Sagittal Abdominal Diameter and Waist Circumference as Markers of Early Organ Damage in Patients With Type 2 Diabetes

Introduction

Type 2 diabetes is a common chronic disease associated with a substantially increased risk of macrovascular complications (1, 2). The development of type 2 diabetes is closely associated with obesity and abdominal obesity is the best obesity-related predictor of type 2 diabetes (3). Both general and abdominal adiposity are associated not only with chronic diseases like diabetes but also with cardiovascular disease (CVD) and premature death (4–6).

Abstract

INTRODUCTION AND OBJECTIVES

In a cohort of 465 patients with type 2 diabetes aged 55–66 years, the association between the anthropometric measures, waist circumference (WC) and sagittal abdominal diameter (SAD) versus subclinical cardiovascular organ damage by measuring pulse wave velocity (PWV) and left ventricular mass index (LVMI), was studied.

METHODS

Blood pressure, weight, height, and WC were measured within primary care. The SAD was measured by using standardized caliper equipment. Blood samples were taken for analysis of HbA1c and serum lipids. The LVMI was measured by M-mode echocardiography. Aortic PWV was measured by applanation tonometry (Sphygmocor) over the carotid and femoral arteries. The baseline characteristics were compared with data from a control group with nondiabetic patients that were randomly recruited from the general population.

RESULTS

The diabetic cohort was more obese than the age-matched controls and there were significant correlations between aortic PWV and WC (r=0.23; p<.01) and SAD (r=0.25; p<.01) in the diabetic group. The LVMI was also correlated to WC (r=0.26; p<.01) and SAD (r=0.25; p<.01). When analyzed in a multiple regression model, SAD and WC were both associated with PWV and LVMI, independently of age, sex, systolic blood pressure, serum lipids, and HbA1c.

CONCLUSION

Patients with type 2 diabetes were more obese than the nondiabetic controls and both measurements of abdominal obesity, WC or SAD, were associated with markers of early cardiovascular organ damage.

Keywords

type 2 diabetes, obesity, pulse wave velocity, left ventricular mass