Measuring the abdomen's height rather than its circumference

Association between sagittal abdominal diameter-to-height ratio and all-cause mortality among adults in the United States: a longitudinal study

BACKGROUND

The global health crisis of obesity has prompted a need for better indicators of abdominal obesity than body mass index, with sagittal abdominal diameter emerging as a potential candidate. Nonetheless, the association between sagittal abdominal diameter-to-height ratio (SADHtR) and mortality remains inadequately established. Our objective was to contribute novel evidence to this association.

METHODS

This study encompassed 12,572 participants aged 18-80 years from the National Health and Nutrition Examination Survey 2011-2016. Mortality data were tracked until December 31, 2019. Weighted multivariable Cox proportional hazard models were employed to evaluate the association between SADHtR and all-cause mortality, with subgroup analyses conducted for result robustness.

RESULTS

Following a median follow-up period of 69 months, each standard deviation (SD) increase in SADHtR was consistently associated with a higher risk of all-cause mortality across three models, yielding a hazard ratio (HR) and 95% confidence interval (CI) of 1.51(1.29,1.76) in model 3. Additionally, compared to the first tertile of SADHtR, the third tertile exhibited a higher risk for all-cause mortality, with HRs(95%CIs) of 1.58(1.25,2.01) in model 1, 2.01(1.33,3.02) in model 2, and 1.74(1.19,2.57) in model 3. Notably, subgroup analysis revealed persistent positive associations between SADHtR and all-cause mortality among subgroups based on age-at-risk (< 65, ≥ 65 years), sex, diabetes, hypertension, and hyperlipidemia.

CONCLUSIONS

Elevated SADHtR was consistently associated with a higher risk of all-cause mortality in American adults. Regular SADHtR measurement should be considered to be integrated into clinical practice and healthcare examinations.

Association between sagittal abdominal diameter-to-height ratio and arteriosclerotic cardiovascular disease among the United States adults: A cross-sectional study

Objectives

Abdominal obesity is recognized as a significant determinant of Arteriosclerotic cardiovascular disease (ASCVD), with sagittal abdominal diameter (SAD) being considered a more precise indicator of visceral fat. Nevertheless, the association between SAD and ASCVD remains unexplored in large-scale general-population studies.

Methods

The study included 11,211 participants aged 20 to 80 from the National Health and Nutrition Examination Survey. Logistic regression models were utilized to evaluate the association between the SAD-to-height ratio (SADHtR) and ASCVD. Subgroup analyses based on age categories, sex, diabetes, and hypertension were conducted to assess result robustness.

Results

The median SADHtR value was 0.13 (0.12-0.15), and 1,006 cases (7.46 %) of ASCVD were recorded. Multivariable models showed that each standard deviation increase in SADHtR was positively associated with higher odds of ASCVD (OR 1.48, 95 % CI 1.36-1.62 in model 1; OR 1.41, 95 % CI 1.28-1.54 in model 2; OR 1.18, 95 % CI 1.08-1.30 in model 3). Comparing the first quartile of SADHtR to the second to fourth quartiles, positive associations with ASCVD were observed in models 1 and 2. However, in model 3, only the fourth quartile of SADHtR remained statistically significant (OR 1.58, 95 % CI 1.17-2.15), with all p-values for the trend being less than 0.05. No interactions were found in the subgroup analyses.

Conclusion

This study demonstrates a positive association between SADHtR and ASCVD in the general adult population of the United States. Our findings indicate that SADHtR, especially when ≥ 0.155, could be a valuable metric for assessing the risk of ASCVD.