title: The distance between the lower edge of the xiphisternum and the center of the umbilicus as an indicator of abdominal obesity and cardiovascular disease risk.
abstract: OBJECTIVE
  Abdominal obesity is considered an independent risk factor for cardiovascular disease (CVD).
  
  
  OBJECTIVE
  To compare the distance between the lower edge of xiphisternum and the center of the umbilicus (XUD) with other anthropometric measurements in predicting risk factors for CVD.
  
  
  METHODS
  A random sample of 4,485 (males 1,772, females 2,713) nationally representative noninstitutionalized adults aged >or=18 years were included in the analysis. XUD, BMI, waist circumference (WC), waist-to-hip ratio (WHR), systolic and diastolic blood pressure were measured and fasting venous blood samples were collected to determine glucose, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein cholesterol and triacylglyceride levels. Oral glucose tolerance test (OGTT) was also preformed.
  
  
  RESULTS
  The mean XUD (+/- SD) was 17.4 +/- 3.2 cm and 17.0 +/- 3.0 cm for males (M) and females (F) respectively (M vs. F; p < 0.001). XUD had significant correlations with the cardiovascular risk factors analyzed as continuous variables (p < 0.001), except LDL cholesterol for women. However, the strengths of associations were weak for all associations (<0.3). The correlations of BMI, WC and WHR with XUD were significant (p < 0.001). The area under the curve (AUC) in the receiver operating characteristic (ROC) curve analysis for XUD in predicting the presence of two or more CVD risk factors was 0.62 (95%CI 0.61- 0.64); the corresponding AUC values for BMI (0.71, 95% CI 0.69-0.72), WC (0.71 95% CI, 0.70-0.73), and WHR (0.67 95% CI, 0.65-0.68) were higher than that for XUD.
  
  
  CONCLUSIONS
  The XUD showed significant correlations with the cardiovascular risk factors among Sriii Lankan adults. However, in predicting CVD risk XUD was inferior to BMI, WC, and WHR.
authors.affiliation: Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka. prasad.katulanda@ocdem.ox.ac.uk
authors.forename: Prasad
authors.initials: P
authors.lastname: Katulanda
authors.forename: Mallika Arachchige Ranil
authors.initials: MA
authors.lastname: Jayawardena
authors.forename: Mohamed Hussain Rezvi
authors.initials: MH
authors.lastname: Sheriff
authors.forename: David Richard
authors.initials: DR
authors.lastname: Matthews
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology* / Q000473:pathology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014472:Umbilicus; D049629:Waist-Hip Ratio; D014989:Xiphoid Bone
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides