Weight-Adjusted Waist Index: an anthropometric measure for frailty in older adults.

PURPOSE: Current measures of frailty often rely on subjective assessments or complex scoring systems. This study aims to investigate the utility of a novel anthropometric measure, the Weight-Adjusted Waist Index (WWI), as a simple and objective predictive marker for frailty in older adults. METHODS: This cross-sectional study included 847 patients aged 65 years and older. Comprehensive geriatric assessments and anthropometric measurements were conducted. Frailty was diagnosed using the Clinical Frailty Scale (CFS). The association between WWI and frailty was analyzed using multivariate logistic regression analysis. RESULTS: The mean age of the participants was 74.9 ± 6 years, with 56.3% (n = 477) being women and 14.8% (n = 125) classified as frail. The frail group had a significantly higher WWI than the non-frail group (p < 0.001). In multivariate logistic regression analysis, WWI remained significantly associated with frailty, even after adjusting for other potential confounding factors (OR = 2.51, 95% CI 1.77-3.57, p < 0.001). The predictive ability of WWI for frailty was measured by the area under the receiver operating characteristic (ROC) curve, which was 0.705 (95% CI 0.67-0.73; p < 0.001). The optimal WWI threshold for predicting frailty was identified as > 12. CONCLUSION: The Weight-Adjusted Waist Index shows significant potential as a simple and objective predictive marker for frailty in older adults.

Association between weight-adjusted waist index and overactive bladder: a cross-sectional study based on 2009-2018 NHANES.

Background: The weight-adjusted waist index (WWI) is a novel obesity indicator that appears to outperform the body mass index (BMI) and waist circumference (WC) in assessing both overweight and obesity. Studies have demonstrated the relationship between obesity and overactive bladder (OAB). The purpose of this study is to examine the correlation between WWI and OAB. Methods: This research utilizes data from the National Health and Nutrition Examination Survey (NHANES) collected between 2009 and 2018. Each participant's WWI was calculated as their WC in centimeters by the square root of weight in kilograms. The Overactive Bladder Symptom Score (OABSS) questionnaire is used to determine whether a participant has OAB. Multivariate logistic regression and generalized additive model analysis were employed to investigate the relationship between WWI and OAB. We used smoothing curve fitting to explore non-linear relationships. Additionally, subgroup analysis and interaction tests are conducted. Results: In this cross-sectional study involving 35,950 subjects, we found that individuals with a higher WWI have a higher risk of OAB (OR = 1.41, 95% CI: 1.02-1.74). Subgroup analysis and interaction testing showed that the relationship between WWI and OAB is consistent across various population characteristics. Smoothing curve fitting reveals a positive non-linear relationship between WWI and OAB. Furthermore, the association between WWI and OAB is stronger than that of other obesity-related indicators. Conclusion: Weight-adjusted waist index may be able to predict the incidence of OAB and that WWI-based obesity management may help to reduce the risk of OAB.

Association between healthy lifestyle and frailty in adults and mediating role of weight-adjusted waist index: results from NHANES.

BACKGROUND: The relationship between healthy lifestyle and frailty remains unclear. Healthy weight is crucial for overall well-being, but using body mass index (BMI) to evaluate weight management is inefficient. This study clarifies the association between healthy lifestyle or its factors (non-smoking, moderate drinking, healthy weight, healthy diet, sufficeint physical activity, and non-sedentary) and frailty, and the feasibility of using the weight-adjusted waist index (WWI) reflecting central obesity as an intermediate indicator. METHODS: This study included 4,473 participants from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Healthy lifestyle quality was assessed by summing the scores of each healthy lifestyle factor. Frailty was assessed using a 49-item frailty index (FI), categorizing participants into robust, pre-frail, and frail. Logistic regression to investigate the association between healthy lifestyle or its factors, WWI, and frailty. Smooth curve fitting and threshold effect analyses were used to elucidate the nonlinear association. Subgroup and two other sensitivity analyses were conducted to confirm the stability of the results. A causal mediation model examined the proportion of frailty mediated by WWI. RESULTS: The study identified 13.98% of the participants as frail. Optimal healthy lifestyle and frailty were negatively associated (OR: 0.39, 95%CI: 0.27-0.58). Five healthy lifestyle factors (non-smoking, healthy weight, healthy diet, sufficient physical activity, and non-sedentary) were associated with a lower prevalence of frailty, with odds ratios (OR) ranging from 0.48 to 0.61. We also analyzed the association between a healthy lifestyle and WWI (OR: 0.32, 95%CI: 0.27-0.37), WWI and frailty (OR: 1.85, 95%CI: 1.59-2.16). A positive association between WWI and FI was observed beyond the inflection point (9.99) (OR: 0.03, 95%CI: 0.02-0.03). Subgroup and sensitivity analyses confirmed stable associations between healthy lifestyle, WWI, and frailty. WWI partially mediated the association between a healthy lifestyle and frailty (mediating ratio = 20.50-20.65%). CONCLUSIONS: An optimal healthy lifestyle and positive healthy lifestyle factors are associated with a lower incidence of frailty. WWI may mediate the relationship between a healthy lifestyle and frailty.

Corrigendum: Association between weight-adjusted waist index and kidney stones: a propensity score matching study.

[This corrects the article DOI: 10.3389/fendo.2024.1266761.].

Association of the weight-adjusted waist index with hypertension in the context of predictive, preventive, and personalized medicine.

Objective: Hypertension (HTN) is a prevalent global health concern. From the standpoint of preventive and personalized medicine (PPPM/3PM), early detection of HTN offers a crucial opportunity for targeted prevention and personalized treatment. This study aimed to evaluate the association between the weight-adjusted waist index (WWI) and HTN risk. Methods: A case-control study using data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 was conducted. Logistic regression models assessed the association between WWI and HTN. Subgroup analyses explored differences in age, sex, ethnicity, and diabetes status. Restricted cubic spline (RCS) analyses examined potential nonlinear relationships. Results: A total of 32,116 participants, with an average age of 49.28 ± 17.56 years, were included in the study. A significant positive association between WWI and the risk of HTN was identified (odds ratio [OR], 2.49; 95% CI, 2.39-2.59; P < 0.001). When WWI was categorized into quartiles (Q1-Q4), the highest quartile (Q4) exhibited a stronger association compared to Q1 (OR, 2.94; 95% CI, 2.65-3.27; P < 0.001). Subgroup analyses indicated that WWI was a risk factor for HTN across different populations, although variations in the magnitude of effect were observed. Furthermore, the findings from the RCS elucidated a nonlinear positive correlation between WWI and HTN. Conclusion: WWI is independently associated with HTN risk, highlighting its potential as a risk assessment tool in clinical practice. Incorporating WWI into early detection strategies enhances targeted prevention and personalized management of HTN. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00375-3.

Association between the weight-adjusted-waist index and circadian syndrome in findings from a nationwide study.

Weight-adjusted-waist index (WWI) is an emerging parameter for evaluating obesity. We sought to ascertain the link between WWI and circadian syndrome (CircS). The study population consisted of 8275 eligible subjects who were included in the ultimate analysis from the NHANES 2011-2018. By using multivariable regression models, the association of WWI and CircS was analyzed. In subgroup analysis, we explored the relationship in different groups and tested the stability of the intergroup connection using interaction testing. To investigate whether WWI and CircS had a potential non-linear relationship, smooth curve fittings, and threshold effects tests were also constructed. In a multivariate linear regression model, WWI is significantly positively related to CircS (OR = 1.77, 95% CI 1.50-2.08). Through subgroup analysis and interaction testing, the stability of this positive association was also validated. It was further found that there was an inverted U-shaped association, with a turning point of 11.84, between WWI and CircS. Our findings supported a strong association between WWI values and CircS. Central obesity management is pivotal for preventing or alleviating CircS.

Association between weight-adjusted waist index and overactive bladder syndrome among adult women in the United States: a cross-sectional study.

PURPOSE: The weight-adjusted waist index (WWI) is a recently developed index for measuring obesity. The aim of this study was to investigate the association between WWI levels and overactive bladder (OAB) in a nationally representative population. METHODS: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) database between 2007 and 2016. OAB was defined as the Overactive Bladder Syndrome Symptom Score (OABSS, score ≥ 3). The WWI index was calculated as the square root of waist circumference (WC, cm) divided by body weight (kg). We used weighted logistic regression models to assess the relationship between the WWI index and OAB in adult women. The reliability of the findings was assessed using restricted cubic spline, subgroup analysis. RESULTS: A total of 10,563 individuals were included in the study, and the prevalence of OAB was 18.6%. Higher WWI was associated with an increased risk of overactive bladder syndrome. In model 1 with unadjusted variables (OR = 1.148; 95% CI = 1.148-1.149, p < 0.001), model 2 (OR = 1.253; 95% CI = 1.253-1.254, p < 0.001) and model 3 with fully adjusted variables (OR = 1.215; 95% CI = 1.214-1.215, p < 0.001) in which the association was significant. The results of the subgroup analyses showed that age stratification and stroke status could modify this association between WWI and OAB. Restricted cubic spline showed a nonlinear relationship between WWI and OAB (p for nonlinear < 0.05). CONCLUSION: Weight-adjusted waist circumference index (WWI) values are positively associated with the risk of developing OAB in adult women in the United States, but further studies are needed to elucidate the causal relationship between WWI and OAB.

The association between the weight-adjusted-waist index and frailty in US older adults: a cross-sectional study of NHANES 2007-2018.

Objective: This study aimed to evaluate the relationship between the weight-adjusted waist circumference index (WWI) and the frailty in American adults aged over 60 years. Methods: We utilized data from the National Health and Nutrition Examination Surveys (NHANES) spanning from 2007 to 2018. WWI was calculated using the square root of waist circumference (cm) divided by body weight (kg). The frailty index ≥ 0.25 was employed to assess frailty. Weighted multivariate logistic regression was conducted to explore the association between WWI and frailty. Generalized Additive Modeling (GAM) was used to explore potential non-linear relationships. Receiver operating characteristic curve (ROC) analysis was used to assess the predictive ability of WWI for frailty. Results: The study encompassed 7765 participants. Higher WWI was significantly associated with higher odds of frailty. In the fully adjusted model, each unit increase of WWI was associated with an 82% increased odds of frailty (OR: 1.82, 95% CI: 1.61 - 2.06; P < 0.001). GAM found significant nonlinear relationships and threshold effects. Conclusion: The study presented a robust correlation between elevated WWI and increased odds of frailty among American older adults. However, these findings require further validation in large-scale, prospective studies.

Association Between Weight-Adjusted Waist Index and Albuminuria in Type 2 Diabetes Mellitus in the Chinese Population.

Purpose: This study aimed to investigate the relationship between weight-adjusted waist index (WWI) and albuminuria in patients with type 2 diabetes mellitus (T2DM) in the Chinese population. Patients and Methods: A total of 860 adult patients in the Department of Endocrinology of the Affiliated Hospital of Jiangsu University were retrospectively analyzed from June 2018 to September 2023. Correlations between WWI and albuminuria (albumin-to-creatinine ratio (UACR) ≥ 30 mg/g were defined as albuminuria) were analyzed using the Pearson and Spearman methods. The associations between albuminuria and Age, gender, body mass index (BMI), waist circumference/ hip circumference (WHR), systolic blood pressure(SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2h PG), fasting plasma insulin (FIns), 2-h postprandial insulin (2hINS), glycosylated hemoglobin (HbA1c), WWI, homeostasis model assessment of insulin resistance (HOMA-IR) were analyzed via binary logistic regression. Results: Compared with the normal albumin group, serum urea nitrogen, serum creatinine, UACR, and WWI levels in the albuminuria group were significantly increased, while estimated glomerular filtration rate (eGFR) levels were significantly decreased (P < 0.05). Correlation analyses revealed that WWI was positively correlated with UACR but negatively correlated with urea nitrogen, serum creatinine, and eGFR (P < 0.05). Binary logistic regression analyses indicated that WWI was an independent risk factor for albuminuria in T2DM patients. Receiver operating characteristic curve results showed that the area under the curve for albuminuria as predicted by WWI was 0.605 [95% CI = (0.563-0.646), P < 0.001]. Conclusion: WWI is independently associated with albuminuria in the Chinese patients with type 2 diabetes and may serve as a simple indicator for albuminuria risk assessment.

Association between weight-adjusted-waist index and gynecologic cancers: a population-based study.

Objective: This study aims to analyze the association between the weight-adjusted waist index (WWI) and the risk of gynecologic cancers, using data collected from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. Methods: We employed multiple logistic regression analysis to investigate the relationship between WWI and risk of gynecologic cancers. Subsequent subgroup analyses were performed on specific populations of interest. A restricted cubic spline model was used to explore potential non-linear relationships. Additionally, the effectiveness of WWI in predicting sarcopenia was assessed through Receiver Operating Characteristic (ROC) curve analysis. K-fold cross-validation was applied for model assessment. Results: Among the 4,144 participants, 98 self-reported having gynecologic cancers. In the fully adjusted model, WWI was significantly associated with the prevalence of gynecologic cancers (OR = 1.38, 95% CI: 1.02-1.88, p = 0.0344). Our findings indicate a linear positive association between WWI and the risk of gynecologic cancers. Subgroup analysis revealed that WWI had the strongest association with cervical cancer (OR = 1.46, 95% CI: 0.97-2.18, p = 0.0354) and endometrial cancer (OR = 1.39, 95% CI: 0.81-2.39, p = 0.0142). No significant association was found between WWI and the risk of ovarian cancer (OR = 1.16, 95% CI: 0.48-2.72, p = 0.5359). Restricted cubic spline analysis confirmed a linear relationship between WWI and the risk of cervical, endometrial, and ovarian cancers. ROC curve analysis demonstrated that WWI had superior predictive capability for gynecologic cancers. Conclusion: Elevated levels of WWI were significantly associated with an increased risk of gynecologic cancers in American women, displaying a stronger association than other obesity markers. Therefore, WWI may serve as a distinct and valuable biomarker for assessing the risk of gynecologic cancers, particularly cervical and endometrial cancers.

Weight-adjusted waist index as a practical predictor for diabetes, cardiovascular disease, and non-accidental mortality risk.

BACKGROUND AND AIM: Identifying a more suitable marker among various measures of adiposity, demonstrating strong associations and predictive ability for clinical use, remains a topic of debate. Weight-adjusted waist index (WWI) has been proposed as a novel index of adiposity, yet its exploration is limited, especially in Chinese populations. This study seeks to examine the associations between body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHTR), weight-adjusted waist index (WWI), waist circumference divided by body mass to the power of 0.333 (WC/M0.333), visceral adiposity index (VAI), lipid accumulation product (LAP), and the incidence of diabetes, cardiovascular disease, and non-accidental mortality in Chinese populations. Furthermore, our goal is to compare the respective predictive values of these measures for these health outcomes. METHODS AND RESULTS: This prospective cohort study included 21,750 subjects with a 9-year follow-up period. Cox proportional hazard models were used to investigate the relationship between eight anthropometric indexes and the incidence of diabetes, cardiovascular disease, and non-accidental mortality. The predictive value of these eight indexes was compared using the area under the curve metric. Significant positive associations were found between WWI and the risk of diabetes. Using the first quartile (Q1) of WWI as the reference group, hazard ratios with 95% confidence intervals for the risk of diabetes were 1.58 (0.98-2.55) for Q2, 2.18 (1.34-3.35) for Q3, and 2.27 (1.41-3.67) for Q4. Significant associations were observed with the highest quartile of WWI for the risk of cardiovascular disease [Q2: HR 1.45 (95% CI 1.06-1.98); Q3: 1.33 (0.97-1.83); Q4: 1.55 (1.13-2.14)] and risk of non-accidental mortality [Q2: 0.94 (0.80-1.11); Q3: 1.24 (1.04-1.48); Q4: 1.44 (1.16-1.79)]. Receiver operating characteristic analysis revealed that WWI exhibited superior discrimination and accuracy in predicting cardiovascular disease and non-accidental mortality compared to other adiposity indexes (BMI, WC, WHR, WHTR, WC/M0.333, VAI, and LAP). CONCLUSION: WWI exhibited the most robust and consistent association with the incidence of cardiovascular disease and non-accidental mortality. Given its simplicity and widespread use, WWI emerges as a novel and practical predictor of diabetes, cardiovascular disease, and non-accidental mortality among the eight adiposity indexes investigated in this study.

The association of weight-adjusted waist index with the risk of osteoporosis in patients with type 2 diabetes: a cross-sectional study.

BACKGROUND: The relationship between obesity and type 2 diabetes with bone health has always been a topic of debate. The weight-adjusted waist index has become a commonly used indicator for assessing central obesity, fat, and muscle mass. However, currently there is no research reporting the association between weight-adjusted waist index and risk of osteoporosis in populations of type 2 diabetes. Therefore, this study aims to provide new information on the association between weight-adjusted waist index and risk of osteoporosis in type 2 diabetes. METHODS: This cross-sectional study involved 963 patients with type 2 diabetes who were admitted to the Department of Endocrinology of Cangzhou Central Hospital. Multivariate logistic regression models were used to assess the association between weight-adjusted waist index and osteoporosis. The potential nonlinear association was evaluated. The effects of interaction between subgroups were assessed using the likelihood ratio test. RESULTS: Weight-adjusted waist index was positively associated with the risk of osteoporosis, regardless of traditional confounding factors. For each 1 unit increased in weight-adjusted waist index, the risk of osteoporosis increased by 67%. Furthermore, there was a nonlinear relationship between weight-adjusted waist index and osteoporosis. The subgroup analysis did not reveal any significant interactions. CONCLUSIONS: Our study indicated a positive association between weight-adjusted waist index and the risk of osteoporosis in adult Chinese type 2 diabetes patients, and this relationship was nonlinear.

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

Background: The relationship between the weight-adjusted-waist index (WWI) and grip strength, a crucial marker in assessing sarcopenia, lacks clarity. We aimed to explore the relationship between WWI and muscle strength across genders. Methods: The cross-sectional study involved adults with complete data on WWI and grip strength from the 2011-2014 National Health and Nutrition Examination Survey. WWI was derived by dividing waist circumference by the square root of weight. Weighted multivariable logistic regression and smooth curve fitting techniques were used to examine the independent association and potential non-linear relationship between WWI and grip strength. A two-piecewise linear regression model was utilized to determine the threshold effect. Additionally, subgroup analyses and interaction tests were conducted. Results: The study encompassed 9,365 participants, including 4,661 males and 4,704 females. Multivariate logistic regression analysis revealed a negative correlation between WWI and grip strength among males (ß = -11.49, 95% CI: -12.38, -10.60, p < 0.001) as well as females (ß = -2.53, 95% CI: -2.98, -2.08, p < 0.001). Subgroup analysis showed that the negative correlation of WWI with grip strength remained consistent across various age groups and levels of obesity for both males and females. Conclusion: An increase in WWI correlates with reduced muscle strength in both males and females. WWI was negatively associated not only with muscle mass but also with muscle strength. WWI may serve as an assessment tool for sarcopenia, but further large-scale studies are needed to clarify causality.

The association between Weight-adjusted-Waist Index (WWI) and cognitive function in older adults: a cross-sectional NHANES 2011-2014 study.

BACKGROUND: The impact of obesity on cognitive function has engendered considerable interest. Weight-adjusted waist index (WWI) has emerged as a novel and innovative marker of obesity that reflects weight-independent abdominal obesity. However, the association between WWI and cognitive function remains unclear. To address this gap, the present study aims to explore the relationship between weight-adjusted waist index (WWI) and cognitive performance in older adults. METHODS: We conducted a cross-sectional investigation using datasets from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. The study included 3,472 participants (48.59% male, 51.41% female) of various races (Mexican American, Other Hispanic, Non-Hispanic White, Non-Hispanic Black, and Other), with a mean age of 69.95 years (SD = 6.94). Multivariate regression and smoothing curve fitting were used to investigate the linear and nonlinear relationship between WWI and cognitive performance in the following domains: learning and memory, verbal fluency, and processing speed, as measured by Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD-WL), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST), respectively. Subgroup analysis and interaction tests were conducted to examine the stability of this relationship across groups. Machine learning models based on random forests were used to analyze the predictive performance of WWI for cognitive function. RESULTS: A total of 3,472 participants were included in the analysis. The results revealed significant negative associations between WWI and low scores on the CERAD-WL [-0.96 (-1.30, -0.62)], AFT [-0.77 (-1.05, -0.49)], and DSST [-3.67 (-4.55, -2.79)]. This relationship remained stable after converting WWI to a categorical variable. In addition, this significant negative association was more pronounced in men than women and diminished with advancing age. Non-linear threshold effects were observed, with correlations intensifying between WWI and CERAD-WL when WWI surpassed 12.25, AFT when WWI surpassed 11.54, and DSST when WWI surpassed 11.66. CONCLUSIONS: A higher WWI, indicating increased abdominal obesity, was associated with deficits in learning, memory, verbal fluency, and processing speed among older adults. These findings suggest that abdominal obesity may play a crucial role in cognitive decline in this population. The stronger relationship observed between WWI and cognition in men highlights the need for gender-specific considerations in interventions targeting abdominal obesity. The results demonstrate the importance of interventions targeting abdominal obesity to preserve cognitive performance in older adults.

Anthropometric indicators and cardiovascular diseases risk in pre-diabetic and diabetic adults: NHANES 1999-2018 cross-sectional analysis.

BACKGROUND: Since cardiovascular disease (CVD) stands as the primary cause of death in those with diabetes, and given the substantial influence of obesity as a common risk factor for both diabetes and atherosclerotic conditions, this investigation sought to find the relationship between anthropometric indicators and CVD risk within these populations. METHODS: Our study examined 36,329 adults, including those with diagnosed diabetes, pre-diabetes, and without diabetes from National Health and Nutrition Examination Survey (NHANES) data spanning 1999 to 2018. Various anthropometric indicators such as body mass index (BMI), waist circumference, weight-adjusted waist index (WWI), waist-to-height ratio (WHtR), weight, and height were assessed. Baseline characteristics were compared among the three groups after weighting. Participants were then grouped based on anthropometric indicators, and logistic regression models were used to analyze the association between these indicators and CVD risk in the total diabetes group (including diabetic and pre-diabetic individuals). Threshold effect analysis was conducted to explore nonlinear relationships, and mediation analyses assessed whether serum parameters influenced these relationships. RESULTS: This cross-sectional study involved 36,329 participants, weighted to a count of approximately 160.9 million, including over 45.9 million pre-diabetic individuals and around 16.6 million diabetic individuals. Baseline analysis showed significant associations between all six anthropometric indicators and CVD risk across patients with different diabetes statuses. Weighted restricted cubic spline (RCS) curve analysis highlighted increased CVD risk among the total diabetes group for each anthropometric indicator compared to the non-diabetic group. Anthropometric indicators were then divided into quartiles, and after adjusting for confounders, Model 3 revealed that the highest BMI group had a heightened risk of CVD compared to the lowest BMI group. Similar trends were observed in the WWI and WHtR subgroups. Threshold effect analysis of anthropometric indicators unveiled nonlinear associations between waist circumference, height, WWI and CVD risk. Mediation analysis suggested that lipid parameters, especially HDL, significantly mediated these relationships. CONCLUSION: In individuals with diabetes and pre-diabetes, BMI, weight, and WHtR displayed a consistent, linear increase correlation with CVD risk. Conversely, the link between waist circumference, height, and WWI and CVD risk showcased a more complex, nonlinear pattern. Moreover, HDL level emerged as notable mediator in the association between anthropometric indicators and the risk of CVD.

Weight-adjusted waist index is a potential early predictor of degraded bone microarchitecture: A cross-sectional study of the national health and nutrition examination survey 2007-2008.

PURPOSE: This study aimed to investigate the association between weight-adjusted waist index (WWI) and trabecular bone score (TBS) and to assess the ability of WWI to identify individuals with degraded bone microarchitecture (DBMA). METHODS: This cross-sectional study included participants aged 20 and older from the National Health and Nutrition Examination Survey. Furthermore, WWI was calculated by waist circumference and body weight. In addition, linear regression models were employed to investigate the association between WWI and TBS, while logistic regression models were employed to determine the association between WWI and the risk of DBMA. Finally, the performance of WWI in identifying individuals with DBMA was using the receiver operating characteristic (ROC) curves with area under the ROC curve. RESULTS: A total of 4,179 participants with a mean age of 49.90 years were included in the final analysis. WWI was negatively associated with TBS and positively associated with an increased risk of DBMA. Furthermore, the associations between WWI and TBS, as well as DBMA risk, were stable regardless of stratification by age, sex, race, or body mass index (BMI). Moreover, WWI achieved good performances in identifying individuals with DBMA or low TBS. In addition, the combination of WWI and BMI showed better performances in identifying individuals with DBMA or low TBS than WWI or BMI alone. CONCLUSION: WWI established a negative association with TBS and a positive association with the risk of DBMA. Clinicians should be alert to the potential risk of DBMA among individuals with high WWI. Moreover, WWI, alone or in combination with BMI, has the potential to serve as an early screening strategy in identifying individuals with DBMA.

Relationship between weight-adjusted-waist index and blood pressure as well as incident hypertension among middle-aged and elderly Chinese: A longitudinal study.

BACKGROUND AND AIM: The Weight-Adjusted Waist Index (WWI) is a novel obesity metric linked to metabolic disorders. Its relationship with blood pressure and hypertension prevalence in middle-aged and elderly Chinese is unclear. This study examined the association between WWI, blood pressure, and hypertension incidence. METHODS AND RESULTS: This cross-sectional study included 9298 participants from the China Health and Retirement Longitudinal Study, with 4120 non-hypertensive individuals enrolled in the cohort study. In the cross-sectional analysis, WWI was positively associated with systolic blood pressure (SBP) (Beta 0.88, 95% CI: 0.57-1.21, p < 0.001), showing stronger correlations than waist circumference (WC) (Beta 0.20, 95% CI: 0.16-0.23, p < 0.001) and body mass index (BMI) (Beta 0.63, 95% CI: 0.52-0.74, p < 0.001). WWI also showed a positive association with diastolic blood pressure (DBP) (Beta 0.51, 95% CI: 0.32-0.69, p < 0.001), stronger than those with WC (Beta 0.13, 95% CI: 0.11-0.15, p < 0.001) and BMI (Beta 0.43, 95% CI: 0.37-0.50, p < 0.001). In the longitudinal cohort study, there were 1325 (32%) incident cases of hypertension by the end of follow-up. WWI was positively associated with incident hypertension (OR 1.11, 95% CI: 1.04-1.18, p = 0.001), with a stronger predictive value than WC (OR 1.02, 95% CI: 1.01-1.03, p < 0.001) and BMI (OR 1.04, 95% CI: 1.02-1.06, p < 0.001). CONCLUSION: Elevated WWI may serve as an independent risk factor for incident hypertension in the middle-aged and elderly Chinese population.

Longitudinal relationship between weight-adjusted waist index and depressive symptoms in middle-aged and older Chinese adults: A prospective cohort study.

BACKGROUND: The association between obesity and depressive symptoms remains controversial. The Weight-adjusted waist index (WWI) shows advantages in assessing central obesity. This study aimed to investigate the longitudinal relationship between WWI and depressive symptoms. METHOD: This prospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011-2020. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depressive Symptoms Scale (CESD-10) scores. Linear mixed models were used to examine longitudinal associations. RESULTS: A total of 6835 participants over the age of 45 were included. WWI was positively associated with CESD-10 scores (ß per 1 SD increase = 0.052SD; 95%CI: 0.021 to 0.083SD) and was linked to a faster increase in CESD-10 scores over time (ß = 0.095SD/year; 95%CI: 0.090 to 0.100 SD/year). Conversely, BMI was negatively associated with CESD-10 scores (ß per 1 SD increase = -0.067SD; 95%CI: -0.097 to -0.038SD). However, the negative association between BMI and CESD-10 scores weakened over time (ß per 1 SD increase = 0.008SD/y; 95%CI: 0.003 to 0.013 SD/y). Nonlinear associations were detected between both WWI and BMI with CESD-10 scores. LIMITATIONS: Self-reported depressive symptoms assessments may have introduced information bias. The observational design limits ruling out unobserved confounding factors. CONCLUSIONS: Our findings highlight the association between WWI and the long-term progression of depressive symptoms in middle-aged and older adults. WWI may enhance our understanding of the link between obesity and depressive symptoms and could be superior to BMI in predicting depressive symptom progression.

Association between weight-adjusted waist index and risk of diabetes mellitus type 2 in United States adults and the predictive value of obesity indicators.

BACKGROUND: The weight-adjusted waist index (WWI) is a quantitative anthropometric index that can be applied to evaluate obesity. This study examined the relationship between adult United States (US) residents' risk of diabetes mellitus type 2 (T2DM) and WWI. METHODS: The NHANES (National Health and Nutrition Examination Survey) 2001-2018 provided the data for this investigation. This study used multifactorial logistic regression analysis, smoothed curve fitting, subgroup analysis, and interaction tests to assess the association between WWI and T2DM. Additionally, threshold effects were calculated using a two-stage linear regression model. The receiver operating characteristic(ROC) curves evaluated the diagnostic ability of the WWI and commonly used obesity indicators. RESULTS: 20,477 participants were enrolled in the analysis, and patients with greater levels of WWI had a higher prevalence of T2DM. WWI and T2DM have a non-linear relationship, with a positive association found on the left side of the breakpoint (WWI = 12.35) (OR = 1.82, 95%CI:1.64-2.02), whereas, on the right side, no such relationship was found (OR = 0.9, 95%CI:0.61-1.34). For every unit rise in WWI, the probability of having T2DM increased by 67% after controlling for all other variables (OR:1.67,95%CI:1.53-1.83). Based on subgroup analyses, individuals under 40 had a higher correlation between WWI and T2DM (P < 0.001).ROC analyses showed that WWI had the best discrimination and accuracy in predicting T2DM compared to other obesity indicators (WC, BMI, and Weight). CONCLUSION: Higher WWI values had a higher prevalence of T2DM in US individuals, especially in adults under 40. WWI has the strongest ability to predict T2DM. Therefore, the importance of WWI in the early identification of T2DM in US adults should be emphasized.

Association between weight-adjusted-waist index and bowel habits.

Obesity has become a global public health issue and is closely related to bowel habits. The Weight-Adjusted-Waist Index (WWI), a new indicator of obesity, provides a more accurate assessment of central obesity. This study aims to investigate the relationship between WWI and bowel habits. The 2005-2010 National Health and Nutrition Examination Survey (NHANES) dataset was used for the cross-sectional survey. Bowel habits were defined by self-report. Multiple logistic regression models were used to test the linear association of WWI with chronic diarrhea and constipation. Fitted smoothed curves and threshold effects analysis were used to characterize nonlinear relationships. Subgroup analyses and interaction tests were used to determine the heterogeneity and stability of the study. This population-based study included 14,238 adults (≥ 20 years). After adjusting for covariates, there was a significant positive association between WWI and chronic diarrhea (OR [95% CI] 1.27 [1.14, 1.41]). There was a non-linear association between WWI and chronic constipation, and we found a breakpoint of 9.77, with a positive correlation on the left side of the breakpoint and no statistical significance on the right side. Subgroup analyses and interaction tests showed stable and consistent results between WWI and bowel habits across the stratification factors. Elevated levels of WWI are associated with an increased risk of chronic diarrhea. A range of WWI < 9.77 is associated with an increased risk of chronic constipation. WWI is a stable valid indicator for assessing intestinal health in U.S. adults, and we should be mindful of the importance of maintaining good levels of body fat in our daily lives to maintain healthy bowel habits.