INTRAABDOMINAL PRESSURE, SAGITTAL ABDOMINAL DIAMETER AND OBESITY COMORBIDITY

Objectives. To determine relationship of intra-abdominal pressure to c entral obesity and the co-morbidity of obesity. Design. Non-randomized , prospective. Setting. University hospital, operating room. Subjects. Eighty-four anaesthetized consecutive patients prior to gastric bypas s for morbid obesity and five non-obese patients before colectomy for ulcerative colitis. Main outcome measures. Weight, body mass index (BM I), co-morbid history, sagittal abdominal diameter, waist:hip (W:H) ra tio and urinary bladder pressure, as an estimate of intra-abdominal pr essure. Results. Urinary bladder pressure was greater in the obese tha n the non-obese (18+/-0.7 vs. 7+/-1.6 cm H2O, P < 0.001), correlated w ith sagittal abdominal diameter (r = +0.67, P < 0.001) and was greater (P < 0.05) in patients with, than those without, morbidity probably ( hypoventilation, gastroesophageal reflux, venous stasis, stress incont inence, incisional hernia) or possibly (hypertension, diabetes) due to increased abdominal pressure. W:H ratio correlated with urinary bladd er pressure in men (r = +0.6, P < 0.05) but not women (r = -0.3). Conc lusions. Increased sagittal abdominal diameter was associated with inc reased intraabdominal pressure which contributed to obesity-related co morbidity. W:H ratio was not a reliable indicator of intra-abdominal p ressure for women who often have both peripheral and central obesity. Further studies are needed to evaluate the relationship between intra- abdominal pressure and Type II diabetes and hypertension.