Yang Yulu, Huang Jianwu, Wu Jiacheng, Li Xuehan, Wang Yalei, Chen Hao, Qiu Zhihua, Zhou Zihua
Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ren Fail. 2025 Dec;47(1):2506813. doi: 10.1080/0886022X.2025.2506813. Epub 2025 May 28.
The Weight-adjusted Waist Index (WWI) and Cardiometabolic Index (CMI) are novel metrics developed to evaluate visceral fat distribution and metabolic health. This study aimed to explore the associations between these indices and albuminuria in hypertensive patients.
We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES), obtained between 2005 and 2020. Multivariate logistic regression models, generalized additive models, and smooth curve fitting were employed to examine the relationships between WWI, CMI, and albuminuria. Nonlinear associations were further investigated using a piecewise linear model to identify inflection points. Subgroup analyses were performed, and the diagnostic performance of these indices was evaluated using Receiver Operating Characteristic (ROC) curves.
After adjusting for potential confounders, both WWI and CMI were significantly associated with increased odds of albuminuria (OR = 1.37 and 1.09, respectively). The relationship between WWI and urinary albumin-creatinine ratio (UACR) exhibited a nonlinear pattern, with an inflection point at 11.65. For WWI values lower than 11.65, significant correlations were observed. Subgroup analysis revealed a stronger association between WWI and albuminuria in males. ROC curve analysis indicated that WWI outperformed CMI in detecting albuminuria, with CMI showing slightly lower diagnostic accuracy. When combined with other clinical indicators, the integrated area under the curve (AUC) reached 0.732.
Both WWI and CMI demonstrated significant associations with albuminuria in hypertensive patients, highlighting their potential utility in disease screening. Clinical attention should be directed toward individuals with WWI below 11.65, particularly male subjects, as this threshold was associated with significantly increased prevalence of albuminuria.
体重调整腰围指数（WWI）和心脏代谢指数（CMI）是为评估内脏脂肪分布和代谢健康而开发的新指标。本研究旨在探讨这些指数与高血压患者蛋白尿之间的关联。
我们使用2005年至2020年期间获得的美国国家健康与营养检查调查（NHANES）数据进行了横断面分析。采用多变量逻辑回归模型、广义相加模型和平滑曲线拟合来研究WWI、CMI与蛋白尿之间的关系。使用分段线性模型进一步研究非线性关联以确定拐点。进行了亚组分析，并使用受试者工作特征（ROC）曲线评估这些指数的诊断性能。
在调整潜在混杂因素后，WWI和CMI均与蛋白尿几率增加显著相关（OR分别为1.37和1.09）。WWI与尿白蛋白肌酐比值（UACR）之间的关系呈现非线性模式，拐点为11.65。对于低于11.65的WWI值，观察到显著相关性。亚组分析显示男性中WWI与蛋白尿之间的关联更强。ROC曲线分析表明，在检测蛋白尿方面WWI优于CMI，CMI的诊断准确性略低。当与其他临床指标结合时，曲线下综合面积（AUC）达到0.732。
WWI和CMI在高血压患者中均与蛋白尿显著相关，突出了它们在疾病筛查中的潜在效用。临床应关注WWI低于11.65的个体，尤其是男性受试者，因为该阈值与蛋白尿患病率显著增加相关。
