Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.
Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, 330006, Jiangxi, China.
BMC Psychiatry. 2023 Jul 19;23(1):519. doi: 10.1186/s12888-023-05027-w.
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.
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.
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.
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.
肥胖与痴呆之间的关联仍存在争议。因此，本研究旨在探讨体重调整腰围指数（WWI），一种反映肥胖的新人体测量指标，与中国高血压人群中痴呆的关系。
本横断面研究共纳入 10289 名高血压患者，为中国 H 型高血压登记研究的一部分。WWI 计算为腰围（WC）除以体重的平方根。采用简易精神状态检查（MMSE）量表评估认知功能。根据教育背景，应用不同的 MMSE 截断值来定义痴呆：≥7 年受教育者<24 分，1-6 年受教育者<20 分，文盲者<17 分。采用多变量线性回归和多变量二项逻辑回归分析分别评估 WWI 与 MMSE 和痴呆之间的关系。
总体而言，患者的平均年龄为 63.7±9.7 岁，49.0%为男性。多变量线性回归分析显示，WWI 与 MMSE 呈负相关（β，-1.09；95%置信区间[CI]：-1.24，-0.94）。同样，多变量二项逻辑回归分析发现 WWI 与痴呆风险呈正相关（比值比[OR]，1.45；95%CI：1.35，1.56）。与 WWI 四分位 1 的个体相比，WWI 对 MMSE 和痴呆的校正β和 OR 值分别为-2.28（95%CI：-2.62，-1.94）和 2.12（95%CI：1.81，2.48）。平滑曲线拟合结果证实了 WWI 与 MMSE 和痴呆之间的线性关系。亚组分析显示，在有午睡习惯的高血压患者中，WWI 与痴呆之间的相关性更强。
WWI 与高血压人群中的痴呆独立且呈正相关，尤其是在有午睡习惯的人群中。数据表明，WWI 可能成为评估临床实践中痴呆风险的简单有效工具。
