The impact of using sagittal abdominal diameter to predict major cardiovascular events in European patients with type 2 diabetes

Nutr Metab Cardiovasc Dis. 2017 May;27(5):418-422. doi: 10.1016/j.numecd.2017.02.001. Epub 2017 Feb 16.


Background and aims: 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.

Methods and 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).

Conclusion: 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. NCT01049737.

Keywords: Anthropometric measurements; Cardiovascular risk; Diabetes; Obesity.

Publication types

  • Comparative Study

MeSH terms

  • Adiposity
  • Aged
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity, Abdominal / diagnosis*
  • Obesity, Abdominal / epidemiology
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Reproducibility of Results
  • Risk Assessment
  • Risk Factors
  • Sagittal Abdominal Diameter*
  • Sweden / epidemiology
  • Time Factors
  • Waist Circumference

Associated data