title: Abdominal diameter index: a more powerful anthropometric measure for prevalent coronary heart disease risk in adult males.
abstract: OBJECTIVE
  The authors wished to compare the strength of association of several anthropometric measures of body size and fat distribution among themselves and in comparison with other known risk factors for prevalent coronary heart disease (CHD).
  
  
  METHODS
  Prevalent CHD was assessed in 466 middle-aged, male, multiracial Triborough Bridge and Tunnel Authority officers in New York City by verified history, electrocardiogram or exercise stress test. Anthropometric measures included body mass index, waist, hip and thigh circumferences, waist-hip ratio, waist-thigh ratio, sagittal abdominal diameter and abdominal diameter index (sagittal abdominal diameter/thigh circumference). Results were compared with other CHD risk factors measured simultaneously (history of diabetes, smoking, blood pressure, lipid profile, apolipoproteins A and B, lipoprotein (a), homocysteine, fibrinogen, urinary microalbumin, serum vitamin E and ferritin) and a calculated 10-year CHD risk using a Framingham algorithm (10-year Framingham CHD risk).
  
  
  RESULTS
  CHD was found in 29 individuals. Of the six anthropometric measures, abdominal diameter index gave the largest and most significant standardized odds ratio (OR) for CHD [1.80, 95% confidence interval (CI) 1.20, 2.71], equivalent to 10-year Framingham CHD risk. Men in the highest compared with the lowest tertile of abdominal diameter index had a univariate OR of 5.47 (95% CI 1.55, 19.28) which was the only anthropometric measure that remained significant after adjusting for 10-year Framingham CHD risk.
  
  
  CONCLUSIONS
  For middle-aged American men, abdominal diameter index may be the most powerful anthropometric measure of risk for prevalent CHD.
authors.affiliation: Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA. donald.smith@mssm.edu
authors.forename: D A
authors.initials: DA
authors.lastname: Smith
authors.forename: E M
authors.initials: EM
authors.lastname: Ness
authors.forename: R
authors.initials: R
authors.lastname: Herbert
authors.forename: C B
authors.initials: CB
authors.lastname: Schechter
authors.forename: R A
authors.initials: RA
authors.lastname: Phillips
authors.forename: J A
authors.initials: JA
authors.lastname: Diamond
authors.forename: P J
authors.initials: PJ
authors.lastname: Landrigan
mesh_terms: D000005:Abdomen / Q000473:pathology*; D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000453:epidemiology; D001837:Body Weights and Measures / Q000379:methods; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology; D005293:Ferritins / Q000097:blood; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014810:Vitamin E / Q000097:blood
chemical_list: D014280:Triglycerides; D014810:Vitamin E; D005293:Ferritins; D002784:Cholesterol