Association of weight-adjusted waist index with all-cause mortality among non-Asian individuals: a national population-based cohort study

• Published in: Nutrition journal Vol. 23; no. 1; pp. 62 - 12
• Main Authors: Cao, Ting, Xie, Ruijie, Wang, Jiusong, Xiao, Meimei, Wu, Haiyang, Liu, Xiaozhu, Xie, Songlin, Chen, Yanming, Liu, Mingjiang, Zhang, Ya
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.06.2024; BioMed Central; BMC
• Subjects: Adult; African Americans; Aged; All-cause mortality; Analysis; Body Mass Index; Body Weight; Cause of Death; China; Cohort Studies; Female; Forecasts and trends; Health aspects; Humans; Male; Middle Aged; Mortality; NHANES; Nutrition Surveys - methods; Nutrition Surveys - statistics & numerical data; Obesity; Obesity - mortality; Patient outcomes; Physiological aspects; Proportional Hazards Models; Risk Factors; Surveys; United States - epidemiology; Waist Circumference; Waiting lines; Weight-adjusted-waist; United States; China; Obesity; NHANES; Weight-adjusted-waist; All-cause mortality
• ISSN: 1475-2891; 1475-2891
• DOI: 10.1186/s12937-024-00947-z

The Weight-Adjusted Waist Index (WWI) is a new indicator of obesity that is associated with all-cause mortality in Asian populations. Our study aimed to investigate the linear and non-linear associations between WWI and all-cause mortality in non-Asian populations in the United States, and whether WWI was superior to traditional obesity indicators as a predictor of all-cause mortality. We conducted a cohort study using data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES), involving 18,592 participants. We utilized Cox proportional hazard models to assess the association between WWI, BMI, WC, and the risk of all-cause mortality, and performed subgroup analyses and interaction tests. We also employed a receiver operating characteristics (ROC) curve study to evaluate the effectiveness of WWI, BMI, and WC in predicting all-cause mortality. After adjusting for confounders, WWI, BMI, and WC were positively associated with all-cause mortality. The performance of WWI, BMI, and WC in predicting all-cause mortality yielded AUCs of 0.697, 0.524, and 0.562, respectively. The data also revealed a U-shaped relationship between WWI and all-cause mortality. Race and cancer modified the relationship between WWI and all-cause mortality, with the relationship being negatively correlated in African Americans and cancer patients. In non-Asian populations in the United States, there is a U-shaped relationship between WWI and all-cause mortality, and WWI outperforms BMI and WC as a predictor of all-cause mortality. These findings may contribute to a better understanding and prediction of the relationship between obesity and mortality, and provide support for effective obesity management strategies.