Cheng Meng-Ke, Guo Yao-Yao, Zhang Zi-Yin, Kang Xiao-Nan, Wang Dan, Ren Hui-Hui, Yuan Gang
Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.
Branch of National Clinical Research Center for Metabolic Disease, Hubei, P.R. China.
Ann Med. 2025 Dec;57(1):2522970. doi: 10.1080/07853890.2025.2522970. Epub 2025 Jun 23.
Obesity is a known risk factor for diabetic peripheral neuropathy (DPN), but the relationship between body mass index (BMI) and DPN remains controversial.
This study explores the relationship between weight-adjusted waist index (WWI) and DPN in Chinese patients with Type 2 Diabetes Mellitus (T2DM), with the goal of establishing WWI as an effective tool for the early detection and risk stratification of DPN.
A total of 1790 participants were included. The relationships between WWI, BMI, WC, and DPN were analyzed using logistic regression, restricted cubic spline, and subgroup analysis, with ROC-AUC used to assess the diagnostic performance of the obesity indices.
During this cross-sectional study, a total of 895 cases of DPN were recorded. Each 1-SD increase in WWI was associated with an increased risk of DPN in Model 1 (OR: 1.72, 95% CI: 1.37-2.16), Model 2 (OR: 1.41, 95% CI: 1.10-1.80), and Model 3 (OR: 1.37, 95% CI: 1.06-1.77). A linear relationship was observed between WWI and DPN when WWI was greater than 10.757 cm/√kg (OR: 1.375, 95% CI: 1.115-1.7). BMI was nonlinearly associated with DPN (-nonlinear < 0.05), and age significantly modified the relationship between BMI and DPN. ROC analysis indicated that WWI had superior diagnostic performance compared to BMI and WC.
WWI is linearly and independently associated with DPN and demonstrates greater stability and predictive value than BMI and WC. Therefore, WWI may serve as a more reliable indicator for identifying individuals at risk for DPN.
肥胖是糖尿病周围神经病变（DPN）的已知危险因素，但体重指数（BMI）与DPN之间的关系仍存在争议。
本研究探讨体重调整腰围指数（WWI）与中国2型糖尿病（T2DM）患者DPN之间的关系，旨在将WWI确立为DPN早期检测和风险分层的有效工具。
共纳入1790名参与者。采用逻辑回归、限制性立方样条和亚组分析，分析WWI、BMI、腰围（WC）与DPN之间的关系，用ROC曲线下面积（ROC-AUC）评估肥胖指数的诊断性能。
在这项横断面研究中，共记录了895例DPN病例。在模型1（比值比：1.72，95%置信区间：1.37-2.16）、模型2（比值比：1.41，95%置信区间：1.10-1.80）和模型3（比值比：1.37，95%置信区间：1.06-1.77）中，WWI每增加1个标准差，DPN风险增加。当WWI大于10.757 cm/√kg时，观察到WWI与DPN之间存在线性关系（比值比：1.375，95%置信区间：1.115-1.7）。BMI与DPN呈非线性相关（-非线性<0.05），年龄显著改变了BMI与DPN之间的关系。ROC分析表明，与BMI和WC相比，WWI具有更好的诊断性能。
WWI与DPN呈线性且独立相关，比BMI和WC具有更高的稳定性和预测价值。因此，WWI可能是识别DPN风险个体的更可靠指标。
