MRI sagittal abdominal diameter is a stronger predictor of metabolic syndrome than visceral fat area or waist circumference in a high-risk vascular cohort.
OBJECTIVE
To determine whether sagittal abdominal diameter (SAD) is associated with the metabolic syndrome independently of visceral fat area (VFA) and waist circumference (WC).


METHODS
Forty-three high-risk vascular patients were evaluated for metabolic syndrome criteria and underwent magnetic resonance imaging (MRI) to quantify SAD and VFA at the L4-L5 disc. COMPARISONS: 1. Baseline differences in patients with and without the metabolic syndrome 2. Forward binary logistic regression analysis of predictors of the metabolic syndrome with SAD, VFA and WC as independents 3. Correlates of SAD.


RESULTS
Patients with metabolic syndrome had greater SAD, VFA and WC than patients without the metabolic syndrome (P < 0.01). Of SAD, VFA and WC, only SAD was associated with metabolic syndrome on forward binary logistic regression; beta 0.68, Wald's statistic 10.8 (P = 0.001) and c-statistic 0.89 (P < 0.001). A > 22.7 cm SAD threshold identified metabolic syndrome with a 91% sensitivity and 80% specificity. SAD correlated with waist circumference (r = 0.918), high-density lipoprotein-cholesterol (r = -0.363), triglyceride (r = 0.401), fasting glucose (r = 0.428) and the QUICK index of insulin sensitivity (r = -0.667) (all P < 0.05).


CONCLUSIONS
MRI-measured SAD is associated with the metabolic syndrome and renders the current gold standard of VFA redundant. This measure of obesity-related cardiovascular risk requires validation and evaluation in a prospective cohort.
Hoenig
Michel R
MR
University of Queensland, Centre for Clinical Research, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. drmhoenig@yahoo.com.au
D000005:Abdomen / Q000473:pathology*; D050154:Adiposity; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000473:pathology; D009765:Obesity / Q000473:pathology; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D018709:Statistics, Nonparametric; D055105:Waist Circumference