The association between weight-adjusted-waist index and total bone mineral density in adolescents: NHANES 2011-2018

Xiaohua Wang; Shuo Yang; Gansheng He; Lin Xie

doi:10.3389/fendo.2023.1191501

The association between weight-adjusted-waist index and total bone mineral density in adolescents: NHANES 2011-2018

Front Endocrinol (Lausanne). 2023 May 17:14:1191501. doi: 10.3389/fendo.2023.1191501. eCollection 2023.

Authors

Xiaohua Wang¹, Shuo Yang¹, Gansheng He¹, Lin Xie¹

Affiliation

¹ Department of Spine Surgery, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.

Abstract

Introduction: The weight-adjusted waist index (WWI) serves as an innovative obesity measure, seemingly surpassing body mass index (BMI) and waist circumference (WC) in evaluating lean and fat mass. This study aimed to explore the relationship between WWI and total bone mineral density (BMD) in US adolescents.

Methods: This population-based study investigated adolescents aged 8-19 years with comprehensive WWI and total BMD data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. WWI was computed by dividing WC by the square root of body weight. Weighted multivariate linear regression and smoothed curve fitting were employed to examine linear and non-linear associations. Threshold effects were determined using a two-part linear regression model. Additionally, subgroup analyses and interaction tests were conducted.

Results: Multivariate linear regression analysis revealed a significant negative association between WWI and total BMD in 6,923 US adolescents aged 8-19 years [β = -0.03, 95% CI: (-0.03, -0.03)]. This negative correlation remained consistent across all subcategories, with the exception of age, encompassing gender,ethnicity, and diabetes status subgroups. Furthermore, a non-linear relationship and saturation effect between WWI and total BMD were identified, with an inflection point at 9.88 cm/√kg.

Conclusions: Our research demonstrated a notable negative relationship and saturation effect between WWI and total BMD among US adolescents.

Keywords: NHANES; adolescent; bone mineral density; obese; osteoporosis; weight-adjusted-waist index.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Body Mass Index
Bone Density*
Humans
Linear Models
Nutrition Surveys
Obesity* / diagnosis

Grants and funding

The current research was funded by Jiangsu Provincial Traditional Chinese Medicine Science and Technology Development Plan Project (2020 ZD202008), Science and Technology Projects in Jiangsu Province (2019 BE2019765), and Natural Science Foundation of Jiangsu Province (BK20221420).