Sagittal abdominal diameter resembles waist circumference as a surrogate marker of insulin resistance in adolescents—Brazilian Metabolic Syndrome Study

• Published in: Pediatric diabetes Vol. 19; no. 5; pp. 882 - 891
• Main Authors: da Silva, Cleliani de Cassia, Vasques, Ana Carolina J, Zambon, Mariana P, Camilo, Daniella F, De Bernardi Rodrigues, Ana Maria, Antonio, Maria Ângela R G M, Geloneze, Bruno
• Format: Journal Article
• Language: English
• Published: Former Munksgaard John Wiley & Sons A/S 01-08-2018; Wiley Subscription Services, Inc
• Subjects: Abdominal Fat; abdominal obesity; Adolescent; Adolescents; Blood pressure; Brazil; Child; Cholesterol; Cross-Sectional Studies; Female; Glucose Clamp Technique; Health risk assessment; High density lipoprotein; Homeostasis; Humans; Insulin; Insulin Resistance; Male; Metabolic syndrome; Metabolic Syndrome - physiopathology; Obesity; Sagittal Abdominal Diameter; Teenagers; Triglycerides; Uric acid; Waist Circumference; Brazil; glucose clamp technique; abdominal obesity; adolescents; insulin resistance; sagittal abdominal diameter
• ISSN: 1399-543X; 1399-5448
• DOI: 10.1111/pedi.12664

Objective
To evaluate the association of the sagittal abdominal diameter (SAD) with insulin resistance (IR) and metabolic syndrome (MetS) components, and to compare SAD with waist circumference (WC).
Subjects/Methods
This was a multicenter, cross‐sectional study of 520 adolescents (10‐ to 18‐years old). IR was assessed using the homeostasis model assessment of IR (HOMA‐IR) and the hyperglycaemic clamp (n = 76).
Results
SAD and WC were positively correlated with HOMA‐IR (r = 0.637 and r = 0.653) and inversely correlated with the clamp‐derived insulin sensitivity index (ISI) (r = −0.734 and r = −0.731); P < .001. In the multivariable linear regression analysis, SAD was positively associated with HOMA‐IR (B = 0.046 ± 0.003) and inversely associated with the clamp‐derived ISI (B = −0.084 ± 0.009) after adjusting for sex, age, and Tanner's stages (P < .001). When WC replaced the SAD, it was positively associated with HOMA‐IR (B = 0.011 ± 0.001) and inversely associated with the clamp‐derived ISI (B = −0.018 ± 0.002); P < .001. The values of the areas under the curves (AUC) were 0.823 and 0.813 for SAD and WC, respectively. In Bland‐Altman analysis, there were agreement between both, SAD and WC, with the clamp‐derived ISI (mean = 0.00; P > .05). The SAD and WC were positively associated with blood pressure, triglycerides, and uric acid, and inversely associated with high‐density lipoprotein (HDL)‐cholesterol after adjusting for sex, age, and Tanner's stages.
Conclusion
The SAD was associated with IR and MetS components, with a good discriminatory power for detecting IR. When compared to WC, SAD showed equivalent results.