The Association of Sagittal Abdominal Diameter with Metabolic Syndrome Risk Before and After Weight-loss Surgery in Adolescents


Metabolic syndrome (MetS) affects ∼10% of US adolescents. Abdominal obesity is the
most prevalent component and may indicate MetS risk in adolescents undergoing weight-loss


Assess MetS risk/severity and its association with abdominal obesity (measured by
sagittal abdominal diameter, SAD) before and after weight-loss surgery in adolescents
to determine whether SAD predicts MetS risk in this population.


Data were collected in the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS)
study at 5 sites (US children’s hospitals) performing weight-loss surgery in adolescents.
The current study is a secondary analysis of these data.


We examined data collected pre-surgery through 5 years post-surgery. MetS risk/severity
was defined using the MetS severity z-score (MetS-z), and MetS prevalence was determined
using age-appropriate criteria. Association between SAD and MetS-z was evaluated with
an adjusted linear mixed model.


Among 228 individuals (75% female, 72% white), mean age 16.5y and BMI 53 kg/m2, 79% met MetS criteria pre-surgery. MetS-z (1.5) and SAD (32cm) were correlated (r=0.6,
p<0.0001) pre-surgery, and both improved significantly at 6 months, 1, and 5 years
post-surgery, remaining highly correlated at each timepoint. SAD predicted MetS-z
(β=0.118, 95% CI 0.109, 0.127) after adjustment for age, visit, surgery type, and
caregiver education.


Abdominal obesity is a key MetS risk marker in youth undergoing weight-loss surgery.
Both SAD and Met-z measures may be useful for MetS risk assessment and tracking post-surgery
changes in this population, but more research is needed to identify effective lifestyle
interventions targeting abdominal obesity.

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