Department of Respiratory Medicine, Shaoxing Second Hospital, Zhejiang, China.
Department of Nutrition, Shaoxing Second Hospital, Zhejiang, China.
Heart Lung. 2024 Nov-Dec;68:166-174. doi: 10.1016/j.hrtlng.2024.07.002. Epub 2024 Jul 14.
There is a close relationship between obesity and the occurrence of asthma.The weight-adjusted waist index (WWI) is a relatively novel anthropometric parameter that reflects obesity.
We aimed to explore the association between WWI and mortality in the asthma population.
We included adult with asthma from NHANES 1999-2018. WWI = Waist circumference (cm)/square root of body weight (kg). Current asthma was determined by the participant's responses in standardized questionnaires. All-cause, cardiovascular disease (CVD), cancer, and respiratory disease mortality information was obtained by prospectively matching these data to the National Death Index. Multivariate-adjusted Cox proportional hazards regression analyses, Kaplan Meier survival analyses, restricted cubic spline (RCS) analyses, stratified analyses, and sensitivity analyses were used to clarify these associations.
A total of 101,316 participants were included in the study, and 3223 were diagnosed with asthma.WWI was independently and positively associated with all-cause and all factor-specific mortality in asthma. In fully adjusted models, each unit increase in WWI was associated with 43 % (hazard ratio [HR] and 95 % confidence interval [CI] = 1.43 [1.25,1.64], p < 0.0001), 58 % (1.58 [1.25, 1.99], p < 0.001), 50 % (1.50 [1.19, 1.90], p < 0.001), and 79 % (1.79 [1.34, 2.39], p < 0.0001) increased all-cause, CVD, cancer, and respiratory disease mortality, respectively. RCS analyses showed largely linear associations between WWI and all mortality risks. Stratified analyses indicated that these associations were influenced by multiple factors, and that age was consistently the effect modifier across all associations.
WWI is an independent predictor of all-cause, CVD, cancer, and respiratory-related mortality in the adult asthma population. These findings highlight that WWI may have novel prognostic value as a simple and easily accessible obesity parameter in asthma patients.
肥胖与哮喘的发生密切相关。体重调整腰围指数（WWI）是一种反映肥胖的相对新颖的人体测量参数。
我们旨在探讨 WWI 与哮喘人群死亡率之间的关系。
我们纳入了来自 NHANES 1999-2018 年的成年哮喘患者。WWI=腰围（cm）/体重（kg）的平方根。当前哮喘通过参与者在标准化问卷中的回答来确定。通过前瞻性地将这些数据与国家死亡指数相匹配，获得全因、心血管疾病（CVD）、癌症和呼吸系统疾病死亡率信息。多变量调整的 Cox 比例风险回归分析、Kaplan-Meier 生存分析、限制性立方样条（RCS）分析、分层分析和敏感性分析用于阐明这些关联。
共有 101316 名参与者纳入研究，其中 3223 人被诊断为哮喘。在哮喘患者中，WWI 与全因和所有因素特异性死亡率独立且呈正相关。在完全调整的模型中，WWI 每增加一个单位，与全因死亡率增加 43%（风险比[HR]和 95%置信区间[CI]=1.43[1.25,1.64]，p<0.0001）、与 CVD 死亡率增加 58%（1.58[1.25,1.99]，p<0.001）、与癌症死亡率增加 50%（1.50[1.19,1.90]，p<0.001）和与呼吸系统疾病死亡率增加 79%（1.79[1.34,2.39]，p<0.0001）相关。RCS 分析显示，WWI 与所有死亡风险之间存在大致线性关联。分层分析表明，这些关联受到多种因素的影响，年龄是所有关联中的一致效应修饰剂。
WWI 是成人哮喘人群全因、CVD、癌症和与呼吸相关的死亡率的独立预测因子。这些发现强调，作为哮喘患者简单且易于获得的肥胖参数，WWI 可能具有新的预后价值。
