title: Sagittal Abdominal Diameter as a Surrogate Marker of Insulin Resistance in an Admixtured Population--Brazilian Metabolic Syndrome Study (BRAMS).
abstract: BACKGROUND
  Sagittal abdominal diameter (SAD) has been proposed as a surrogate marker of insulin resistance (IR). However, the utilization of SAD requires specific validation for each ethnicity. We aimed to investigate the potential use of SAD, compared with classical anthropometrical parameters, as a surrogate marker of IR and to establish the cutoff values of SAD for screening for IR.
  
  
  METHODS
  A multicenter population survey on metabolic disorders was conducted. A race-admixtured sample of 824 adult women was assessed. The anthropometric parameters included: BMI, waist circumference (WC), waist-to-hip ratio and SAD. IR was determined by a hyperglycemic clamp and the HOMA-IR index.
  
  
  RESULTS
  After adjustments for age and total body fat mass, SAD (r = 0.23 and r = -0.70) and BMI (r = 0.20 and r = -0.71) were strongly correlated with the IR measured by the HOMA-IR index and the clamp, respectively (p < 0.001). In the ROC analysis, the optimal cutoff for SAD in women was 21.0 cm. The women with an increased SAD presented 3.2 (CI 95%: 2.1-5.0) more likelihood of having IR, assessed by the HOMA-IR index compared with those with normal SAD (p < 0.001); whereas women with elevated BMI and WC were 2.1 (95% CI: 1.4-3.3) and 2.8 (95% CI: 1.7-4.5) more likely to have IR (p < 0.001), respectively. No statistically significant results were found for waist-to-hip ratio.
  
  
  CONCLUSIONS
  SAD can be a suitable surrogate marker of IR. Understanding and applying routine and simplified methods is essential because IR is associated with an increased risk of obesity-related diseases even in the presence of normal weight, slight overweight, as well as in obesity. Further prospective analysis will need to verify SAD as a determinant of clinical outcomes, such as type 2 diabetes and cardiovascular events, in the Brazilian population.
authors.affiliation: LIMED-Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, State University of Campinas, Campinas, São Paulo, Brazil; School of Applied Sciences, State University of Campinas, Limeira, São Paulo, Brazil.
authors.forename: Ana Carolina J
authors.initials: AC
authors.lastname: Vasques
authors.affiliation: LIMED-Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, State University of Campinas, Campinas, São Paulo, Brazil.
authors.forename: Roberta S L
authors.initials: RS
authors.lastname: Cassani
authors.affiliation: Department of Endocrinology, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors.forename: Adriana C e
authors.initials: AC
authors.lastname: Forti
authors.affiliation: LIMED-Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, State University of Campinas, Campinas, São Paulo, Brazil.
authors.forename: Brunna S
authors.initials: BS
authors.lastname: Vilela
authors.affiliation: LIMED-Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, State University of Campinas, Campinas, São Paulo, Brazil.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Pareja
authors.affiliation: Department of Endocrinology, State University of Campinas, Campinas, São Paulo, Brazil.
authors.forename: Marcos Antonio
authors.initials: MA
authors.lastname: Tambascia
authors.affiliation: LIMED-Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, State University of Campinas, Campinas, São Paulo, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Geloneze
mesh_terms: D000328:Adult; D015415:Biomarkers; D001938:Brazil; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000208:ethnology; D008875:Middle Aged; D012372:ROC Curve; D064346:Sagittal Abdominal Diameter; D055815:Young Adult
chemical_list: D015415:Biomarkers