title: The impact of using sagittal abdominal diameter to predict major cardiovascular events in European patients with type 2 diabetes.
abstract: OBJECTIVE
  Obesity is associated with diabetes type 2 and one of the most important risk factors for cardiovascular disease. We explored if sagittal abdominal diameter (SAD) is a better predictor of major cardiovascular events than waist circumference (WC) and body mass index (BMI) in type 2 diabetes.
  
  
  RESULTS
  The CARDIPP study consists of a cohort of patients with type 2 diabetes. In this study we used data from 635 participants with no previous myocardial infarction or stroke, with a mean follow-up time of 7.1 years. SAD, WC and BMI were measured at baseline and the end-point was first cardiovascular event, measured as a composite of ICD-10 codes for acute myocardial infarction, stroke or cardiovascular mortality. SAD was significantly higher in the major cardiovascular event group compared to participants that did not suffer a major cardiovascular event during follow-up (p < 0.001). SAD >25 cm was the only anthropometric measurement that remained associated with major cardiovascular events when adjusted for modifiable and non-modifiable factors (hazard ratio 2.81, 95% confidence interval 1.37-5.76, p = 0.005).
  
  
  CONCLUSIONS
  SAD with the cut off level of >25 cm, if confirmed in larger studies, may be used as a more independent risk-assessment tool compared with WC in clinical practice, to identify persons with type 2 diabetes at high cardiovascular risk. ClinicalTrials.gov: NCT01049737.
authors.affiliation: Division of Community Medicine, Primary Care, Department of Medicine and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Department of Local Care West, County Council of Östergötland, SE-581 83 Linköping, Sweden. Electronic address: karin.radholm@liu.se.
authors.forename: K
authors.initials: K
authors.lastname: Rådholm
authors.affiliation: Division of Community Medicine, Primary Care, Department of Medicine and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Department of Local Care West, County Council of Östergötland, SE-581 83 Linköping, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Tengblad
authors.affiliation: Division of Community Medicine, Primary Care, Department of Medicine and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Department of Local Care West, County Council of Östergötland, SE-581 83 Linköping, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Dahlén
authors.affiliation: Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, SE-58185 Linköping, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Länne
authors.affiliation: Department of Clinical Physiology, Faculty of Medicine and Health Sciences, Linköping University, Linköping, SE-58183, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Engvall
authors.affiliation: Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, SE-58185 Linköping, Sweden.
authors.forename: F H
authors.initials: FH
authors.lastname: Nystrom
authors.affiliation: Division of Community Medicine, Primary Care, Department of Medicine and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Department of Local Care West, County Council of Östergötland, SE-581 83 Linköping, Sweden.
authors.forename: C J
authors.initials: CJ
authors.lastname: Östgren
mesh_terms: D050154:Adiposity; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D064346:Sagittal Abdominal Diameter; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055105:Waist Circumference
keywords: Anthropometric measurements; Cardiovascular risk; Diabetes; Obesity