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

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. 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. 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. 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.

He Y ，Shi L 《-》

Is weight-adjusted waist index more strongly associated with diabetes than body mass index and waist circumference?: Results from the database large community sample study.

The uncertainty regarding the correlation between the weight-adjusted waist index (WWI) and diabetes within the National Health and Nutrition Examination Survey (NHANES) necessitates further exploration. As indicators of obesity, the differences in the intensity of association between WWI, body mass index (BMI), and waist circumference (WC) with diabetes are worth exploring. This investigation is undertaken to elucidate the association between WWI and diabetes in the NHANES dataset and to compare the extent to which BMI, WC, and WWI were closely associated with diabetes. Then, choose an obesity index that is more strongly associated with diabetes. A comprehensive cross-sectional stratified survey of 7,973 participants from the 2017-2020 NHANES was conducted. WWI is an anthropometric measure based on WC and weight. The formula is WWI (cm/√kg) = WC/√weight. The association between WWI and diabetes was investigated using weighted multiple logistic regression, smooth curve fitting, stratified analysis, and interaction testing. The participants' average age was 50.84±17.34 years, and 50.68% of them were female. The detection rate of diabetes was 15.11%. This positive association was particularly notable among non-diabetic patients. For each unit increase in BMI and WC as continuous variables, the likelihood of developing diabetes in the fully adjusted model increased by 5% (OR = 1.05; 95%CI, 1.03-1.07) and 3% (OR = 1.03; 95%CI, 1.02-1.04), respectively, but for each one-unit increase in WWI, the likelihood of developing diabetes increased by 111% (OR = 2.11; 95% CI, 1.68-2.65). Tests of interactions revealed that in various subgroups, the association between diabetes and WWI remained steady. We analyzed 2017-2020 NHANES data to explore the link between WWI and diabetes, finding a consistent positive correlation. The correlation between WWI and diabetes was stronger than that between WC and BMI. WWI seems to offer better potential aid in disease prevention and diagnosis.

Wu J ，Guo J 《PLoS One》

The association between weight-adjusted waist circumference index and cardiovascular disease and mortality in patients with diabetes.

Cardiovascular disease (CVD) is a significant health concern, particularly among patients with diabetes. The weight-adjusted waist circumference index (WWI), a novel metric that accounts for central obesity, has shown potential in predicting obesity-related health risks. This study aimed to evaluate the association of WWI with CVD and mortality in patients with diabetes. Utilizing data from the National Health and Nutrition Examination Survey from 1999 to 2020, WWI was calculated by dividing waist circumference (WC) by the square root of body weight. Multivariate logistic regression, multivariate Cox regression and restricted cubic spline curves were used to assess the association between WWI and the prevalence of CVD and mortality in patients with diabetes, subgroup and sensitivity analyses were carried out to delve into the stability of the findings. The predictive performance of WWI was evaluated using the area under the receiver operating characteristic curve (ROC). This study included 8,005 individuals with diabetes. With the increase in WWI values, the risk of developing CVD and the likelihood of mortality progressively rise. The fully adjusted continuous model indicated a 28% higher chance of developing CVD and a 25% higher risk of all-cause mortality for each one-unit increase in WWI. When using the lowest quartile of WWI as the reference category, the highest quartile was linked to an increased risk of CVD (OR 1.66; 95% CI 1.10-2.50, p = 0.015) and all-cause mortality (HR 1.53, 95% CI 1.27-1.83, p < 0.001) among patients with diabetes. Subgroup and sensitivity analyses confirmed that these associations were consistent and stable in most different demographics. The ROC analysis indicated that WWI had a higher predictive capacity for CVD and all-cause mortality than WC, waist to hip ratio, and weight to height ratio. The WWI was significantly associated with the prevalence of CVD and all-cause mortality among patients with diabetes in the United States and may serve as a useful tool for identifying individuals at risk.

Tao Z ，Zuo P ，Ma G 《Scientific Reports》

Correlation of weight-adjusted waist index with diabetic retinopathy in US adults aged ≥ 40 years: the NHANES 2005-2008.

The effect of obesity on diabetic retinopathy (DR) has been under scrutiny in recent years. The weight-adjusted waist index (WWI) has been reported to better assess the degree of centripetal obesity in humans, with a higher WWI indicating a higher amount of body fat. The present study is the first to investigate the relationship between WWI and DR and to assess the difference in the predictive ability of WWI and other obesity indices for DR. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008. Researchers collected complete anthropometric data (weight and waist circumference), dilated fundus images, and adult baseline information. Independent interactions between WWI and DR were investigated using multivariate regression and subgroup analyses. In addition, nonlinear associations and threshold effects between WWI and DR were searched for by smoothed curve fitting and by two-stage linear regression modeling. Finally, the receiver operating characteristic curve (ROC) was plotted to compare the predictive power of WWI with other indices of obesity for DR. A total of 1228 eligible patients with diabetes were collected in this study. There were 631 (51.38%) males and 597 (48.62%) females. Among them, 545 (44.38%) were without diabetic retinopathy, 555 (45.20%) had mild diabetic retinopathy, 100 (8.14%) had moderate/severe diabetic retinopathy and 28 (2.28%) had proliferative diabetic retinopathy (PDR). In the fully adjusted model, each unit increase in WWI was associated with a corresponding 31% reduction in the prevalence of DR [OR (95% CI) = 0.69 (0.58, 0.83)]. Compared with subjects in the lowest quartile (quartile 1), subjects in the highest quartile of WWI levels (quartile 4) were 45% less likely to have DR [OR (95% CI) = 0.55 (0.38, 0.78)]. In the case of female participants, a U-shaped correlation was observed between WWI and DR with an inflection point of 11.49. WWI also possesses a better predictive ability for DR compared to obesity indicators such as weight, BMI, and ABSI. This study showed a negative association between WWI and DR in the U.S. population aged 40 years and older.

Li X ，Huang Y ，Chen M 《Scientific Reports》

Association of weight-adjusted-waist index with all-cause and cardiovascular mortality in individuals with diabetes or prediabetes: a cohort study from NHANES 2005-2018.

Weight-adjusted waist index (WWI) is a new marker of central obesity. This study explored the association of WWI with all-cause and cardiovascular disease (CVD) mortality in individuals with diabetes or prediabetes. 6551 participants with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES) records between 2005 and 2018 were included. The association of WWI with all-cause and CVD mortality was assessed using Kaplan-Meier survival analysis, Cox proportional hazards model (Cox regression), and restricted cubic spline (RCS). The predictive value of WWI for mortality was analyzed using time-dependent receiver operating characteristic curves (ROC). There were 1083 all-cause deaths and 360 CVD deaths. Multivariable-adjusted Cox regression analyses showed WWI was positively correlated with the risk of all-cause and CVD mortality in subjects with diabetes or prediabetes. Multivariate-adjusted RCS analyses showed a linear and positive correlation of WWI with all-cause mortality risk, and a nonlinear relationship with CVD mortality, with a threshold of 12.35. The area under the curve (AUC) for 3, 5, and 10-years survival for all-cause mortality was 0.795, 0.792, and 0.812, respectively, and for CVD mortality was 0.815, 0.833, and 0.831, respectively. WWI is a valuable predictor of all-cause mortality risk in patients with diabetes and prediabetes, and a valuable predictor of CVD mortality risk when patients with diabetes and prediabetes are considered as a whole.

Zhao P ，Du T ，Zhou Q ，Wang Y ... -  《Scientific Reports》