SAGITTAL ABDOMINAL DIAMETER IN DETERMINING INSULIN RESISTANCE IN NEWLY DIAGNOSED TYPE 2 DIABETES

Quang Toàn Lê 1,2,, Khánh Huyền Đỗ 1
1 National Hospital of Endocrinology
2 University of Medicine and Pharmacy, Vietnam National University, Hanoi

Main Article Content

Abstract

Background: To determine insulin resistance in patients with type 2 diabetes using a simple clinical index has practical significance. Objectives: To investigate the relationship between sagittal abdominal diameter (SAD) and insulin resistance compared to classic anthropometric indices and initially establish the SAD cutoff point to determine insulin resistance in patients with newly diagnosed type 2 diabetes. Subjects and methods: 136 newly diagnosed type 2 diabetes patients (not yet using blood glucose-lowering drugs) at the National Endocrinology Hospital were evaluated on: 1/ anthropometric indexes: body mass index ( BMI), waist circumference (WC), waist to hip ratio (WHR) and SAD; 2/insulin resistance index HOMA2-IR. Results: The patients with insulin resistance (HOMA2-IR ≥ 1.14) had statistically significantly higher SAD than the ones without insulin resistance (HOMA2-IR < 1.14) in both men and women. SAD has a statistically significant positive correlation with HOMA2-IR in men and women with r correlations of 0.442 (p < 0.001) and 0.672 (p < 0.001) respectively, while BMI, WC and WHR have no significant correlation with HOMA2-IR. The area under the curve of SAD in determining insulin resistance (95% confidence interval) in men and women was 0.683 (0.556 – 0.855) and 0.724 (0.592 – 0.809), respectively. The SAD cutoff point of 19.0cm in women and 20.5cm in men had a sensitivity of 76.5% and 73.7%, respectively, and a specificity of 48.4% and 59.1%, respectively, in determining insulin resistance. Conclusions: SAD has a fairly strong positive correlation with HOMA2-IR and can be used to determine insulin resistance in patients with type 2 diabetes.

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References

1. Despres JP: Abdominal obesity as important component of insulin-resistance syndrome. Nutrition. 1993, 9: 452–459.
2. Vasques ACJ, Cassani RSL, Forti AC e, et al. Sagittal Abdominal Diameter as a Surrogate Marker of Insulin Resistance in an Admixtured Population—Brazilian Metabolic Syndrome Study (BRAMS). PLoS ONE, 2015, 10(5): e0125365. doi:10.1371/journal.pone.0125365.
3. Riserus U, de Faire U, Berglund L, Hellenius ML. Sagittal abdominal diameter as a screening tool in clinical research: cutoffs for cardiometabolic risk. J Obes. 2010, 757939: 11. doi:10.1155/2010/757939.
4. Petersson H, Daryani A and Risérus U: Sagittal abdominal diameter as a marker of inflammation and insulin resistance among immigrant women from the Middle East and native Swedish women: a cross-sectional study. Cardiovascular Diabetology, 2007, 6:10. doi:10.1186/1475-2840-6-10.
5. Pimentel GD, Moreto F, Takahashi MM, Portero-McLellan KC, Burini RC. Sagital abdominal diameter, but not waist circumference is strongly associated with glycemia, triacilglycerols and HDL-C levels in overweight adults. Nutr Hosp. 2011; 26(5):1125-1129.
6. Wajchenberg BL, Giannella-Neto D, da Silva ME, Santos RF. Depot-specific hormonal characteristics of subcutaneous and visceral adipose tissue and their relation to the metabolic syndrome. Horm Metab Res, 2002, 34(11-12):616-21.
7. Nordhamn K, S¨odergren E, Olsson E, Karlstr¨om B, Vessby B, Berglund L. Reliability of anthropometric measurements in overweight and lean subjects: consequences for correlations between anthropometric and other variables. International Journal of Obesity. 2000; 24 (5): 652–657.
8. World Health Organization. Expert committee on physical status: the use and interpretation of anthropometry—report of WHO Expert Committee. WHO Tech. Rep. Ser 854. 1995.
9. American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care, 2022; 45(Suppl. 1):S17–S38.