Weight-adjusted waist index reflects fat and muscle mass in the opposite direction in older adults

Association of ultra-processed food consumption with muscle mass among young and middle-aged US adults

INTRODUCTION

Muscle mass is vital for physical activity and fundamental physiological processes supporting long-term health. While aging is inevitable, certain modifiable factors positively influence muscle preservation and overall well-being. However, the relationship between the consumption of ultra-processed foods (UPF) and muscle mass is not yet clear.

METHODS

This study included 7,173 men and nonpregnant women aged 20-59 years with valid 24-hour dietary recalls and accessible whole-body dual-energy x-ray absorptiometry (DXA) scans from NHANES 2011-2018. UPFs were identified through the NOVA classification system, and the percentage of energy derived from UPF consumption was evaluated in quintiles. Muscle mass measures were derived from DXA scans and quantified by the total and regional muscle mass index (MMI, kg/m²) and appendicular muscle mass index (AMMI, kg/m²). Multivariable-adjusted generalized linear regression models were applied to investigate the association between consumption of UPFs and muscle mass measures overall and by sociodemographic subgroups.

RESULTS

The multivariable-adjusted differences of total MMI from the lowest to highest quintile of UPF consumption were 0 (reference), -0.03 (95% CI, -0.13, 0.07), -0.13 (95%CI, -0.24, -0.04), -0.12 (95% CI, -0.23, -0.01), and - 0.17 (95% CI, -0.27, -0.08) (P for trend < 0.001). Subtotal MMI followed a similar magnitude of associational pattern as total MMI. For trunk MMI, corresponding values from the lowest to highest quintiles of UPF consumption were 0 (reference), -0.02 (95% CI, -0.07, 0.02), -0.05 (95%CI, -0.11, 0.00), -0.07 (95% CI, -0.13, -0.01), and - 0.07 (95% CI, -0.12, -0.01). For AMMI, corresponding values from the lowest to highest quintiles of UPF consumption were 0 (reference), -0.004 (95% CI, -0.07, 0.06), -0.08 (95%CI, -0.14, -0.02), -0.05 (95% CI, -0.11, 0.02), and - 0.10 (95% CI, -0.16, -0.04) (All P for trend < 0.001). While most subgroups maintained similar overall patterns, heterogeneous findings were also observed. For example, the multivariable-adjusted differences in total MMI between the lowest and highest quantile of UPF consumption were - 0.19 (95% CI, -0.32, -0.06) for non-Hispanic Whites, 0.18 (95% CI, 0.01, 0.36) for non-Hispanic Blacks, -0.25 (95%CI, -0.45, -0.04) for Hispanics, -0.25 (95% CI, -0.51, 0.05) for non-Hispanic Asians and - 0.32 (95% CI, -0.75, 0.12) for others (P for interaction < 0.001).

CONCLUSION

Higher consumption of UPFs was significantly associated with lower values of total and regional muscle mass. Specifically, comparing the highest quantile of UPF consumption to the lowest, total MMI decreased by 0.93%, trunk MMI decreased by 0.76%, and AMMI decreased by 1.25%. The differences in associational patterns between UPF consumption and muscle mass across sociodemographic subgroups require further investigation.

Association between weight-adjusted-waist index and depression in US adults: A cross-sectional study

BACKGROUND

Current evidence implicates a significant association between depression and obesity and related metabolic dysfunction. The weight-adjusted-waist index (WWI) was recently identified as an ideal index that integrates total body fat, muscle mass, and bone mass. This study investigated the relationship between WWI and depressive symptoms in adults.

METHODS

Participants from the National Health and Nutrition Examination Survey (2005-2018) were enrolled. Depressive symptom severity was measured with the Patient Health Questionnaire-9 (PHQ-9). Survey-weighted multivariable logistic regression, subgroup analysis, and generalized additive models were used to determine the relationship between WWI and depressive symptoms.

RESULTS

A total of 34,575 participants were included, with a mean WWI of 11.01; 2,979 participants were suspected of having depressive symptoms (PHQ-9 score ≥ 10). A significant positive association was identified between WWI and depressive symptoms (odds ratio = 1.416, 95 % confidence interval: 1.303-1.539, P < 0.0001). Subgroup analyses suggested that the association between WWI and depressive symptoms was stronger in individuals who were female, overweight, divorced, middle-aged or older (over 40 years old), and had diabetes. Furthermore, the non-linear multivariable regression revealed an inflection point for the WWI at 11.438, and the association was only significant when the WWI was higher than this point.

LIMITATIONS

This study was retrospective and only included participants from the United States; therefore, further validation is needed from studies in other countries, especially middle-to-low-income countries, using longitudinal cohorts.

CONCLUSIONS

This study identified a significant positive association between WWI and depressive symptoms.

Association of weight-adjusted waist index with all-cause mortality among non-Asian individuals: a national population-based cohort study

INTRODUCTION

The Weight-Adjusted Waist Index (WWI) is a new indicator of obesity that is associated with all-cause mortality in Asian populations. Our study aimed to investigate the linear and non-linear associations between WWI and all-cause mortality in non-Asian populations in the United States, and whether WWI was superior to traditional obesity indicators as a predictor of all-cause mortality.

METHODS

We conducted a cohort study using data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES), involving 18,592 participants. We utilized Cox proportional hazard models to assess the association between WWI, BMI, WC, and the risk of all-cause mortality, and performed subgroup analyses and interaction tests. We also employed a receiver operating characteristics (ROC) curve study to evaluate the effectiveness of WWI, BMI, and WC in predicting all-cause mortality.

RESULTS

After adjusting for confounders, WWI, BMI, and WC were positively associated with all-cause mortality. The performance of WWI, BMI, and WC in predicting all-cause mortality yielded AUCs of 0.697, 0.524, and 0.562, respectively. The data also revealed a U-shaped relationship between WWI and all-cause mortality. Race and cancer modified the relationship between WWI and all-cause mortality, with the relationship being negatively correlated in African Americans and cancer patients.

CONCLUSIONS

In non-Asian populations in the United States, there is a U-shaped relationship between WWI and all-cause mortality, and WWI outperforms BMI and WC as a predictor of all-cause mortality. These findings may contribute to a better understanding and prediction of the relationship between obesity and mortality, and provide support for effective obesity management strategies.

Association of weight-adjusted waist index with hyperuricemia and gout among middle-aged and older adults in America: a cross-sectional analysis of NHANES 2007-2014

OBJECTIVES

The weight-adjusted waist circumference index (WWI), a novel obesity indicator, gives better accuracy in assessing both muscle and fat mass. Our goal was to evaluate the relationship between WWI and the occurrence of hyperuricemia/gout among middle-aged and older adults in America.

METHODS

We analyzed the National Health and Nutrition Examination Survey (NHANES) data from the 2007-2014 cycles. Logistic regression analyses, subgroup analyses, and restricted cubic splines (RCS) were performed to evaluate the association between WWI and hyperuricemia/gout prevalence.

RESULTS

A total of 5332 adults aged 50 years and above were included in this study. The prevalence of hyperuricemia and gout was 23.20% and 6.70% respectively. The fourth quartile of WWI was associated with a 56% higher risk for hyperuricemia, compared with the first quartile (OR = 1.56, 95% CI 1.07-2.27, P trend < 0.001). A similar association was found between continuous WWI increase and OR of hyperuricemia in the fully adjusted model (OR = 1.35, 95% CI = 1.13-1.61, P < 0.05). However, WWI was not significantly associated with the prevalence of gout. The RCS model suggested a significant linear relationship between WWI and the risk of hyperuricemia/gout. Stratification analysis showed that the positive associations of WWI with the risk of hyperuricemia were more pronounced in participants who were women, aged 50-59, smokers, no physical activity, non-diabetes, hypertension, and hyperlipidemia.

CONCLUSIONS

Our findings suggest a positive correlation between WWI and hyperuricemia among middle-aged and older adults in America. Employing WWI as a tool for hyperuricemia prevention may be meaningful. Key Points • Weight-adjusted waist circumference index is a new obesity evaluation index. • Weight-adjusted waist circumference index is associated with hyperuricemia not gout. • The association is more pronounced in participants who were women, aged 50-59, smokers, no physical activity, non-diabetes, hypertension, and hyperlipidemia.

The association between weight-adjusted-waist index and psoriasis: A cross-sectional study

INTRODUCTION

This study explored the association between psoriasis and the weight-adjusted waist index (WWI), a newly developed measure of adiposity. The research was conducted among adults in the United States.

METHODS

Utilizing survey data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2009 to 2014, the present study aimed to investigate the potential correlation between psoriasis and WWI within a sample of 15,920 adult participants. Employing multivariable logistic regression and nonlinear curve fitting techniques, we analyzed this plausible association. Additionally, a subgroup analysis was conducted to ascertain the consistency across diverse populations.

RESULTS

A significant positive association was discovered between psoriasis and WWI in the investigated sample of 15,920 adults. After conducting a comprehensive adjustment of the model, it was observed that each incremental unit of WWI was significantly associated with an 14% elevated likelihood of developing psoriasis (OR = 1.16, 95% CI 1.01-1.36). Moreover, individuals belonging to the highest quartile of WWI exhibited a 47% higher risk of psoriasis compared to those in the lowest quartile (OR = 1.44, 95% CI 1.01-2.06). This positive correlation remained consistent across various subgroups. The study also compared WWI with BMI and waist circumference, finding that WWI is a more stable metric of obesity.

CONCLUSIONS

Our study suggested that in US adults, there is a positive association between WWI and psoriasis. It also indicated that WWI showed potential as a valuable index of psoriasis among the general population.

Prevalence and risk factors of sarcopenia in patients on maintenance hemodialysis: a retrospective cohort study

BACKGROUND

This study aimed to explore the prevalence and related risk factors of sarcopenia in patients on maintenance hemodialysis (MHD).

METHODS

This cohort study enrolled 165 patients on MHD. The patients were divided into sarcopenia and non-sarcopenia groups based on the presence of sarcopenia or not. Sarcopenia was diagnosed according to the consensus of the Asian Sarcopenia Working Group that considers reduced muscle mass and decreased muscle strength (19). The muscle mass was measured using the multi-frequency bioelectrical impedance (Inbody260) and skeletal muscle index (SMI) was used: <7.0 kg/m2 (male); <5.7 kg/m2 (female) - with muscle mass reduction. The electronic grip dynamometer was used for measuring dominant handgrip strength (HGS) to reflect muscle strength. Male patients with HGS < 28 kg and female patients with HGS < 18 kg were considered with a decrease in muscle strength. The demographic characteristics, laboratory indexes, anthropometrical measurements, body compositions, and InBody score were compared between groups. The multivariate logistic regression was used to explore the risk factors for sarcopenia.

RESULTS

Of the 165 patients on MHD, 36 had sarcopenia, and the prevalence was 21.82%. Patients in the sarcopenia group had higher ages and lower body mass index, serum albumin level, circumference of waist, hip, and biceps, handgrip strength, total water content, protein inorganic salt concentrations, skeletal muscle mass, basal metabolic rate, obesity degree, SMI, and body fat content. The multivariate logistic regression showed that age, waist circumference, handgrip strength, and InBody score were influencing factors for sarcopenia in patients on hemodialysis.

CONCLUSION

The prevalence of sarcopenia was high in patients on MHD. Higher age, lower waist circumference, lower handgrip strength, and lower InBody score were independent risk factors for sarcopenia in such patients.

The relationship between body roundness index and depression: A cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018

BACKGROUND

Depression is linked to obesity. The body roundness index (BRI) provides a more accurate assessment of body and visceral fat levels than the body mass index or waist circumference. However, the association between BRI and depression is unclear. Therefore, we investigated this relationship using the National Health and Nutrition Examination Survey (NHANES) database.

METHODS

In this population-based cross-sectional study, data from 18,654 adults aged ≥20 years from the NHANES 2011-2018 were analyzed. Covariates, including age, gender, race/ethnicity, education level, marital status, poverty-income ratio, alcohol status, smoking status, hypertension, diabetes mellitus, cardiovascular disease, energy intake, physical activity, total cholesterol, and triglycerides were adjusted in multivariable logistic regression models. In addition, smooth curve fitting, subgroup analysis, and interaction testing were conducted.

RESULTS

After adjusting for covariates, BRI was positively correlated with depression. For each one-unit increase in BRI, the prevalence of depression increased by 8 % (odds ratio = 1.08, 95 % confidence interval = 1.05-1.10, P < 0.001).

LIMITATIONS

As this was a cross-sectional study, we could not determine a causal relationship between BRI and depression. Patients with depression in this study were not clinically diagnosed with major depressive disorder.

CONCLUSION

BRI levels were positively related to an increased prevalence of depression in American adults. BRI may serve as a simple anthropometric index to predict depression.

The association between weight-adjusted-waist index and sarcopenia in adults: a population-based study

This study aims to investigate the relationship between weight-adjusted-waist index (WWI), a new body index, and sarcopenia, while also assessing the potential of WWI as a tool for screening sarcopenic patients. The cross-sectional study involved adults who possessed complete data on WWI and appendicular skeletal muscle mass from the 1999-2006 and 2011-2018 National Health and Nutrition Examination Surveys. Weighted multivariate regression and logistic regression analyses were employed to explore the independent relationship between WWI and sarcopenia. The study included 26,782 participants. The results showed that WWI demonstrated a positive correlation with sarcopenia risk. In the fully adjusted model, with each 1 unit increase in WWI, the risk of developing sarcopenia rose 14.55 times higher among males (OR: 14.55, 95% CI 12.33, 17.15) and 2.86 times higher among females (OR: 2.86, 95% CI 2.59, 3.15). The optimal cutoff values of WWI for sarcopenia were 11.26 cm/√kg for males and 11.39 cm/√kg for females. Individuals with a higher WWI have an increased risk of developing sarcopenia, and a high WWI functions as a risk factor for sarcopenia. Assessing WWI could assist in identifying individuals at risk of sarcopenia.

Associations between weight-adjusted-waist index and telomere length: Results from NHANES: An observational study

Previous studies have demonstrated the connection between obesity and telomere length. A recently devised metric for determining obesity, the weight-adjusted-waist index (WWI), offers a distinct advantage in predicting fat and lean mass by depicting weight-independent abdominal adiposity. This article presents the results of the inaugural study on the relationship between WWI and telomere length in adult populations. The cross-sectional investigation analyzed data from 3479 participants from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2000. To inspect linear and nonlinear correlations, we adopted weighted multiple logistic regression analysis and smooth curve fit, respectively. In addition, threshold effects and subgroup analyses were accomplished. In the fully adapted model, a significant adverse association of WWI with telomere length was detected [β = -0.02, 95% CI: (-0.03, -0.00), P value = 0.01]. The adverse correlation remained consistent across all subcategories. We also discovered an inverted U-shaped curve linking WWI and telomere length, with a conspicuous inflection point of 10.07 cm/√kg. For the first time, our research demonstrated strong links between WWI and telomere length. The inflection point suggests that controlling WWI within an optimum range might be essential for aging and health.

Association between Weight-Adjusted Waist Index and depressive symptoms: A nationally representative cross-sectional study from NHANES 2005 to 2018

BACKGROUND

Depressive symptoms are strongly associated with the development of various diseases and are one of the leading causes of disability in the world. However, the relationship between weight-adjusted waist index (WWI) and depressive symptoms has not been studied. This study aimed to assess the relationship between depressive symptoms and WWI.

METHODS

This study took NHANES data from 2005 to 2018 with 32,374 participants. Depressive symptoms were measured by a questionnaire (PHQ-9).WWI was determined by dividing the square root of waist circumference (cm) by weight (kg). Multivariate logistic regression models, smoothed curve fitting, and weighted generalized additive model (GAM) regression were used to examine the relationship between depressive symptoms and WWI, BMI, and waist circumference. Subgroup analyses and interaction tests were also performed.

RESULTS

In fully adjusted models, the OR (95 % CI) for WWI and depressive symptoms with WWI, BMI, and waist circumference were 1.18 (1.05, 1.34), BMI 1.01 (1.00, 1.02, 1.01 (1.00, 1.01), respectively. Participants in the highest quartile (Q4) had a 49 % higher depressive symptoms compared to those in the lowest quartile (Q1) (OR = 1.49, 95 % CI:1.14-1.96). Subgroup analyses and interaction tests showed a stable relationship between depressive symptoms and WWI.

LIMITATIONS

It is difficult to determine a causal relationship between the two; questionnaire collection may be somewhat biased; CONCLUSIONS: WWI was positively associated with depressive symptoms. This association was stronger than BMI and waist circumference. However, this relationship was stable. This study emphasizes the potential utility of WWI in preventing depressive symptoms and improving prognosis in the population.

Association between weight-adjusted waist index and serum total testosterone in males aged 6-19 years in the United States: Data from NHANES 2013-2016

Objective

This study aimed to estimate the association between weight-adjusted waist index and serum total testosterone (sTT) in males aged 6-19 years in the United States.

Methods

A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016. sTT was considered as the response variable, and weight-adjusted waist circumference index (WWI) as the independent variable. Multiple linear regression was performed to estimate the association between the two variables, and subgroup analysis was performed to identify sensitive cohorts. Smoothing curve fitting and threshold effects analysis was carried out to assess possible nonlinear relationships between WWI and sTT.

Results

The study included 4207 participants. The mean value of sTT (117.93 ng/dl) was used as the grouping basis, with 1066 participants having serum total testosterone levels above the mean. A negative association was observed between WWI and sTT [beta coefficient (β) = -72.50, 95% confidence interval (CI): -79.45, -65.55], which decreased as WWI increased (P for trend<0.05). Subgroup analysis indicated a stronger negative correlation in late adolescent (16-19 years) males (β = -128.94, 95% CI: -146.75, -111.13). The smoothing curve fit analysis revealed a U-shaped curve relationship for the negative correlation between WWI and sTT. Threshold effect analysis suggested a significant change when WWI exceeded 10.09 (β = -15.82, 95% CI: -24.11, -7.54), and stepwise threshold effect analysis indicated that this negative correlation became less stable when WWI exceeded 11.45 (β = -0.80, 95% CI: -9.15, 7.56).

Conclusions

Participants with higher WWI exhibited lower total testosterone levels, and a negative association was found between WWI and total testosterone, particularly in late adolescent males aged 16-19 years. Among males aged 6-19 years, caution should be exercised regarding the risk of lower testosterone levels associated with elevated WWI, particularly when WWI is below 10.09.

The relationship between weight-adjusted-waist index and diabetic kidney disease in patients with type 2 diabetes mellitus

Purpose

Obesity, particularly abdominal obesity, is seen as a risk factor for diabetic complications. The weight-adjusted-waist index (WWI) is a recently developed index for measuring adiposity. Our goal was to uncover the potential correlation between the WWI index and diabetic kidney disease (DKD) risk.

Methods

This cross-sectional study included adults with type 2 diabetes mellitus (T2DM) who participated in the NHANES database (2007-2018). The WWI index was calculated as waist circumference (WC, cm) divided by the square root of weight (kg). DKD was diagnosed based on impaired estimated glomerular filtration rate (eGFR<60 mL/min/1.73m2), albuminuria (urinary albumin to urinary creatinine ratio>30 mg/g), or both in T2DM patients. The independent relationship between WWI index and DKD risk was evaluated.

Results

A total of 5,028 participants with T2DM were included, with an average WWI index of 11.61 ± 0.02. As the quartile range of the WWI index increased, the prevalence of DKD gradually increased (26.76% vs. 32.63% vs. 39.06% vs. 42.96%, P<0.001). After adjusting for various confounding factors, the WWI index was independently associated with DKD risk (OR=1.32, 95%CI:1.12-1.56, P<0.001). The area under the ROC curve (AUC) of the WWI index was higher than that of body mass index (BMI, kg/m2) and WC. Subgroup analysis suggested that the relationship between the WWI index and DKD risk was of greater concern in patients over 60 years old and those with cardiovascular disease.

Conclusions

Our findings suggest that higher WWI levels are linked to DKD in T2DM patients. The WWI index could be a cost-effective and simple way to detect DKD, but further prospective studies are needed to confirm this.

Associations of weight-adjusted-waist index and depression with secondary infertility

Background

Obesity and psychological factors were identified as risk factors for female infertility. The study investigated the correlation between WWI, depression, and secondary infertility, focusing on the potential mediating role of depression.

Methods

According to the data from NHANES, this cross-sectional study used multiple regression analysis, subgroup analysis, and smooth curve fitting to explore the relationship between WWI, depression, and secondary infertility. The diagnostic ability of WWI was evaluated and compared to other obesity indicators using the ROC curve. The mediating effect test adopted the distribution of the product.

Results

This study involved 2778 participants, including 381 (13.7%) women with secondary infertility. Results showed that higher WWI (OR = 1.31; 95% CI, 1.11-1.56) and depression scores (OR = 1.03; 95% CI, 1.01-1.06) were associated with secondary infertility. There was a positive correlation between WWI and secondary infertility (nonlinear p = 0.8272) and this association was still consistent in subgroups (all P for interaction> 0.05). Compared with other obesity indicators, WWI (AUC = 0.588) also shows good predictive performance for secondary infertility. Mediation analysis showed that depression mediated the relationship between 3.94% of WWI and secondary infertility, with a confidence interval of Za * Zb excluding 0.

Conclusion

WWI exhibited a relatively good correlation in predicting secondary infertility than other obesity indicators, and depression may be a mediator between WWI and secondary infertility. Focusing on the potential mediating role of depression, the risk of secondary infertility due to obesity may be beneficially reduced in women.

Association between anthropometric indices and hyperuricemia: a nationwide study in China

This article explored the relationship between anthropometric indices and hyperuricemia in Chinese adults. The ability of each anthropometric index to predict hyperuricemia was also compared in this article. This is a cross-sectional study containing 69,842 samples from 31 provinces and cities in China. Anthropometric indices included body mass index (BMI), waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), waist-to-height ratio (WHtR), lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride-glucose index (TyG), waist circumference-triglyceride index (WTI), and weight-adjusted waist index (WWI). The survey data obtained were disaggregated and analyzed according to sex and age. BMI, WC, BRI, WHtR, LAP, VAI, TyG, WTI, and WWI were all significantly associated with hyperuricemia (P < 0.001). In the total population, WTI (AUC 0.7015, P < 0.001) had the highest predictive power, and WWI (AUC 0.5417, P < 0.001) had the lowest. In addition, after dividing the male and female populations, LAP (AUC 0.6571, P < 0.001 for men; AUC 0.7326, P < 0.001 for women) had the highest predictive power among both men and women. The ABSI (AUC 0.5189, P < 0.001 for men; AUC 0.5788, P < 0.001 for women) had the lowest predictive power among both men and women. BMI, WC, BRI, WHtR, LAP, VAI, TyG, and WTI were positively correlated with the risk of hyperuricemia and serum uric acid concentrations in both sexes. Among the general population, WTI had the highest predictive power. After dividing the population by sex, LAP had the highest predictive power in both men and women. Key Points • Anthropometric indices are highly correlated with hyperuricemia. Waist circumference-triglyceride index (WTI) is first found to be associated with hyperuricemia, and it has high predictive power. • The predictive power of anthropometric indices for hyperuricemia is more useful in women. • The restricted cubic splines visually shows the ratio of anthropometric indices to hyperuricemia ratio and the patient's serum uric acid concentration.

Association between weight-adjusted waist index and non-alcoholic fatty liver disease: a population-based study

BACKGROUND

Obesity is the most important driver of non-alcoholic fatty liver disease (NAFLD); nevertheless, the relationship of weight-adjusted waist index (WWI), a new obesity index, with NAFLD is unclear.

METHODS

This retrospective study used data from the NAGALA project from 1994 to 2016. WWI values were calculated using waist circumference (WC) and weight measurements of the participants. Three stepwise adjusted logistic regression models were developed to assess the relationship of WWI with NAFLD in the whole population and in both sexes. Additionally, we also conducted a series of exploratory analysis to test the potential impact of body mass index (BMI), age, smoking status and exercise habits on the association of WWI with NAFLD. Receiver operating characteristic (ROC) curves were used to estimate cut-off points for identifying NAFLD in the entire population and in both sexes.

RESULTS

The current study included a population of 11,805 individuals who participated in health screenings, including 6,451 men and 5,354 women. After adjusting for all non-collinear variables in the multivariable logistic regression model, we found a significant positive correlation of WWI with NAFLD. For each unit increase in WWI, the risk of NAFLD increased by 72% in the entire population, by 84% in men, and by 63% in women. Furthermore, subgroup analyses revealed no significant discrepancies in the correlation of WWI with NAFLD across individuals with varying ages, exercise habits, and smoking status (all P-interaction > 0.05), except for different BMI groups (P-interaction < 0.05). Specifically, compared to the overweight/obese group, the relationship of WWI with NAFLD was significantly stronger in the non-obese group, especially in non-obese men. Finally, based on the results of ROC analysis, we determined that the WWI cut-off point used to identify NAFLD was 9.7675 in men and 9.9987 in women.

CONCLUSIONS

This study is the first to establish a positive correlation between WWI and NAFLD. Moreover, assessing the influence of WWI on NAFLD in individuals without obesity may yield more valuable insights compared to those who are overweight or obese.

The association between weight-adjusted-waist index and depression: Results from NHANES 2005-2018

OBJECTIVE

The weight-adjusted-waist index (WWI) serves as an innovative obesity measure, seemingly surpassing body mass index (BMI) and waist circumference (WC) in evaluating lean and fat mass. This study aimed to explore the relationship between WWI and depression in United States (US) adults.

METHODS

This population-based study investigated adults with comprehensive WWI and PHQ-9 (9-item Patient Health Questionnaire) data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. WWI was computed by dividing WC by the square root of body weight. Weighted multivariate logistic regression and smoothed curve fitting were employed to examine linear and non-linear associations. Additionally, subgroup analyses and interaction tests were conducted.

RESULTS

A total of 34,528 participants were enrolled with a prevalence of depression of 7.61 %. WWI was positively related to depression with the full adjustment [odds ratio (OR) = 1.21, 95 % confidence interval (95 % CI): 1.13-1.29]. After converting WWI to a categorical variable by quartiles (Q1-Q4), compared to Q1 the highest WWI quartile was linked to an obviously increased likelihood of depression (OR = 1.51, 95 % CI: 1.29-1.76). Subgroup analysis revealed the stability of the independent positive relationship between WWI and depression (all P for trend >0.05).

CONCLUSION

WWI levels were positively related to an increased likelihood of depression in US adults. Our findings indicated that WWI may serve as a simple anthropometric index to predict depression.

Relationship between cognitive function and weight-adjusted waist index in people ≥ 60 years old in NHANES 2011-2014

BACKGROUND

Widespread attention has been given to the detrimental effects of obesity on cognitive function. However, there is no evidence on the connection between low cognitive performance and the WWI (weight-adjusted waist index). This study looked into the connection between poor cognitive performance and the WWI in senior Americans.

METHODS

A cross-sectional research study was carried out with information from the NHANES 2011-2014. With multivariate linear regression models, the pertinence between the WWI and low cognitive function in persons older than 60 years was examined. The nonlinear link was described using threshold effect analyses and fitted smoothed curves. Interaction tests and subgroup analysis were also conducted.

RESULTS

The study had 2762 individuals in all, and subjects with higher WWI values were at greater risk for low cognitive function. In the completely adjusted model, the WWI was positively connected with low cognitive performance assessed by CERAD W-L (OR = 1.22, 95% CI 1.03-1.45, p = 0.0239), AFT (OR = 1.30, 95% CI 1.09-1.54, p = 0.0029), and DSST (OR = 1.59, 95% CI 1.30-1.94, p < 0.0001). The effect of each subgroup on the positive correlation between the WWI and low cognitive performance was not significant. The WWI and low cognitive performance as determined by CERAD W-L and AFT had a nonlinear connection (log-likelihood ratio < 0.05).

CONCLUSION

Among older adults in the United States, the risk of low cognitive performance may be positively related to the WWI.

Association of changes in waist circumference, waist-to-height ratio and weight-adjusted-waist index with multimorbidity among older Chinese adults: results from the Chinese longitudinal healthy longevity survey (CLHLS)

BACKGROUND

The association of changes in waist circumference (WC), waist-to-height ratio (WHtR) and weight-adjusted-waist index (WWI) with subsequent risk of multimorbidity remains unclear among older Chinese adults. Therefore, we aimed to assess this association by utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS).

METHODS

Our study was based on the 2011/2012 wave of the CLHLS whose follow-up surveys were conducted in 2014 and 2017/2018. A total of 2900 participants aged 65 and above at baseline were enrolled. WC, WHtR, and WWI were calculated from measured height, weight, and waist circumference. Multimorbidity refers to the coexistence of two or more of 18 chronic diseases. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs) to evaluate the effect of three-year changes in WC, WHtR, and WWI on the risk of multimorbidity.

RESULTS

During a mean follow-up time of 4.2 (2.0) years, 906 multimorbidity cases were identified. Compared to participants in the persistently low WC group, those in the WC gain group and the persistently high WC group had a higher multimorbidity risk with adjusted HRs (95%CI) of 1.23 (1.01-1.50) and 1.34(1.14-1.58), respectively. Participants in the WHtR gain group and the persistently high WHtR group also had higher risks of multimorbidity with HRs (95%CI) of 1.35 (1.08-1.67) and 1.27 (1.05-1.53), respectively, relative to the persistently low WHtR group. Compared to the persistently low WWI group, those in the WWI loss group had a lower risk of multimorbidity with HRs (95%CI) of 0.80 (0.66-0.98). For every standard deviation increase in WC, WHtR, and WWI over three years, the risk of multimorbidity was higher by 12% (95%CI: 1.05-1.19), 13% (95%CI: 1.06-1.20), and 12% (95%CI: 1.05-1.20), respectively.

CONCLUSIONS

Associations of changes in WC, WHtR and WWI with multimorbidity are significant among older Chinese adults. The findings highlight the importance of evaluating changes in WC, WHtR, and WWI in screening and prevention of multimorbidity in older adults.

Association between weight-adjusted-waist index and gallstones: an analysis of the National Health and Nutrition Examination Survey

BACKGROUND

The weight-adjusted-waist index (WWI) is a novel obesity index, and gallstones are associated with obesity. This study aimed to investigate the possible relationship between WWI and gallstones.

METHODS

The datasets from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 were used in a cross-sectional investigation. Multivariate linear regression models were used to examine the linear connection between WWI and gallstones incidence. Fitted smoothing curves and threshold effect analysis were used to describe the nonlinear relationship.

RESULTS

The study comprised 8004 participants over the age of 20, including 833 reported with gallstones. Participants in the higher WWI tertile tended to have a higher gallstones prevalence. In the final adjusted model, a positive association between WWI and gallstones prevalence was observed (OR = 1.34, 95% CI: 1.20‒1.49). Participants in the highest WWI tertile had a significantly 71% higher risk of gallstones than those in the lowest WWI tertile (OR = 1.71, 95% CI: 1.35‒2.17). A nonlinear correlation was found between the WWI and gallstones prevalence, with an inflection point of 12.7.

CONCLUSIONS

Our study found that higher WWI levels connected with increased prevalence of gallstones. However, more prospective studies are needed to validate our findings.

Study from the United States: increased prevalence of kidney stones in patients with high weight-adjusted waist index

Objective

Using data from NHANES 2007-2018, to examine the association between WWI (weight-adjusted waist index) index and prevalence of kidney stones.

Methods

Using multiple logistic regression analysis of the National Health and Nutrition Examination Survey (NHANES) 2007-2018, we evaluated the association between WWI index and the prevalence of kidney stones, followed by subgroup analysis of sensitive populations. Smooth curve fitting was used to determine whether there was a non-linear relationship between the WWI index and kidney stone prevalence, and threshold effect analysis was used to test this relationship.

Results

Among 29,280 participants, 2,760 self-reported renal calculi. After adjustment for all confounders, there was a positive association between WWI and kidney stone prevalence (OR = 1.20, 95% CI: 1.12, 1.28), and this positive association was stronger with increasing WWI (and P = 0.01 for trend). Our results indicate a non-linear positive correlation between WWI index and kidney stones, with the saturation threshold effect analysis and the most important threshold value at 11.02. According to subgroup analysis, WWI showed the strongest association with kidney stone prevalence in participants aged 20-39 years, males, other US ethnic groups, and participants without hypertension and diabetes.

Conclusion

Increased WWI is positively associated with increased incidence of kidney stones, and increased WWI is a high risk for kidney stones that should be treated with caution. This association should be more pronounced in people between the ages of 20 and 39 years, in men, in other US ethnic populations, and in participants who do not have hypertension or diabetes.

Association between the weight-adjusted waist index and the odds of type 2 diabetes mellitus in United States adults: a cross-sectional study

Objective

To examine the association between the weight-adjusted waist index (WWI) and the odds of type 2 diabetes mellitus(T2DM)among U.S. adults.

Methods

Data from the National Health and Nutrition Examination Survey (NHANES) spanning six years (2007-2018) were utilized, encompassing 31001 eligible participants. Weighted multivariate logistic regression models and smoothed fit curves were employed to assess the association between WWI and the odds of T2DM, as well as dose-response relationships in the overall population and the odds of T2DM in various subgroups.

Results

In the fully adjusted continuous model, each one-unit increase in WWI was associated with a 1.14-fold increase in the odds of T2DM within the entire study population (2.14 [1.98,2.31], P < 0.0001). In the fully adjusted categorical model, when using the lowest tertile of WWI (T1) as the reference group, the second tertile (T2) and the third tertile (T3) were associated with a 0.88-fold (1.88 [1.64,2.17], P < 0.0001) and a 2.63-fold (3.63 [3.11,4.23], P < 0.0001) increase in the odds of T2DM. These findings indicated a positive correlation between WWI values and the odds of T2DM, aligning with the results of the smoothed-fitted curves. In the analysis of subgroups, in addition to maintaining consistency with the overall population results, we found interactions between age and hypertension subgroups.

Conclusion

In conclusion, WWI was found to be positively associated with the odds of T2DM in U.S. adults.

Weight-adjusted waist index is not superior to conventional anthropometric indices for predicting type 2 diabetes: a secondary analysis of a retrospective cohort study

BACKGROUND

Weight-adjusted waist index (WWI) is a new anthropometric indicator to assess adiposity. Current knowledge regarding its association with type 2 diabetes mellitus (T2DM) is limited. This present study aims to evaluate the association of WWI with the risk of T2DM in the Japanese population, and to compare its predictive ability with body mass index (BMI) and waist circumference (WC).

METHODS

This was a secondary analysis of a retrospective cohort study involving 15,464 participants. Participants were divided into quartiles based on baseline WWI levels. Cox regression model, Kaplan-Meier curve, and smooth curve fitting were used to explore the relationship between WWI and T2DM. The discriminative ability of obesity indices in predicting T2DM was compared by the receiver operating characteristic (ROC) curve.

RESULTS

After a mean follow-up of 6.05 years, 373 participants were diagnosed with T2DM. In fully adjusted models, the risk of incident T2DM was 1.96 times higher for each 1-unit increment in WWI levels (95% CI: 1.61-2.39, P < 0.001). Smooth curve fitting analysis showed a linear positive association between baseline WWI and new-onset T2DM. Subgroup analysis showed consistent results which subjects in the 4th WWI quartile had the highest risk of developing T2DM in different age, gender, and BMI groups. WWI did not exhibit better predictive ability compared with BMI and WC in the results of ROC curve.

CONCLUSION

WWI, a new metabolic index, can be used to predict new-onset T2DM in the Japanese population. However, its predictive capability was not superior to conventional anthropometric indices.

Sex Differences in the Association of Weight-Adjusted-Waist Index with Sarcopenic Obesity: A Cross-Sectional Study of Hemodialysis Patients

Objective: To explore the association between weight-adjusted-waist index (WWI) and sarcopenic obesity (SO) in patients with maintenance hemodialysis (MHD). Methods: A multicenter, cross-sectional study that included 3311 adult MHD patients was conducted in 20 hemodialysis (HD) centers from June 1, 2021, to August 30, 2021. Body composition was evaluated by body composition monitor based on bioimpedance spectroscopy. Hand grip strength was measured by CAMRY® dynamometer. WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). Multiple logistic regression models, spearman correlation analysis, and receiver-operating characteristic (ROC) analyses were conducted. Results: The median age of the study was 55 years, and 39.4% of patients were female. The prevalence of SO was 22.7% in the total population, and patients with SO had higher WWI. Higher WWI quartiles were independently associated with a higher risk of SO in men after adjusting for potential confounders, including age, dialysis vintage, body mass index, biochemical indicators, and various medical histories; the odds ratio (OR) of SO was highest in the fourth quartile of the WWI (OR: 4.08, 95% confidence interval: 2.65-6.27, P for trend <0.001). Age-adjusted WWI provided a better diagnostic power than WWI only for SO in men (area under the ROC curve: 0.72 vs. 0.68, P < 0.001). WWI was not associated with SO in female HD patients. Conclusion: WWI is independently associated with SO in male but not female MHD patients. This anthropometric index is simple to calculate, making it applicable in clinical practice.

Associations between weight-adjusted-waist index and infertility: Results from NHANES 2013 to 2020

Female infertility is a significant problem for women of reproductive age worldwide. Obesity has been proven to pose a danger for infertility in women. Weight-adjusted waist circumference index (WWI) is a recently created biomarker of obesity, and this research aims to explore the relationship between female infertility and WWI. Data for this investigation were gathered from National Health and Nutrition Examination Survey. We used weighted multivariate logistic regression, subgroup analysis, interaction testing, and smoothed curve fitting to investigate the relationship between infertility and WWI. A total of 6333 women were included and 708 (11.18%) had infertility. It was discovered that women with higher WWI had increased probabilities of infertility (OR = 1.92, 95% CI: 1.42-2.59) adjusting for confounders. In addition, WWI was linked to increased chances of infertility in women aged 28 to 36 years (OR = 1.59, 95% CI: 1.28-1.97). According to the results of this cross-sectional survey, WWI is positively associated with infertility among adult females in the U.S. And it can help identify infertile women and may help reduce the risk of infertility.

The association between weight-adjusted-waist index and self-reported infertility among women of reproductive age in the United States

AIM

This study aimed to determine whether the weight-adjusted-waist index (WWI) affected infertility in women of childbearing age in the United States.

METHODS

In this study, a database from the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES) was used. We analyzed 3374 participants' data cross-sectionally. The survey used WWI and fertility status as independent and dependent variables. To determine the effect of WWI, an analysis of the independent relationship between WWI and infertility was conducted using weighted multivariable logistic regression and a generalized additive mode (GAM). A smooth curve fitting test was used to calculate whether there was a linear association between WWI and the incidence rate of infertility, as well as subgroup analyses and interaction tests.

RESULTS

The prevalence of infertility was 10.19% among 3374 participants. Higher WWI quartiles were associated with higher infertility rates. Based on a fully adjusted model, the effects of WWI on fertility were positive (odds ratio = 1.39, 95% confidence interval: 1.17-1.66). As a result of smooth curve fitting, the association was linear across the entire WWI. Different characteristics were associated with different risks of infertility in subgroup analysis.

CONCLUSION

Among women of reproductive age in the United States, WWI levels were positively associated with infertility. This relationship needs to be confirmed by further studies.

Relationship between the weight-adjusted-waist index and kidney stone: a population-based study

BACKGROUND

At present, a growing number of studies have shown a positive association between obesity and kidney stone, while traditional anthropometric measures, such as body mass index (BMI) and Waist circumference (WC), have limited ability to assess the risk of kidney stone. Therefore, this study aimed to investigate the association between the weight-adjusted-waist index (WWI) and the risk of kidney stone.

METHOD

Data from the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2016 were used. A total of 17,292 participants from NHANES were included in the study. Multivariate logistic regression and restricted cubic splines (RCS) were used to investigate the relationship between WWI and kidney stone. Interaction analysis was performed for subgroups to verify the results. Meanwhile, the receiver operating characteristic curve (ROC) was used to analyze the efficacy of different anthropometric indices in predicting the risk of kidney stone.

RESULTS

After adjusting for potential confounding factors, we found a positive and independent association between kidney stone and WWI. After adjusting for all covariates, a one-unit increase in WWI was associated with a 36% increase in the risk of kidney stones. Dose-response curve analysis showed that WWI was non-linear correlated with the prevalence of kidney stone. In ROC analysis, WWI showed better discrimination for kidney stone (area under the curve: 0.612; 95% CI: 0.599-0.626; optimal cutoff value: 11.063) compared with other indices.

CONCLUSION

In this study, increased WWI was strongly associated with the risk of kidney stone.

Association between weight-adjusted-waist index and the risk of hyperuricemia in adults: a population-based investigation

Objective

This investigation sought to elucidate the potential correlation between a recently characterized adiposity metric, termed the Weight-Adjusted-Waist Index (WWI) and hyperuricemia.

Methods

A cross-sectional design was employed in this study, featuring both hyperuricemic and non-hyperuricemic subjects with complete WWI data, sourced from the National Health and Nutrition Examination Survey (NHANES) spanning 2017 to March 2020. WWI was calculated utilizing the formula which involves the division of waist circumference (WC) by the square root of the body weight. In order to determine the relationship between WWI and hyperuricemia, both univariate and multivariate logistic regression models, appropriately weighted, were employed in the analysis. The linearity of relationships was validated using smooth curve fitting. Additionally, subgroup evaluations and interaction assessments were conducted.

Results

The study sample comprised 7437 subjects, yielding a hyperuricemia prevalence of 18.22%. Stratifying WWI into tertiles, a progressive rise in hyperuricemia prevalence was evident with increasing WWI (Tertile 1: 11.62%, Tertile 2: 17.91%, Tertile 3: 25.13%). The odds ratio (OR) demonstrated that individuals within the highest WWI tertile were significantly more prone to hyperuricemia than those in the lowest tertile (OR = 2.41, 95% CI: 1.88-3.08).

Conclusion

This study provides evidence that an elevated WWI is correlated with an increased risk of hyperuricemia in the adult population of the United States. These results suggest that WWI may serve as a viable anthropometric indicator for predicting hyperuricemia.

The relationship between obesity associated weight-adjusted waist index and the prevalence of hypertension in US adults aged ≥60 years: a brief report

Objectives

The main objective was to examine the relationship between weight-adjusted waist index (WWI) and the prevalence of hypertension among individuals aged ≥60 years who participated in the NHANES between 2011 and 2018 years.

Methods

The data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. In this population-based study, we focused on participants who were over 60 years old. Data were collected from the aforementioned survey, and the variable of interest was WWI, which was calculated as waist (cm) divided by the square root of body weight (kg). Multivariable logistic regression model was applied to calculate adjusted ORs with 95% CIs in order to explore any possible correlation between WWI and the prevalence of hypertension. Subgroup analysis were used to verify the stability of the relationship between WWI and the prevalence of hypertension. The interaction tests were also conducted in this research.

Results

Results revealed that adults aged ≥60 years who were in the highest WWI quartile had significantly higher chances of developing hypertension when compared to those in the lowest quartile, after adjusting for covariates and potential confounders (p < 0.001).

Conclusion

These findings suggest that there is a strong correlation between elevated levels of WWI and the risk of developing hypertension among older adults. As such, WWI could serve as a unique and valuable biomarker for identifying hypertension risk at an earlier stage in the older adults population.

Weight-adjusted waist as an integrated index for fat, muscle and bone health in adults

BACKGROUND

Unhealthy body composition, including high fat mass, low muscle mass and low bone mass, is a critical health issue in adults. The weight-adjusted waist index (WWI) estimates fat and muscle mass and may have implications for bone health. We examined its association with body composition outcomes in a large Korean adult cohort.

METHODS

This study used data from the Korean National Health and Nutrition Examination Survey (2008-2011). WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD), appendicular lean mass (ALM) and total body fat percentage. Unhealthy body composition was defined as combined presence of high fat mass, low bone mass and low muscle mass.

RESULTS

A total of 5983 individuals (3034 men [50.7%] and 2949 women [49.3%]; mean age: 63.5 ± 8.7 years) were included. WWI was positively correlated with total body fat percentage (r = 0.478, P < 0.001) and inversely with ALM/weight (r = -0.485, P < 0.001) and BMD at the lumbar spine (r = -0.187, P < 0.001), femoral neck (r = -0.269, P < 0.001) and total hip (r = -0.255, P < 0.001). Higher WWI quartiles correlated with lower BMD, T-scores and ALM/weight, along with increased total body fat, evident in both genders and more pronounced in women, even after adjusting for confounders. This trend remained statistically significant across WWI quartiles for all analyses (P < 0.001). Higher WWI quartiles were also significantly associated with higher odds of unhealthy body composition, with adjusted odds ratio in the highest WWI group of 18.08 (95% CI, 4.32-75.61) in men and 6.36 (95% CI, 3.65-11.07) in women. The optimal cutoff values of WWI for unhealthy body composition were 10.4 cm/√kg in men and 10.5 cm/√kg in women.

CONCLUSIONS

In community-dwelling adults, high WWI values are associated with unfavourable body composition outcomes, indicating high fat mass, low muscle mass and low bone mass. WWI can potentially serve as an integrated index of body composition, underscoring the need for further research to validate its use in clinical settings.

The association of body mass index and weight waist adjustment index with serum ferritin in a national study of US adults

BACKGROUND

Abnormal serum ferritin levels are associated with a variety of diseases. Meanwhile, abnormal serum ferritin is influenced by a variety of risk factors, but its correlation with obesity remains poorly described.

OBJECTIVE

This study aimed to investigate the association of body mass index (BMI) and weight waist adjustment index (WWI) with serum ferritin in US adults.

METHODS

Participants in this study took part in the National Health and Nutrition Examination Survey (NHANES) prior to the pandemic from 2017 to March 2020. Serum ferritin was used as the sole response variable and BMI and WWI were used as independent variables. Multiple linear regression was used to assess the relationship between serum ferritin and the independent variables, and smoothed curve fitting and threshold effects analysis were performed to assess the presence of non-linear relationships. To validate the sensitive individuals for the correlation between the independent and the dependent variables, a subgroup analysis was performed.

RESULTS

A final total of 7552 participants were included in this study. Both independent variables had a positive relationship with serum ferritin, with effect values of (β = 0.68, 95% CI: 0.17-1.19) when BMI was the independent variable and (β = 8.62, 95% CI: 3.53-13.72) when WWI was the independent variable in the fully adjusted model. This positive association between the two obesity-related indexes and serum ferritin became more significant as BMI and WWI increased (P for trend < 0.001). In subgroup analyses, the positive association between the independent variables and serum ferritin was more pronounced in participants who were male, 40-59 years old, white, and had diabetes and hypertension. In addition, smoothed curve fitting and threshold effects analysis demonstrated a linear positive association of BMI and WWI with serum ferritin.

CONCLUSIONS

In the US adult population, while there was a linear positive association of WWI and BMI with serum ferritin, the effect values between WWI and serum ferritin were more significant. Male, 40-59 years old, white, participants with diabetes and hypertension should be cautious that higher WWI might entail a risk of higher serum ferritin levels.

Higher weight-adjusted waist index is associated with increased likelihood of kidney stones

Objectives

The objective of this study was to evaluate the association between weight-adjusted waist index (WWI) and the prevalence of kidney stones among adults in the United States.

Methods

The cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2007-2018. A total of 31,344 participants were categorized into two groups: those with kidney stones and those without. WWI was determined by dividing waist circumference (cm) by the square root of body weight (kg). To examine the relationship between kidney stones and WWI, multivariate logistic regression models, smoothed curve fitting, and weighted generalized additive model (GAM) regression were employed. Subgroup analysis and interaction tests were conducted to explore the stability of this association across different groups.

Results

The final analysis comprised a total of 31,344 participants, including 2,928 individuals who had a history of kidney stones. In the fully adjusted model, an increase in WWI exhibited a positive correlation with the prevalence of kidney stones (OR=1.34, 95% CI: 1.18-1.51). When WWI was converted into quartiles (Q1-Q4), participants in the highest quartile (Q4) had a 69% greater risk of developing kidney stones compared to those in the lowest quartile (Q1) (OR=1.69, 95% CI: 1.28-2.25). This positive association was particularly notable among non-diabetic patients.

Conclusion

Our study demonstrates a significant positive association between weight-adjusted waist index levels and an elevated prevalence of kidney stones among US adults. Furthermore, this research highlights the potential utility of weight-adjusted waist index in the prevention of kidney stones in the overall population. This relationship is limited and further research is needed to test this hypothesis.

Association between weight-adjusted-waist index and chronic kidney disease: a cross-sectional study

AIMS

We aimed to investigate the potential association between weight-adjusted-waist index (WWI) and chronic kidney disease (CKD).

DESIGN AND METHODS

This research examined data collected from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2020. CKD was defined as the low estimated glomerular filtration rate (eGFR) or the existence of albuminuria (urinary albumin-to-creatinine ratio (ACR) ≥ 30mg/g). Low-eGFR was described as eGFR < 60 mL/min/1.73m2. The associations between WWI with CKD, albuminuria, and low-eGFR were examined using generalized additive models and weighted multivariable logistic regression models. We also analyzed the associations of other obesity indicators with CKD, albuminuria, and low-eGFR, including body mass index (BMI), waist-to-height ratio (WHtR), waist circumference(WC), height, and weight. The receiver operating characteristic (ROC) curves were used to assess and compare their diagnostic abilities.

RESULTS

Males made up 48.26% of the total 40,421 individuals that were recruited. The prevalences of CKD, albuminuria, and low-eGFR were 16.71%, 10.97%, and 7.63%, respectively. WWI was found to be positively linked with CKD (OR = 1.42; 95% CI: 1.26, 1.60). A nonlinear connection between WWI and CKD was found using smooth curve fitting. Additionally, a higher prevalence of albuminuria is linked to a higher level of WWI (OR = 1.60; 95% CI: 1.40, 1.82). Different stratifications did not substantially influence the connection between WWI and CKD, albuminuria, and low-eGFR, according to subgroup analysis and interaction tests. We observed higher height was related to higher low-eGFR prevalence (OR = 1.05; 95% CI: 1.03, 1.06). ROC analysis revealed that WWI had the best discrimination and accuracy for predicting CKD and albuminuria compared to other obesity indicators (BMI, WHTR, WC, height and weight). In addition, height had the highest area under the curve (AUC) value for predicting low-eGFR.

CONCLUSION

WWI is the best obesity indicator to predict CKD and albuminuria compared to other obesity indicators (BMI, WHTR, WC, height, and weight). WWI and CKD and albuminuria were found to be positively correlated. Furthermore, height had the strongest ability to predict low-eGFR. Therefore, the importance of WWI and height in assessing kidney health in US adults should be emphasized.

Association between weight-adjusted-waist index and risk of cardiovascular diseases in United States adults: a cross-sectional study

BACKGROUND

As a new obesity-related index, the weight-adjusted-waist index (WWI) appears to be a good predictor of cardiovascular disease (CVD) in East Asian populations. This study aimed to validate the association between WWI and CVD in United States (US) adults and also evaluate its relationships with the prevalence of specific CVDs.

METHODS

The data were obtained from the 2009-2016 National Health and Nutrition Examination Survey. WWI was calculated as waist circumference divided by the square root of weight, and CVD was ascertained based on self-reported physician diagnoses. Multivariable logistic regression models and subgroup analyses were performed to evaluate the association between WWI and CVD.

RESULTS

A total of 21,040 participants were included. There was a positive linear relationship between WWI and the odds of CVD (P = 0.310). After adjusting for all covariates, each unit of increased WWI was associated with 48% increased risk of CVD (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.25-1.74). Moreover, compared with the lowest quintile (< 10.3 cm/√kg), the multivariable-adjusted OR was 3.18 (95% CI: 1.80-5.59) in the highest quintile (≥ 11.8 cm/√kg). Besides, positive associations were also found between WWI and increased prevalence of congestive heart failure (OR: 1.47, 95% CI: 1.11-1.96), coronary heart disease (OR: 1.27, 95% CI: 1.01-1.60), angina (OR: 1.44, 95% CI: 1.06-1.96), heart attack (OR: 1.66, 95% CI: 1.29-2.12), and stroke (OR: 1.32, 95% CI: 1.02-1.70). Subgroup analyses showed that stronger associations between WWI and CVD were detected in participants younger than 50 years of age (P < 0.001).

CONCLUSIONS

High levels of WWI were significantly associated with an increased risk of CVD in US adults, particularly in people under 50 years of age. These findings indicate that WWI may be an intervention indicator to reduce the risk of CVD in the general adult population.

Differential Associations of 6 Adiposity Indices With Dementia in Older Adults: The MIND-China Study

OBJECTIVES

The cross-sectional association between late-life obesity and dementia is often explained by the obesity paradox. We assessed the potential differential associations of various adiposity indices with dementia and subtypes of dementia in rural Chinese older adults.

DESIGN

A population-based cross-sectional study.

SETTING AND PARTICIPANTS

A total of 5277 participants (age ≥60 years; 57.23% female) who were living in rural communities and were examined in March-September 2018 for MIND-China.

METHODS

We used weight, height, and waist circumference (WC) to calculate 6 adiposity indices: body mass index (BMI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI), A Body Shape Index (ABSI), body roundness index (BRI), and Conicity Index (ConI). Dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were clinically diagnosed following the international criteria. Data were analyzed with logistic regression models.

RESULTS

Of the 5277 participants, 303 were diagnosed with dementia, including 193 with AD and 99 with VaD. The multivariable-adjusted odds ratio (95% CI) of dementia associated with the highest (vs lowest) quintile of adiposity index was 2.32 (1.40-3.85) for WWI, 1.56 (1.03-2.36) for ABSI, and 1.40 (0.92-2.11) for ConI. Similarly, higher levels of these 3 adiposity indices were significantly associated with an increased likelihood of AD, whereas a higher BMI was associated with a decreased likelihood of AD. None of the 6 examined adiposity indices was significantly associated with VaD when adjusting for multiple confounders.

CONCLUSIONS AND IMPLICATIONS

The adiposity index WWI is linearly associated with the likelihood of dementia and AD. An increased WWI may be a clinical marker for the dementia syndrome and Alzheimer's dementia.

Association between the weight-adjusted waist index and stroke: a cross-sectional study

BACKGROUND

The weight-adjusted waist index (WWI) is a new measure of obesity, and this study aimed to determine the association between the WWI and stroke.

METHODS

Using the National Health and Nutrition Examination Survey (NHANES) 2011-2020 dataset, cross-sectional data from 23,389 participants were analysed. The correlation between the WWI and stroke was investigated through multivariate logistic regression and smoothing curve fitting. Subgroup analysis and interaction tests were also carried out.

RESULTS

The research involved 23,389 participants, of whom 893 (3.82%) had a stroke. The fully adjusted model revealed a positive correlation between the WWI and stroke [1.25 (1.05, 1.48)]. Individuals who were in the highest quartile of WWI exhibited a 62% higher likelihood of experiencing a stroke than those in the lowest quartile [1.62 (1.06, 2.48)]. Subgroup analysis and interaction tests revealed that this positive correlation was similar in different population settings (all P for interaction  > 0.05).

CONCLUSION

A higher WWI was associated with a higher prevalence of stroke. The results of this study underscore the value of the WWI in stroke prevention and management.

Associations between weight-adjusted waist index and bone mineral density: results of a nationwide survey

BACKGROUND

The weight-adjusted waist circumference index (WWI) is a novel obesity indicator that offers improved accuracy in assessing both muscle and fat mass compared to traditional measures. This study aimed to investigate the association between WWI and bone mineral density (BMD) in adults.

METHODS

Weighted multivariate logistic regression, subgroup analysis, interaction tests and restricted cubic spline (RCS) curves were used to explore the relationship between WWI and BMD based on data from the National Health and Nutrition Examination Survey (NHANES).

RESULTS

This study had 40,568 individuals in total. At all four measurement sites, we detected a negative linear correlation between WWI and BMD. Even when quartile factors for WWI were created, this unfavorable connection maintained. In comparison to those in the lowest quartile, those in the highest percentile of WWI showed declines in lumbar BMD of 0.08 g/cm2 and femoral neck BMD of 0.03 g/cm2, respectively. This adverse correlation, nevertheless, differed among several categories.

CONCLUSIONS

Our findings suggest an adverse correlation between WWI and BMD among US adults. Employing WWI as a tool for osteoporosis prevention in the general population may enhance interventions.

Association between the Weight-Adjusted Waist Index and Serum Uric Acid: A Cross-Sectional Study

Background

Serum uric acid (SUA) was closely related to body metabolism. This study aimed to investigate the relationship between the adult weight-adjusted waist index (WWI) and SUA.

Methods

In the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020, 6494 eligible participants aged ≥20  were included. The multivariate logistic regression model was used to test the correlation between WWI and SUA. At the same time, subgroup analysis was carried out by using multivariate logistic regression according to age, sex, and race. Then, the fitting smooth curve was applied to solve the association between WWI and SUA. Finally, the recursive algorithm was used to calculate the inflection point in the nonlinear relationship, and the two-stage piecewise linear regression model was used to analyze the relationship between WWI and SUA on both sides of the inflection point.

Results

In all the 6494 participants, through the fully adjusted model, this study found that there was a positive correlation between WWI and SUA (β = 5.64; 95% CI: 2.62 and 8.66). In addition, this positive correlation still had certain statistical significance in the subgroup analysis stratified by sex, age, and race. Our research team found a significant positive correlation between the WWI and SUA in females, but the correlation was not significant in males. We also found a small inverted U-shaped curve between the WWI and SUA in men when we stratified the sex subgroups. The small inflection point was determined to be 11.5 cm/√ kg. In racial subgroup analysis, we also found a U-shaped relationship between the WWI and SUA in non-Hispanic White and other race/ethnicity (the inflection point was 11.08 cm/√ kg and 12.14 cm/√ kg, respectively).

Conclusion

This study showed that the WWI was a newly developed and new predictor of centripetal obesity independent of body weight and there was a positive correlation between the WWI and SUA.

Positive association between weight-adjusted-waist index and dementia in the Chinese population with hypertension: a cross-sectional study

PURPOSE

The links between obesity and dementia remain equivocal. Therefore, this study aimed to explore the association between weight-adjusted waist index (WWI), a new anthropometric indicator reflecting obesity, and dementia in the Chinese population with hypertension.

METHODS

A total of 10,289 participants with hypertension were enrolled in this cross-sectional study, a subset of the China H-type hypertension registry study. WWI was calculated as waist circumference (WC) divided by the square root of bodyweight. Mini-mental state examination (MMSE) scale was performed to evaluate the cognitive function. According to educational background, different MMSE cut-off values were applied to define dementia: < 24 for participants with ≥ 7 years of education, < 20 for those with 1-6 years of education, and < 17 for illiterate participants. Multivariable linear regression and multivariable binary logistic regression analyses were conducted to assess the associations between WWI and MMSE and dementia, respectively.

RESULTS

Overall, the mean age was 63.7 ± 9.7 years, and 49.0% were males. Multivariate linear regression analyses showed that WWI was negatively associated with MMSE (β, -1.09; 95% confidence interval [CI]: -1.24, -0.94). Consistently, multivariable binary logistic regression analyses found a positive association between WWI and the risk of dementia (odds ratio [OR], 1.45; 95% CI: 1.35, 1.56). Compared with individuals in quartile 1 of WWI, the adjusted β and OR values of WWI for MMSE and dementia were -2.28 (95% CI: -2.62, -1.94) and 2.12 (95% CI: 1.81, 2.48), respectively. Results of smoothing curve fitting confirmed the linear association between WWI and MMSE and dementia. Subgroup analysis showed a stronger association between WWI and dementia in participants with hypertension with midday napping.

CONCLUSION

WWI was independently and positively associated with dementia among the population with hypertension, especially in those with midday napping. The data suggests that WWI may serve as a simple and effective tool for the assessment of the risk of dementia in clinical practice.

The weight-adjusted-waist index predicts all-cause and cardiovascular mortality in general US adults

BACKGROUND

The authors examined the relationship between Weight-adjusted Waist Index (WWI) and all-cause and cardiovascular mortality among adults in the US.

METHODS

This prospective cohort study included 26,882 individuals who participated in the National Health and Nutrition Examination Survey (NHANES) from 2005 through 2014. WWI was calculated as waist circumference divided by the square root of weight. The main outcomes of this study were all-cause mortality and cardiovascular mortality. Mortality status and cause of death were determined by NHANES-linked National Death Index records through December 31, 2015. Cox proportional hazard models and Kaplan-Meier analysis were used to estimate Hazard Ratios (HR) and 95% CIs for mortality for all causes and cardiovascular diseases.

RESULTS

A total of 26,882 participants with a mean WWI of 10.89 ± 0.01, of whom 49.23% were male. The average follow-up time was 68.95 ± 1.07 months, and 1870 participants were determined as deceased (4.99%), including 349 cardiovascular death (0.88%). The Kaplan-Meier analysis demonstrated a significant difference in all-cause and cardiovascular mortality between patients with WWI <11.33 and ≥11.33 (both log-rank test p < 0.0001). The fully adjusted Cox proportional hazard model indicated that a higher WWI level (≥ 11.33) was associated with an increased 95% risk for cardiovascular mortality (HR = 1.95, 95% CI 1.30‒2.93) and 68% risk for all-cause death (HR = 1.68, 95% CI 1.41‒2.00) compared with the counterparts.

CONCLUSIONS

Elevated WWI levels were associated with a higher risk of cardiovascular mortality and all-cause mortality independently.

Relationship between the novel and traditional anthropometric indices and subclinical atherosclerosis evaluated by carotid intima-media thickness (c-IMT)

Introduction

Over the last few years, novel anthropometric indices have been developed as an alternative to body mass index (BMI) and other traditional anthropometric measurements to enhance the estimate of fat proportion and its relationship to a future cardiovascular event. The purpose of this study was to investigate the association of carotid intima-media thickness (c-IMT) estimated by Doppler ultrasound with current anthropometric indices (traditional and novel).

Methods

A cross-sectional study was conducted on a total of 789 Spanish patients. Traditional (BMI, WHR, and WHtR) and new (WWI, AVI, ABSI, BRI, BAI, CUN-BAE, and CI) anthropometric indices were determined, and carotid Doppler ultrasound was performed to evaluate c-IMT (≥0.90 mm).

Results

Most of the anthropometric indices analyzed were significantly higher among patients with pathological c-IMT, except for BMI, BAI, and CUN-BAE. In multiple linear regression analysis, c-IMT was positively related to ABSI, AVI, BRI, CI, and WWI but not to CUN-BAE, BAI, or traditional anthropometric indices. Similarly, in univariate analysis, all indices were associated with a c-IMT of ≥0.90 mm (p < 0.05), except BMI, BAI, and CUN-BAE; however, only ABSI (adjusted OR: 1.61; 95% CI: 1.08-2.40; p = 0.017), CI (adjusted OR: 1.73; 95% CI: 1.15-2.60; p = 0.008), and WWI (adjusted OR: 1.74; 95% CI: 1.14-2.64; p = 0.009) were significantly associated in multivariate analysis. Finally, CI, ABSI, and WWI provided the largest AUC, and BMI and CUN-BAE showed the lowest AUC.

Conclusion

ABSI, CI, and WWI were positively associated with pathological c-IMT (≥0.90 mm), independent of other confounders.

Association between weight-adjusted-waist index with hepatic steatosis and liver fibrosis: a nationally representative cross-sectional study from NHANES 2017 to 2020

Background

The negative effects of obesity on hepatic steatosis and fibrosis have received considerable attention in recent years. The weight-adjusted-waist index (WWI) reflects weight-independent centripetal obesity. Herein, we provide the first investigation of a link between WWI, hepatic steatosis, and liver fibrosis.

Methods

We used data from the National Health and Nutrition Examination Survey 2017-2020 to conduct a cross-sectional study. The linear relationship between WWI, controlled attenuation parameters, and liver stiffness measurements (LSM) was investigated using multivariate linear regression models. The nonlinear relationship was described using fitted smoothed curves and threshold effect analyses. Subgroup analyses were performed based on gender, age, body mass index, diabetes, hypertension, drinking, and smoking.

Results

This population-based study included 7,594 people, 50.74% of whom were men and 49.26% of whom were women. Multivariate linear regression analysis revealed a significant positive relationship between WWI and hepatic steatosis [CAP, β=7.60, 95% confidence interval (CI) (4.42, 10.78), P<0.0001]. This positive association was stronger when excessive alcohol intake was present compared to when it was absent (P for interaction = 0.031), and when hypertension was present compared to when it was not (P for interaction = 0.014). The linear relationship between WWI and liver fibrosis was not statistically significant on multiple regression analysis [LSM, β=0.03, 95% CI (-0.26, 0.32), P=0.84]. However, a U-shaped association was seen between WWI and LSM, with a negative correlation when WWI< 10.92 and a positive correlation when WWI > 10.92.

Conclusion

We report a strong association between WWI and hepatic steatosis, and suggest that it may potentially be used as a simple anthropometric index to predict hepatic steatosis.

The association between weight-adjusted-waist index and total bone mineral density in adolescents: NHANES 2011-2018

Introduction

The weight-adjusted waist index (WWI) serves as an innovative obesity measure, seemingly surpassing body mass index (BMI) and waist circumference (WC) in evaluating lean and fat mass. This study aimed to explore the relationship between WWI and total bone mineral density (BMD) in US adolescents.

Methods

This population-based study investigated adolescents aged 8-19 years with comprehensive WWI and total BMD data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. WWI was computed by dividing WC by the square root of body weight. Weighted multivariate linear regression and smoothed curve fitting were employed to examine linear and non-linear associations. Threshold effects were determined using a two-part linear regression model. Additionally, subgroup analyses and interaction tests were conducted.

Results

Multivariate linear regression analysis revealed a significant negative association between WWI and total BMD in 6,923 US adolescents aged 8-19 years [β = -0.03, 95% CI: (-0.03, -0.03)]. This negative correlation remained consistent across all subcategories, with the exception of age, encompassing gender,ethnicity, and diabetes status subgroups. Furthermore, a non-linear relationship and saturation effect between WWI and total BMD were identified, with an inflection point at 9.88 cm/√kg.

Conclusions

Our research demonstrated a notable negative relationship and saturation effect between WWI and total BMD among US adolescents.

Relationship between weight-adjusted-waist index and erectile dysfunction in the United State: results from NHANES 2001-2004

Objective

The purpose of this study is to examine the association between a novel adiposity parameter, the weight-adjusted-waist index (WWI), and erectile dysfunction (ED).

Methods

According to National Health and Nutrition Examination Survey (NHANES) 2001-2004, a total of 3884 participants were categorized as ED and non-ED individuals. WWI was calculated as waist circumference (WC, cm) divided by the square root of weight (kg). Weighted univariable and multivariable logistic regression models were conducted to assess the correlation between WWI and ED. Smooth curve fitting was utilized to examine the linear association. The receiver operating characteristic (ROC) curve and DeLong et al.'s test were applied to compare the area under curve (AUC) value and predictive power among WWI, body mass index (BMI), and WC for ED.

Results

WWI was positively related to ED with the full adjustment [odds ratio (OR)=1.75, 95% confidence interval (95% CI): 1.32-2.32, p=0.002]. After converting WWI to a categorical variable by quartiles (Q1-Q4), compared to Q1 the highest WWI quartile was linked to an obviously increased likelihood of ED (OR=2.78, 95% CI: 1.39-5.59. p=0.010). Subgroup analysis revealed the stability of the independent positive relationship between WWI and ED. It was shown that WWI had a stronger prediction for ED (AUC=0.745) than BMI (AUC=0.528) and WC (AUC=0.609). Sensitivity analysis was performed to verify the significantly positive connection between WWI and stricter ED (OR=2.00, 95% CI: 1.36-2.94, p=0.003).

Conclusion

An elevated WWI was related to higher risks of ED in the United State adults, and a stronger predictive power of WWI for ED was observed than BMI and WC.

Associations between weight-adjusted waist index and fractures: a population-based study

INTRODUCTION

The weight-adjusted waist circumference index (WWI) is a novel obesity evaluation indicator that appears to be superior to body mass index (BMI) and waist circumference (WC) in evaluating muscle and fat mass. The purpose of this study was to investigate the association between WWI and fractures among adults.

METHODS

In this cross-sectional study, multivariate logistic regression and smoothed curve fitting were used to investigate linear and nonlinear associations between WWI and fractures, based on data from 28,679 adult participants in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018.

RESULTS

After adjusting for all covariates, the prevalence of hip/wrist/spine fractures among all participants was 1.09%, 8.87%, and 1.97%, respectively. A 1-unit increase in WWI was associated with a 5% increase in the odds of hip fractures [1.05 (1.01, 1.10)], and a 9% increase in the odds of spine fractures [1.09 (1.06, 1.13)], but not with the prevalence of wrist fractures [0.97 (0.94, 1.06)].

CONCLUSIONS

Higher WWI was associated with an increased prevalence of hip fracture and spine fracture, but not wrist fracture.

Association between weight-adjusted waist index and arterial stiffness in hypertensive patients: The China H-type hypertension registry study

Objective

Exploring the relationship between (weight-adjusted waist index) WWI and arterial stiffness (AS) in the total and different BMI populations among patients with hypertension.

Methods

This study enrolled 5232 hypertensive subjects, a subset of the China H-type Hypertension Registry Study. WWI was calculated as WC (cm) divided by the square root of weight (kg). Brachial-ankle pulse wave velocity (baPWV) was measured to determine AS.

Results

The mean WWI was 10.97 (0.78)cm/√kg. In multiple logistic analyses showed that there were significant dose-dependent association between WWI with baPWV in a dose-dependent manner in total population (β 57.98, 95% CI 44.06-71.90), and in different BMI group: group 1 (BMI<18.5kg/m2) (β 94.30, 95% CI 39.36-149.23), group 2 (18.5-23.9kg/m2) (β 74.21, 95% CI 54.57-93.85), group 3 (≥24kg/m2) (β 26.11, 95% CI 5.22-47.01). In stratified analysis, stronger associations between WWI and baPWV were observed in patients with higher BP or lower BMI. Sensitivity analysis by excluding patients treated with lipid-lowering agents did not change the association between WWI and baPWV.

Conclusion

For hypertensive patients, we found that WWI was positively associated with baPWV in different BMI groups. WWI might be considered as an intervening factor in preventing and treatment of AS, besides BP management.

The association of asthma duration with body mass index and Weight-Adjusted-Waist index in a nationwide study of the U.S. adults

BACKGROUNDS

The association between obesity and asthma has been of interest, but whether the duration of asthma has an effect on obesity is still limitedly studied.

AIM

The purpose of this study was to investigate the association between asthma duration and obesity-related indexes, where obesity-related indexes include Body mass index (BMI) and Weight-adjusted-waist index (WWI).

METHODS

Data from National Health and Nutrition Examination Survey (NHANES) 2009-2018 were obtained to conduct this cross-sectional study. Duration of asthma was used as the independent variable and obesity-related indexes as the response variables. Multiple linear regression was used to assess the association between the independent variable and the response variables, and subsequently smoothed curve fitting and threshold effect analysis were performed to clarify whether there was a nonlinear correlation between the independent variable and the response variables. Finally, subgroup analysis was conducted to find sensitive populations.

RESULTS

A total of 9170 participants were included in the analysis. Asthma duration was statistically different between the two groups when all participants were grouped by median WWI (Q1 < 11.65, Q2 ≥ 11.65) (P < 0.001), but not by median BMI (Q1 < 31.8, Q2 ≥ 31.8) (P = 0.130). There was a positive association between asthma duration and WWI [β = 0.016, 95% CI (0.016, 0.017)], but a negative one with BMI [β = - 0.098, 95% CI (- 0.112, - 0.085)], and the correlations between the independent and response variables became more pronounced with increasing asthma duration (P for trend < 0.01). In addition, there were nonlinear relationships between asthma duration with BMI and WWI (log likelihood ratio < 0.001), with the best valid inflection points for asthma duration being 2 years (with WWI as the response variable) and 3 years (with BMI as the response variable), respectively. In the subgroup analysis, the positive association between asthma duration and WWI was more pronounced in the participants who were male, aged less than 40 years, and had asthma onset before 12 years of age. In contrast, when BMI was used as the response variable, the negative association between it and asthma duration was more pronounced among participants of female, aged 60 years or older, and with asthma onset less than 12 years of age.

CONCLUSIONS

In US adults, asthma duration might cause changes in obesity-related indexes. Longer asthma duration might cause weight loss, but might increase the risk of abdominal obesity.

Assessment of existing anthropometric indices for screening sarcopenic obesity in older adults

Sarcopenic obesity is defined as the presence of high fat mass and low muscle mass combined with low physical function, and it is closely related with the onset of cardiovasular diseases (CVD). The existing anthropometric indices, which are being utilised in clinical practice as predictors of CVD, may also be used to screen sarcopenic obesity, but their feasibility remained unknown. Using cross-sectional data of 2031 participants aged 70-84 years (mean age, 75·9 ± 3·9 years; 49·2 % women) from the Korean Frailty and Aging Cohort Study, we analysed the association of anthropometric indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and weight-adjusted waist index (WWI) with sarcopenic obesity. Body composition was measured using dual-energy X-ray absorptiometry. Higher WWI, WHtR and WC quartiles were associated with higher risk of sarcopenic obesity; the odds ratio (OR) of sarcopenic obesity were highest in the fourth quartile of the WWI (OR: 10·99, 95 % CI: 4·92-24·85, P_{for trend} < 0·001). WWI provided the best diagnostic power for sarcopenic obesity in men (area under the receiver operating characteristic curve: 0·781, 95 % CI: 0·751-0·837). No anthropometric indices were significantly associated with sarcopenic obesity in women. WWI was the only index that was negatively correlated with physical function in both men and women. WWI showed the strongest association with sarcopenic obesity, defined by high fat mass and low muscle mass combined with low physical function only in older men. No anthropometric indices were associated with sarcopenic obesity in older women.

Relationship Between Weight-Adjusted Waist Index and Osteoporosis in the Senile in the United States from the National Health and Nutrition Examination Survey, 2017-2020

BACKGROUND

Some studies suggested obesity may be beneficial in preventing bone loss through the negative relationship between body mass index (BMI) and osteoporosis in senile. However, using BMI to measure obesity is unconvincing due to confounding factors such as muscle mass were not taken into account, and few articles have yet taken a better way to evaluate the relationship between obesity and osteoporosis.

METHODOLOGY

Using a cross-sectional sample of 1,979 participants aged ≥65 years from the National Health and Nutrition Examination Survey (NHANES) 2017 to 2020, we evaluated the relation of weight-adjusted waist index (WWI) with osteoporosis. WWI was calculated as waist (cm) divided by the square root of body weight (kg). Diagnosis of osteoporosis was described as follows: according to the updated reference for calculating bone mineral density T-Scores, we marked the BMD value as X, using the formula T _{femoral neck}= (X g/cm²-0.888 g/cm²)/0.121 g/cm², T _{lumbar spine}= (X g/cm²- 1.065 g/cm²)/0.122 g/cm², and defined those with a final T _{femoral neck} <-0.25. T _{lumbar spine}<-0.25 or patients with previously diagnosed OP in other hospitals as osteoporosis.

RESULTS

All the 1,979 participants were between 65 and 80 years, there were 379 (21.1%) with osteoporosis, 608 (30.7%) with WWI exceeding 12 (cm/√kg) (range 8.85-14.14), and 955 (48.3%) women. Furthermore, the relationship between WWI and osteoporosis was nonlinear with a threshold effect point. Odds of OP significantly increased with the increase of WWI (OR 2.33, 95% CI 11.48-3.38, P = 0.0001) at the right side of the threshold point (WWI≥12) according to the threshold effect study.

CONCLUSIONS

Found a significant positive relationship between WWI and osteoporosis. Body fat management in the senile may be good to prevent osteoporosis if confirmed by other prospective studies analyzing the longitudinal risk of osteoporosis with obesity.

Weight-Adjusted-Waist Index Predicts Newly Diagnosed Diabetes in Chinese Rural Adults

The relationship between the weight-adjusted waist index (WWI) and newly diagnosed type 2 diabetes (T2D) remains uncertain. This study intended to explore the association between the WWI and the incidence of newly diagnosed T2D among participants in rural areas of China. In the Northeast China Rural Cardiovascular Health Study, 9205 non-diabetic individuals (mean age 53 ± 10, 53.1% women) without T2D were included at baseline during 2012-2013. They were followed up from 2015 to 2017. WWI was calculated as waist circumference (cm) divided by the square root of weight (kg). We used multivariate logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the probability of new diagnoses across three WWI categories. A total of 358 participants had been diagnosed with T2D during a median follow-up of 4.6 years. After adjusting for potential confounders, compared with the lowest WWI category (<9.79 cm/√kg in men; <10.06 in women), men with WWI 10.06-10.72 and ≥10.37 cm/√kg showed OR (95%CI) for T2D 1.200 (0.816, 1.767) and 1.604 (1.088, 2.364), respectively, while women with WWI 10.06-10.72 and ≥10.37 cm/√kg showed ORs (95%CIs) for T2D 1.191 (0.703, 2.018) and 1.604 (1.088, 2.364), respectively. The ORs were generally consistent on subgroup analysis by gender, age, body mass index, and current smoking and drinking status. Increasing WWI was significantly associated with a higher incidence of newly diagnosed T2D among rural Chinese adults. Our findings help clarify the harmful effect of increasing WWI on newly diagnosed T2D and provide evidence for formulating healthcare policy in rural China.

The relationship between the weight-adjusted-waist index and left ventricular hypertrophy in Chinese hypertension adults

Left ventricular hypertrophy (LVH) is a major cardiac complication of hypertension. Weight-adjusted-waist index (WWI) is a new obesity index that has been found to be positively associated with cardiovascular disease mortality. We aimed to investigate the relationship between the WWI and LVH in Chinese hypertension adults. The study is a community-based cross-sectional study that included 4715 patients with hypertension and integrated clinical and echocardiographic data. LVH was diagnosed by transthoracic echocardiography in these patients based on a criterion of left ventricular mass index (LVMI) over 49.2 g/m^2.7 in men and 46.7 g/m^2.7 in women. The independent association between the WWI quartiles and LVH prevalence was analyzed by logistic regression models. The prevalence of LVH in the first quartile of WWI (Q1: <10.16), second (Q2: 10.16 ~ 10.67), the third (Q3: 10.68~11.19), and the highest quartile (Q4: ≥11.20) was 34.1%, 38.4%, 42.4%, 51.5%, respectively. Logistic regression analysis suggested that the WWI was independently correlated with LVH with adjustment of confounding factors, and increased across the quartile of WWI. Compared to the first quartile of WWI (Q1), the odds ratios (ORs) and their 95% confidence intervals (CIs) for LVH in the increasing quartiles (Q2-Q4) were 1.33(1.08-1.63), 1.50 (1.19-1.89) and 2.28(1.74-2.99), respectively. In stratified analyses, the relationship between WWI and LVH risk persisted. The WWI may be an independent determinant of LVH in Chinese hypertension adults.