2499-PUB: Sagittal Abdominal Diameter (SAD): A Marker of Metabolic Syndrome, Insulin Resistance (HOMA-IR) among Saudi Type 2 Diabetes Mellitus (T2DM) Patients

Abdominal obesity has been identified as an important risk factor for T2DM. Anthropometric measures (BMI, waist circumference (WC) and hip circumference (HC) are commonly used in evaluating obesity. One major shortcoming of these measure are their inability to distinguish between abdominal and visceral adipose tissue. SAD (i.e., the height of the abdomen when lying supine) predict the amount of visceral fat and several studies showed its strong correlation with insulin resistance, hyperinsulinemia as well as its prediction of metabolic syndrome.

The study is ongoing and aimed to evaluate SAD as predictor of metabolic syndrome components and (HOMA-IR) among Saudi T2DM patients.

A cross-sectional sample of 433 T2DM subjects (256 female and 177 male) with mean age of 57.2±11.7 (18-86) years was suitable for analysis. Mean SAD, BMI, WC and HC were 15.6±3.7 cm, 32.9±6, 105.5±12 cm and 113.3±12.7 cm respectively; mean HbA1c and C-peptide were 8.5%±1.5 and 754.6±471pmol/L respectively. SAD (Sensitivity, specificity) with correspondence to metabolic syndrome were (77%, 77%) in males and (72%, 53%) in females. The area below the ROC curve was 14.1 cm for males and 14.75 cm for females.

In Females, Each 1 cm increase in SAD increased 29% of HOMA-IR (aOR 1.293), 95% CI: 1.084-1.542; P = 0.004) and HbA1c increased 70%of moderate to severe HOMA-IR(aOR 1.703, 95% CI: 1.285-2.256; P = 0.001). In males, HbA1c and total cholesterol increased moderate to severe HOMA-IR by 50% and 90% respectively (aOR 1.999, 95% CI: 1.123-3.56; P = 0.019). Insulin level among female (aOR1.051, 95% CI: 1.005-1.098; P = 0.028) and HbA1c among male (aOR1.427, 95% CI: 1.06-1.921; P =0.019) increased 5% and 42% of metabolic syndrome risk respectively.

SAD was a strong predicator of insulin resistance in Female Saudi T2DM patients. The lower cut-off points of SAD in both genders compared with International threshold as well as SAD prediction of metabolic syndrome should be further examined.