significant AUC (p<0.0001), with moderate-to-high values (ROC curves: 0.757–0.871). In conclusion, our findings suggest that gluteal circumference, waist circumference, and sagittal-abdominal diameter in women and trunk fat, visceral-fat ratio, and waist circumference in men may represent more suitable cut-off values superior to body mass index criteria for overweight and obesity in the Spanish institutionalised elderly population.

Sagittal Abdominal Diameter and its Socioeconomic Correlates: Perspective of Sex Differences

Background Sagittal abdominal diameter (SAD) is an anthropometric index associated with visceral adiposity. It remains unclear whether SAD and its socio-economic correlates differ in women and men, which limits the epidemiological and clinical applications of the SAD measurement. The aims of this study are to examine the sex differences in SAD and its socio-economic correlates.Methods A complex stratified multistage clustered sampling design was used to select 6,975 men and 7,079 women aged 18 years or more from the National Health Nutrition and Examination Survey 2011-2016, representative of the US civilian non-institutionalized population. SAD was measured in accordance to the standard protocols using a two-arm abdominal caliper. The sex differences in SAD and its socio-economic correlates were evaluated by performing weighted independent t tests and weighted multiple regression. Results SAD was lower in women than in men in the entire sample, as well as in all the subgroups characterized by age, race, birth place, household income, and body mass index except for non-Hispanic blacks and those with household income < $20,000. Adjusted for other characteristics, age, birth place, household income, and body mass index were associated with SAD in both women and men. Black women were associated with higher SAD then white women (p<.0001), and Hispanic and Asian men were associated with lower SAD than white men (both p<.01). Women born in other countries were more likely to have lower SAD than women born in the US (p<.0001), and so were men (p=.0118). Both women and men with a household income of <$75,000 had higher SAD than those with an income of over $75,000. The associations of age, race, and household income with SAD differed in women and men.Conclusion SAD is lower in women than in men, in the general population as well as in the most socio-economic subgroups. While socio-economic correlates of SAD are similar in women and men, the associations of age, race, and household income with SAD vary across sex.