The association between weight-adjusted-waist index and increased urinary albumin excretion in adults: A population-based study

Zheng Qin; Kaixi Chang; Qinbo Yang; Qiao Yu; Ruoxi Liao; Baihai Su

doi:10.3389/fnut.2022.941926

The association between weight-adjusted-waist index and increased urinary albumin excretion in adults: A population-based study

Front Nutr. 2022 Aug 12:9:941926. doi: 10.3389/fnut.2022.941926. eCollection 2022.

Authors

Zheng Qin^{1

2}, Kaixi Chang^{1

2}, Qinbo Yang^{1

2}, Qiao Yu^{1

2}, Ruoxi Liao^{1

2}, Baihai Su^{1

2}

Affiliations

¹ Department of Nephrology, National Clinical Research Center for Geriatrics, Med-X Center for Materials, West China Hospital, Sichuan University, Chengdu, China.
² Med+ Biomaterial Institute of West China Hospital/West China School of Medicine of Sichuan University, Chengdu, China.

Abstract

Aims: The negative effect of obesity on kidney health has been reported. The association between weight-adjusted-waist index (WWI, a newly developed adiposity index) and albuminuria has not been reported earlier.

Methods: This cross-sectional study was conducted among adults with complete data about WWI and urinary albumin-to-creatinine ratio (ACR) in 2005-2018 National Health and Nutrition Examination Survey (NHANES). WWI was calculated as waist circumference (WC) divided by the square root of weight. Weighted multivariable logistic regression and generalized additive model were employed to explore the independent relationship between WWI with albuminuria and its non-linearity. A two-piecewise linear regression model was used to calculate the threshold effect. Subgroup analysis and interaction tests were also performed.

Results: A total of 36,921 participants were enrolled with a prevalence of albuminuria of 9.32%. The prevalence of albuminuria increased with the higher WWI tertiles (Tertile 1: 5.31%, Tertile 2: 8.23%, Tertile 3: 15.65%). WWI was positively associated with a higher likelihood of albuminuria (OR = 1.28, 95% CI: 1.15-1.43), and this relationship remains stable in subgroups (all P for trend > 0.05). Non-linear positive relationships were detected in females with a breakpoint of 10.93. A positive association between WWI and albuminuria (OR = 1.39, 95% CI: 1.20-1.61) was observed on the right of the breakpoint, while the association on the left was of no statistical significance. WWI showed a stronger correlation with albuminuria (OR = 1.28) than other markers of obesity including body mass index (BMI, OR = 1.02) and WC (OR = 1.01).

Conclusion: Weight-adjusted-waist index levels were positively related to an increased likelihood of albuminuria in United States adults and showed a stronger relationship than BMI and WC. Our findings indicated that WWI may serve as a simple anthropometric index to predict albuminuria.

Keywords: NHANES; albuminuria; cross-sectional study; obesity; weight-adjusted-waist index.