Sagittal abdominal diameter and visceral adiposity: Correlates of beta-cell function and dysglycemia in severely obese women

Nana Gletsu-Miller, Henry S. Kahn, Danijela Gasevic, Zhe Liang, Jennifer K. Frediani, William E. Torres, Thomas R. Ziegler, Lawrence S. Phillips, Edward Lin

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18 Citations (Scopus)

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/m2) 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.

Original languageEnglish
Pages (from-to)874-881
Number of pages8
JournalObesity Surgery
Volume23
Issue number7
DOIs
Publication statusPublished - Jul 2013
Externally publishedYes

Keywords

  • Anthropometry
  • Insulin resistance
  • Intra-abdominal fat
  • Obesity
  • Sagittal abdominal diameter
  • Type 2 diabetes
  • Waist circumference

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