Population distribution of the sagittal abdominal diameter (SAD) from a representative sample of US adults

Comparison of SAD, waist circumference and body mass index for identifying dysglycemia

Henry S. Kahn, Qiuping Gu, Kai Mc Keever Bullard, David S. Freedman, Namanjeet Ahluwalia, Cynthia L. Ogden

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The sagittal abdominal diameter (SAD) measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD's distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, provide the first, national estimates of the SAD distribution among US adults, and test associations of SAD and other adiposity indicators with prevalent dysglycemia.

Methods and Findings: In the 2011-2012 National Health and Nutrition Examination Survey, supine SAD was measured ("abdominal height") between arms of a sliding-beam caliper at the level of the iliac crests. From 4817 non-pregnant adults (age ≥20; response rate 88%) we used sample weights to estimate SAD's population distribution by sex and age groups. SAD's population mean was 22.5 cm [95% confidence interval 22.2-22.8]; median was 21.9 cm [21.6-22.4]. The mean and median values of SAD were greater for men than women. For the subpopulation without diagnosed diabetes, we compared the abilities of SAD, waist circumference (WC), and body mass index (BMI, kg/m2) to identify prevalent dysglycemia (HbA1c ≥5.7%). For age-adjusted, logistic-regression models in which sex-specific quartiles of SAD were considered simultaneously with quartiles of either WC or BMI, only SAD quartiles 3 (p<0.05 vs quartile 1) and 4 (p<0.001 vs quartile 1) remained associated with increased dysglycemia. Based on continuous adiposity indicators, analyses of the area under the receiver operating characteristic curve (AUC) indicated that the dysglycemia model fit for SAD (age-adjusted) was 0.734 for men (greater than the AUC for WC, p<0.001) and 0.764 for women (greater than the AUC for WC or BMI, p<0.001).

Conclusions: Measured inexpensively by bedside caliper, SAD was associated with dysglycemia independently of WC or BMI. Standardized SAD measurements may enhance assessment of dysfunctional adiposity.

Original languageEnglish (US)
Article numbere108707
JournalPloS one
Volume9
Issue number10
DOIs
StatePublished - Oct 1 2014

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Sagittal Abdominal Diameter
Population distribution
waist circumference
population distribution
Waist Circumference
body mass index
Body Mass Index
Demography
Health risks
Nutrition
Medical problems
Logistics
Health
adiposity
Tissue
Adiposity
sampling
calipers
Area Under Curve
Logistic Models

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Kahn, Henry S. ; Gu, Qiuping ; Bullard, Kai Mc Keever ; Freedman, David S. ; Ahluwalia, Namanjeet ; Ogden, Cynthia L. / Population distribution of the sagittal abdominal diameter (SAD) from a representative sample of US adults : Comparison of SAD, waist circumference and body mass index for identifying dysglycemia. In: PloS one. 2014 ; Vol. 9, No. 10.
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abstract = "Background: The sagittal abdominal diameter (SAD) measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD's distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, provide the first, national estimates of the SAD distribution among US adults, and test associations of SAD and other adiposity indicators with prevalent dysglycemia.Methods and Findings: In the 2011-2012 National Health and Nutrition Examination Survey, supine SAD was measured ({"}abdominal height{"}) between arms of a sliding-beam caliper at the level of the iliac crests. From 4817 non-pregnant adults (age ≥20; response rate 88{\%}) we used sample weights to estimate SAD's population distribution by sex and age groups. SAD's population mean was 22.5 cm [95{\%} confidence interval 22.2-22.8]; median was 21.9 cm [21.6-22.4]. The mean and median values of SAD were greater for men than women. For the subpopulation without diagnosed diabetes, we compared the abilities of SAD, waist circumference (WC), and body mass index (BMI, kg/m2) to identify prevalent dysglycemia (HbA1c ≥5.7{\%}). For age-adjusted, logistic-regression models in which sex-specific quartiles of SAD were considered simultaneously with quartiles of either WC or BMI, only SAD quartiles 3 (p<0.05 vs quartile 1) and 4 (p<0.001 vs quartile 1) remained associated with increased dysglycemia. Based on continuous adiposity indicators, analyses of the area under the receiver operating characteristic curve (AUC) indicated that the dysglycemia model fit for SAD (age-adjusted) was 0.734 for men (greater than the AUC for WC, p<0.001) and 0.764 for women (greater than the AUC for WC or BMI, p<0.001).Conclusions: Measured inexpensively by bedside caliper, SAD was associated with dysglycemia independently of WC or BMI. Standardized SAD measurements may enhance assessment of dysfunctional adiposity.",
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Population distribution of the sagittal abdominal diameter (SAD) from a representative sample of US adults : Comparison of SAD, waist circumference and body mass index for identifying dysglycemia. / Kahn, Henry S.; Gu, Qiuping; Bullard, Kai Mc Keever; Freedman, David S.; Ahluwalia, Namanjeet; Ogden, Cynthia L.

In: PloS one, Vol. 9, No. 10, e108707, 01.10.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Population distribution of the sagittal abdominal diameter (SAD) from a representative sample of US adults

T2 - Comparison of SAD, waist circumference and body mass index for identifying dysglycemia

AU - Kahn, Henry S.

AU - Gu, Qiuping

AU - Bullard, Kai Mc Keever

AU - Freedman, David S.

AU - Ahluwalia, Namanjeet

AU - Ogden, Cynthia L.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Background: The sagittal abdominal diameter (SAD) measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD's distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, provide the first, national estimates of the SAD distribution among US adults, and test associations of SAD and other adiposity indicators with prevalent dysglycemia.Methods and Findings: In the 2011-2012 National Health and Nutrition Examination Survey, supine SAD was measured ("abdominal height") between arms of a sliding-beam caliper at the level of the iliac crests. From 4817 non-pregnant adults (age ≥20; response rate 88%) we used sample weights to estimate SAD's population distribution by sex and age groups. SAD's population mean was 22.5 cm [95% confidence interval 22.2-22.8]; median was 21.9 cm [21.6-22.4]. The mean and median values of SAD were greater for men than women. For the subpopulation without diagnosed diabetes, we compared the abilities of SAD, waist circumference (WC), and body mass index (BMI, kg/m2) to identify prevalent dysglycemia (HbA1c ≥5.7%). For age-adjusted, logistic-regression models in which sex-specific quartiles of SAD were considered simultaneously with quartiles of either WC or BMI, only SAD quartiles 3 (p<0.05 vs quartile 1) and 4 (p<0.001 vs quartile 1) remained associated with increased dysglycemia. Based on continuous adiposity indicators, analyses of the area under the receiver operating characteristic curve (AUC) indicated that the dysglycemia model fit for SAD (age-adjusted) was 0.734 for men (greater than the AUC for WC, p<0.001) and 0.764 for women (greater than the AUC for WC or BMI, p<0.001).Conclusions: Measured inexpensively by bedside caliper, SAD was associated with dysglycemia independently of WC or BMI. Standardized SAD measurements may enhance assessment of dysfunctional adiposity.

AB - Background: The sagittal abdominal diameter (SAD) measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD's distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, provide the first, national estimates of the SAD distribution among US adults, and test associations of SAD and other adiposity indicators with prevalent dysglycemia.Methods and Findings: In the 2011-2012 National Health and Nutrition Examination Survey, supine SAD was measured ("abdominal height") between arms of a sliding-beam caliper at the level of the iliac crests. From 4817 non-pregnant adults (age ≥20; response rate 88%) we used sample weights to estimate SAD's population distribution by sex and age groups. SAD's population mean was 22.5 cm [95% confidence interval 22.2-22.8]; median was 21.9 cm [21.6-22.4]. The mean and median values of SAD were greater for men than women. For the subpopulation without diagnosed diabetes, we compared the abilities of SAD, waist circumference (WC), and body mass index (BMI, kg/m2) to identify prevalent dysglycemia (HbA1c ≥5.7%). For age-adjusted, logistic-regression models in which sex-specific quartiles of SAD were considered simultaneously with quartiles of either WC or BMI, only SAD quartiles 3 (p<0.05 vs quartile 1) and 4 (p<0.001 vs quartile 1) remained associated with increased dysglycemia. Based on continuous adiposity indicators, analyses of the area under the receiver operating characteristic curve (AUC) indicated that the dysglycemia model fit for SAD (age-adjusted) was 0.734 for men (greater than the AUC for WC, p<0.001) and 0.764 for women (greater than the AUC for WC or BMI, p<0.001).Conclusions: Measured inexpensively by bedside caliper, SAD was associated with dysglycemia independently of WC or BMI. Standardized SAD measurements may enhance assessment of dysfunctional adiposity.

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