title: Intra-abdominal pressure, sagittal abdominal diameter and obesity comorbidity.
abstract: OBJECTIVE
  To determine relationship of intra-abdominal pressure to central obesity and the comorbidity of obesity.
  
  
  METHODS
  Non-randomized, prospective.
  
  
  METHODS
  University hospital, operating room.
  
  
  METHODS
  Eighty-four anaesthetized consecutive patients prior to gastric bypass for morbid obesity and five non-obese patients before colectomy for ulcerative colitis.
  
  
  METHODS
  Weight, body mass index (BMI), co-morbid history, sagittal abdominal diameter, waist:hip (W:H) ratio and urinary bladder pressure, as an estimate of intra-abdominal pressure.
  
  
  RESULTS
  Urinary bladder pressure was greater in the obese than the non-obese (18 +/- 0.7 vs. 7 +/- 1.6 cm H2O, P < 0.001), correlated with sagittal abdominal diameter (r = +0.67, P < 0.001) and was greater (P < 0.05) in patients with, than those without, morbidity probably (hypoventilation, gastroesophageal reflux, venous stasis, stress incontinence, incisional hernia) or possibly (hypertension, diabetes) due to increased abdominal pressure. W:H ratio correlated with urinary bladder pressure in men (r = +0.6, P < 0.05) but not women (r = -0.3).
  
  
  CONCLUSIONS
  Increased sagittal abdominal diameter was associated with increased intraabdominal pressure which contributed to obesity-related comorbidity. W:H ratio was not a reliable indicator of intra-abdominal pressure for women who often have both peripheral and central obesity. Further studies are needed to evaluate the relationship between intra-abdominal pressure and Type II diabetes and hypertension.
authors.affiliation: Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA.
authors.forename: H
authors.initials: H
authors.lastname: Sugerman
authors.forename: A
authors.initials: A
authors.lastname: Windsor
authors.forename: M
authors.initials: M
authors.lastname: Bessos
authors.forename: L
authors.initials: L
authors.lastname: Wolfe
mesh_terms: D000005:Abdomen / Q000473:pathology* / Q000503:physiopathology*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology*; D011446:Prospective Studies; D001743:Urinary Bladder / Q000503:physiopathology