Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 40700, Israel.
Branch of Planning and Strategy, Clalit Health Services, Tel Aviv 6209804, Israel.
Nutrients. 2024 Mar 27;16(7):961. doi: 10.3390/nu16070961.
Given the importance and continued interest in finding a simple, accessible, and universal measure which reflects both general and abdominal adiposity, this study tested for an association of the ratio of WC decile to BMI decile (WC-d/BMI-d) with all-cause mortality. Individuals aged 18-79 years who had participated in the National Health and Nutrition Examination Survey (NHANES) during the years 2007 to 2018 were included in the analysis. WC and BMI deciles were defined separately for males and females, while WC-d/BMI-d was calculated for each individual. The association of WC-d/BMI-d with mortality was assessed using logistic models for the total study population, and then again after stratification by sex, ethnicity, morbidity level, and BMI categories. Positive associations between WC-d/BMI-d and mortality were demonstrated for the total study population (adjusted OR = 1.545, 95%CI: 1.369-1.722) and within different sub-groups, including the population with a normal BMI level (adjusted OR = 1.32, 95%CI: 1.13-1.50). WC-d/BMI-d increased with age, with ~40 years representing a critical time point when WC-d surpasses BMI-d, with a sharper incline for males as compared to females. WC-d/BMI-d was significantly associated with all-cause mortality amongst NHANES American adults; thus, measurements of WC and its integration with BMI in this metric should be considered in clinical practice.
鉴于寻找一种简单、可及且通用的方法来反映一般和腹部肥胖的重要性和持续兴趣，本研究测试了腰围与 BMI 百分位数比值（WC-d/BMI-d）与全因死亡率之间的相关性。本分析纳入了 2007 年至 2018 年期间参加国家健康和营养检查调查（NHANES）的年龄在 18-79 岁的个体。男性和女性分别定义了 WC 和 BMI 的百分位数，而 WC-d/BMI-d 是为每个个体计算的。使用逻辑回归模型评估了 WC-d/BMI-d 与死亡率之间的相关性，然后根据性别、种族、发病水平和 BMI 类别进行分层后再次评估。结果表明，WC-d/BMI-d 与全人群死亡率之间存在正相关（调整后的 OR = 1.545，95%CI：1.369-1.722），且在不同亚组中也存在相关性，包括 BMI 水平正常的人群（调整后的 OR = 1.32，95%CI：1.13-1.50）。WC-d/BMI-d 随年龄增加而增加，约 40 岁是 WC-d 超过 BMI-d 的关键时间点，男性比女性更为陡峭。WC-d/BMI-d 与 NHANES 美国成年人的全因死亡率显著相关；因此，在临床实践中应考虑 WC 及其在该指标中的 BMI 整合的测量。
