title: Sagittal abdominal diameter is a more independent measure compared with waist circumference to predict arterial stiffness in subjects with type 2 diabetes--a prospective observational cohort study.
abstract: BACKGROUND
  Anthropometric measurements are useful in clinical practice since they are non-invasive and cheap. Previous studies suggest that sagittal abdominal diameter (SAD) may be a better measure of visceral fat depots. The aim of this study was to prospectively explore and compare how laboratory and anthropometric risk markers predicted subclinical organ damage in 255 patients, with type 2 diabetes, after four years.
  
  
  METHODS
  Baseline investigations were performed in 2006 and were repeated at follow-up in 2010. Carotid intima-media thickness (IMT) was evaluated by ultrasonography and aortic pulse wave velocity (PWV) was measured with applanation tonometry over the carotid and femoral arteries at baseline and at follow-up in a cohort of subjects with type 2 diabetes aged 55-65 years old.
  
  
  RESULTS
  There were significant correlations between apolipoprotein B (apoB) (r = 0.144, p = 0.03), C - reactive protein (CRP) (r = 0.172, p = 0.009) at baseline and IMT measured at follow-up. After adjustment for sex, age, treatment with statins and Hba1c, the associations remained statistically significant. HbA1c, total cholesterol or LDL-cholesterol did not correlate to IMT at follow-up. Baseline body mass index (BMI) (r = 0.130, p = 0.049), waist circumference (WC) (r = 0.147, p = 0.027) and sagittal Abdominal Diameter (SAD) (r = 0.184, p = 0.007) correlated to PWV at follow-up. Challenged with sex, SBP and HbA1c, the association between SAD, not WC nor BMI, and PWV remained statistically significant (p = 0.036). In a stepwise linear regression, entering both SAD and WC, the association between SAD and PWV was stronger than the association between WC and PWV.
  
  
  CONCLUSIONS
  We conclude that apoB and CRP, but not LDL-cholesterol predicted subclinical atherosclerosis. Furthermore, SAD was more independent in predicting arterial stiffness over time, compared with WC, in middle-aged men and women with type 2 diabetes.
authors.affiliation: Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, Linköping SE-581 83, Sweden. elsa.dahlen@liu.se
authors.forename: Elsa M
authors.initials: EM
authors.lastname: Dahlén
authors.forename: Niclas
authors.initials: N
authors.lastname: Bjarnegård
authors.forename: Toste
authors.initials: T
authors.lastname: Länne
authors.forename: Fredrik H
authors.initials: FH
authors.lastname: Nystrom
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Ostgren
mesh_terms: D000005:Abdomen; D000368:Aged; D001055:Apolipoproteins B; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D015992:Body Mass Index; D049628:Body Size; D002097:C-Reactive Protein / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D050152:Intra-Abdominal Fat; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness; D055105:Waist Circumference
chemical_list: D001055:Apolipoproteins B; D002097:C-Reactive Protein; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
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