Kunutsor Setor K, Jae Sae Young, Laukkanen Jari A
Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, R2H 2A6, Canada.
Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK.
Geroscience. 2025 Aug 7. doi: 10.1007/s11357-025-01829-w.
The weight-adjusted waist index (WWI) is a novel anthropometric measure designed to better reflect central obesity than traditional indices such as body mass index and waist circumference (WC). This study examined the prospective association between WWI and cardiometabolic multimorbidity (CMM) and evaluated its predictive utility. We included 3,348 participants (mean age 63 years; 45.1% male) from the English Longitudinal Study of Ageing who were free from hypertension, coronary heart disease, diabetes, and stroke at baseline (wave 4: 2008-2009). WWI was calculated as WC (cm) divided by the square root of body weight (kg). CMM was defined as the presence of ≥ 2 of the following conditions at wave 10 (2021-2023): hypertension, cardiovascular disease, diabetes, or stroke. Multivariable logistic regression and measures of discrimination were used to assess associations and predictive value. Over 15 years, 197 participants developed CMM. Restricted cubic spline analysis indicated a linear dose-response relationship between WWI and CMM risk (p for nonlinearity = .44). Each 1 SD increase in WWI was associated with higher odds of CMM (odds ratio, OR = 1.30; 95% CI: 1.12-1.51), persisting after adjustment for physical activity (OR = 1.28; 95% CI: 1.10-1.49). Similar associations were observed across WWI tertiles. Adding WWI to conventional risk models slightly improved discrimination (ΔC-index = 0.0065; p = .29), with a significant improvement in model fit (-2 log likelihood, p = .001). Higher WWI levels were independently and linearly associated with increased CMM risk in older adults. WWI also improved CMM risk prediction beyond conventional risk factors.
体重调整腰围指数（WWI）是一种新的人体测量指标，旨在比体重指数和腰围（WC）等传统指标更好地反映中心性肥胖。本研究探讨了WWI与心血管代谢多发病（CMM）之间的前瞻性关联，并评估了其预测效用。我们纳入了来自英国老龄化纵向研究的3348名参与者（平均年龄63岁；45.1%为男性），他们在基线时（第4波：2008 - 2009年）无高血压、冠心病、糖尿病和中风。WWI的计算方法是腰围（厘米）除以体重（千克）的平方根。CMM被定义为在第10波（2021 - 2023年）存在以下≥2种情况：高血压、心血管疾病、糖尿病或中风。采用多变量逻辑回归和判别指标来评估关联和预测价值。在15年期间，197名参与者发生了CMM。受限立方样条分析表明WWI与CMM风险之间存在线性剂量反应关系（非线性p值 = 0.44）。WWI每增加1个标准差，CMM的发生几率就更高（优势比，OR = 1.30；95%置信区间：1.12 - 1.51），在调整身体活动后仍然存在（OR = 1.28；95%置信区间：1.10 - 1.49）。在WWI三分位数中观察到类似的关联。将WWI添加到传统风险模型中可略微改善判别能力（ΔC指数 = 0.0065；p = 0.29），模型拟合有显著改善（-2对数似然比，p = 0.001）。较高的WWI水平与老年人CMM风险增加独立且呈线性相关。WWI还能在传统风险因素之外改善CMM风险预测。
