First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
Department of Endocrinology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
Sci Rep. 2024 Aug 21;14(1):19369. doi: 10.1038/s41598-024-69404-5.
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.
近年来，肥胖对糖尿病视网膜病变（DR）的影响一直受到关注。体重调整腰围指数（WWI）已被报道可以更好地评估人体向心性肥胖的程度，较高的 WWI 表示体内脂肪含量较高。本研究首次探讨了 WWI 与 DR 之间的关系，并评估了 WWI 与其他肥胖指标对 DR 的预测能力的差异。这项横断面研究利用了 2005 年至 2008 年国家健康和营养检查调查（NHANES）的数据。研究人员收集了完整的人体测量学数据（体重和腰围）、散瞳眼底图像和成人基线信息。使用多元回归和亚组分析研究了 WWI 与 DR 之间的独立相互作用。此外，通过平滑曲线拟合和两阶段线性回归建模搜索了 WWI 与 DR 之间的非线性关联和阈值效应。最后，绘制了受试者工作特征曲线（ROC），以比较 WWI 与其他肥胖指标对 DR 的预测能力。本研究共纳入 1228 名符合条件的糖尿病患者。其中男性 631 例（51.38%），女性 597 例（48.62%）。其中，无糖尿病视网膜病变 545 例（44.38%），轻度糖尿病视网膜病变 555 例（45.20%），中度/重度糖尿病视网膜病变 100 例（8.14%），增殖性糖尿病视网膜病变 28 例（2.28%）。在完全调整模型中，WWI 每增加一个单位，DR 的患病率相应降低 31%[比值比（95%可信区间）=0.69（0.58，0.83)]。与最低四分位数（四分位 1）的受试者相比，WWI 水平最高四分位数（四分位 4）的受试者发生 DR 的可能性降低 45%[比值比（95%可信区间）=0.55（0.38，0.78)]。对于女性参与者，WWI 与 DR 之间呈 U 型相关，拐点为 11.49。与体重、BMI 和 ABSI 等肥胖指标相比，WWI 对 DR 具有更好的预测能力。本研究显示，在美国 40 岁及以上人群中，WWI 与 DR 之间存在负相关关系。
