体重调整腰围指数与腰痛患病率之间的关联：一项来自美国国家健康与营养检查调查的横断面观察研究
Association Between Weight-Adjusted Waist Index and the Prevalence of Low Back Pain: A Cross-Sectional Observational Study from National Health and Nutrition Examination Survey.
作者信息
Que Zhiqiang, Cai Huirong, Chen Dingqiang, Xiao Keyi, Lan Weibin, Rui Gang
机构信息
Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China; The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
出版信息
World Neurosurg. 2025 Mar;195:123660. doi: 10.1016/j.wneu.2025.123660. Epub 2025 Feb 3.
BACKGROUND
The weight-adjusted waist index (WWI) is a novel obesity index that is calculated as the waist circumference (WC) divided by the square root of body weight (kg). Previous studies have revealed that higher body mass index (BMI) and WC increase the risk of low back pain (LBP). However, no research explores the relationship between WWI and LBP.
METHODS
Data utilized in this cross-sectional study were drawn from the National Health and Nutrition Examination Survey. Three logistic regression models were used to evaluate the association between WWI and LBP. Stratified analysis was applied to assess the stability of the results. Receiver-operating characteristic (ROC) curves were employed to visually assess and compare the predictive effectiveness of WWI, BMI, WC, and weight on LBP.
RESULTS
A significant positive correlation was observed between WWI and LBP, model 1 (odds ratio [OR] = 1.222, 95% confidence interval (95% CI) [1.164, 1.283], P < 0.0001), model 2 (OR = 1.187, 95% CI [1.118, 1.261], P < 0.0001), and model 3 (OR = 1.129, 95% CI [1.056, 1.207], P < 0.001). Relative to the Q1, Q3 (model 1 (OR = 1.241, 95% CI [1.114, 1.382], P < 0.001), model 2 (OR = 1.192, 95% CI [1.050, 1.353], P = 0.007), model 3 (OR = 1.145, 95% CI [1.002, 1.310], P = 0.047)) and Q4 (model 1 (OR = 1.524, 95% CI [1.341, 1.733], P < 0.0001), model 2 (OR = 1.422, 95% CI [1.233, 1.640], P < 0.0001), model 3 (OR = 1.333, 95% CI [1.149, 1.547], P < 0.001)) all showed a significant positive correlation between them. The area under the receiver-operating characteristic curve (AUC) for WWI is 0.5447536, the AUC for BMI is 0.5466724, and the AUC for WC and weight is 0.5501341 and 0.5376615, respectively.
CONCLUSIONS
This cross-sectional study revealed a significant positive association between WWI and LBP, but WWI did not show better predictive efficacy than BMI and WC.
背景
体重调整腰围指数（WWI）是一种新型肥胖指数，计算方法为腰围（WC）除以体重（千克）的平方根。先前的研究表明，较高的体重指数（BMI）和腰围会增加下腰痛（LBP）的风险。然而，尚无研究探讨WWI与LBP之间的关系。
方法
本横断面研究使用的数据来自国家健康与营养检查调查。采用三个逻辑回归模型评估WWI与LBP之间的关联。应用分层分析评估结果的稳定性。采用受试者工作特征（ROC）曲线直观评估和比较WWI、BMI、WC和体重对LBP的预测效果。
结果
观察到WWI与LBP之间存在显著正相关，模型1（比值比[OR]=1.222，95%置信区间[95%CI][1.164,1.283]，P<0.0001），模型2（OR=1.187，95%CI[1.118,1.261]，P<0.0001），模型3（OR=1.129，95%CI[1.056,1.207]，P<0.001）。相对于第一四分位数，第三四分位数（模型1（OR=1.241，95%CI[1.114,1.382]，P<0.001），模型2（OR=1.192，95%CI[1.050,1.353]，P=0.007），模型3（OR=1.145，95%CI[1.002,1.310]，P=0.047））和第四四分位数（模型1（OR=1.524，95%CI[1.341,1.733]，P<0.0001），模型2（OR=1.422，95%CI[1.233,1.640]，P<0.0001），模型3（OR=1.333，95%CI[1.149,1.547]，P<0.001））均显示它们之间存在显著正相关。WWI的受试者工作特征曲线下面积（AUC）为0.5447536，BMI的AUC为0.5466724，WC和体重的AUC分别为0.5501341和0.5376615。
结论
本横断面研究揭示了WWI与LBP之间存在显著正相关，但WWI的预测效果并不优于BMI和WC。
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