Abdominal diameter index and 12-year cardiovascular disease incidence in male bridge and tunnel workers.
BACKGROUND
A recent study has suggested that abdominal diameter index (ADI), that is, the supine sagittal abdominal diameter divided by thigh circumference, may be a better measure of the increased risk of abdominal adiposity for prevalent ischemic cardiovascular disease (CVD) than body mass index or waist circumference. The risk associated with all of these measures is believed to arise from the link between visceral obesity and insulin resistance.


METHODS
Male bridge and tunnel workers in New York City without ischemic CVD in the highest and lowest quartiles of ADI (n=218) in a 1993-1994 cross-sectional study of risk factors and prevalent coronary heart disease were administered telephone follow-up questionnaires after 12 years (2005-2006) to assess incident ischemic CVD (new-onset angina, coronary revascularization, myocardial infarction, stroke, peripheral vascular disease and cardiovascular death).


RESULTS
In the univariate analysis of 111 participants able to be contacted, study members in the highest quartile vs the lowest quartile of ADI had a significantly increased cumulative incidence of ischemic CVD (Relative risk (RR)=7.9, P=0.002). In a logistic regression analysis controlling for other cardiovascular risk factors including age, smoking, total cholesterol, high-density lipoprotein cholesterol, triglycerides, blood pressure and glucose, ADI lost statistical significance (RR=4.37, P=0.063), suggesting that ADI may be an anthropometric surrogate for these cardiovascular risk factors.


CONCLUSIONS
ADI is a powerful anthropometric index for 12-year cumulative incidence of ischemic CVD in working men in New York City.
Ehrlich
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Department of Medicine, Mount Sinai Medical Center, New York, NY 10029, USA. adam.ehrlich@mssm.edu
Smith
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DA
D000704:Analysis of Variance; D000886:Anthropometry; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055105:Waist Circumference