title: Sagittal abdominal diameter and visceral adiposity: correlates of beta-cell function and dysglycemia in severely obese women.
abstract: BACKGROUND
  In the context of increasing obesity prevalence, the relationship between large visceral adipose tissue (VAT) volumes and type 2 diabetes mellitus (T2DM) is unclear. In a clinical sample of severely obese women (mean body mass index [BMI], 46 kg/m(2)) with fasting normoglycemia (n = 40) or dysglycemia (impaired fasting glucose + diabetes; n = 20), we sought to determine the usefulness of anthropometric correlates of VAT and associations with dysglycemia.
  
  
  METHODS
  VAT volume was estimated using multi-slice computer tomography; anthropometric surrogates included sagittal abdominal diameter (SAD), waist circumference (WC) and BMI. Insulin sensitivity (Si), and beta-cell dysfunction, measured by insulin secretion (AIRg) and the disposition index (DI), were determined by frequently sampled intravenous glucose tolerance test.
  
  
  RESULTS
  Compared to fasting normoglycemic women, individuals with dysglycemia had greater VAT (P < 0.001) and SAD (P = 0.04), but BMI, total adiposity and Si were similar. VAT was inversely associated with AIRg and DI after controlling for ancestry, Si, and total adiposity (standardized beta, -0.32 and -0.34, both P < 0.05). In addition, SAD (beta = 0.41, P = 0.02) was found to be a better estimate of VAT volume than WC (beta = 0.32, P = 0.08) after controlling for covariates. Receiver operating characteristic analysis showed that VAT volume, followed by SAD, outperformed WC and BMI in identifying dysglycemic participants.
  
  
  CONCLUSIONS
  Increasing VAT is associated with beta-cell dysfunction and dysglycemia in very obese women. In the presence of severe obesity, SAD is a simple surrogate of VAT, and an indicator of glucose dysregulation.
authors: Department of Nutrition Sciences, Purdue University, 700 W. State Street, Stone Hall, West Lafayette, IN 47907, USA. ngletsum@purdue.edu
authors: Nana
authors: N
authors: Gletsu-Miller
authors: Henry S
authors: HS
authors: Kahn
authors: Danijela
authors: D
authors: Gasevic
authors: Zhe
authors: Z
authors: Liang
authors: Jennifer K
authors: JK
authors: Frediani
authors: William E
authors: WE
authors: Torres
authors: Thomas R
authors: TR
authors: Ziegler
authors: Lawrence S
authors: LS
authors: Phillips
authors: Edward
authors: E
authors: Lin
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D050152:Intra-Abdominal Fat / Q000378:metabolism / Q000473:pathology*; D008137:Longitudinal Studies; D061330:Multidetector Computed Tomography; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D064346:Sagittal Abdominal Diameter; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human