Association of the Weight-Adjusted-Waist Index With Risk of All-Cause Mortality: A 10-Year Follow-Up Study

Shuang Cai; Lin Zhou; Yue Zhang; Bokai Cheng; Anhang Zhang; Jin Sun; Man Li; Yongkang Su; Qiligeer Bao; Yan Zhang; Shouyuan Ma; Ping Zhu; Shuxia Wang

doi:10.3389/fnut.2022.894686

Association of the Weight-Adjusted-Waist Index With Risk of All-Cause Mortality: A 10-Year Follow-Up Study

Front Nutr. 2022 May 25:9:894686. doi: 10.3389/fnut.2022.894686. eCollection 2022.

Authors

Shuang Cai^{1

2}, Lin Zhou¹, Yue Zhang¹, Bokai Cheng^{1

2}, Anhang Zhang^{1

2}, Jin Sun^{1

2}, Man Li^{1

2}, Yongkang Su^{1

2}, Qiligeer Bao^{1

2}, Yan Zhang³, Shouyuan Ma¹, Ping Zhu^{1

2}, Shuxia Wang^{1

2}

Affiliations

¹ Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China.
² Medical School of Chinese PLAl, Beijing, China.
³ Department of Outpatient, the First Medical Center, Chinese PLA General Hospital, Beijing, China.

Abstract

Background: To explore the relationship between weight-adjusted-waist index (WWI) and the risk of all-cause mortality in one urban community-dwelling population in China.

Methods: This is a prospective cohort study with a sample of 1,863 older adults aged 60 years or over in Beijing who completed baseline examinations in 2009-2010 and a 10-year follow-up in 2020. WWI was calculated as waist circumference (cm) divided by the square root of weight (kg). Cox regression analysis was performed to investigate the significance of the association of WWI with all-cause mortality. The area under the receiver operating characteristic (ROC) curves were used to compare the ability of each obesity index to predict mortality.

Results: During a median follow-up of 10.8 years (1.0 to 11.3 years), 339 deaths occurred. After adjusted for covariates, the hazard ratios (HRs) for all-cause mortality progressively increased across the tertile of WWI. Compared with the lowest WWI category (tertile1 <10.68 cm/√kg), with WWI 10.68 to 11.24cm/√kg, and≥11.25 cm/√kg, the HRs (95% confidence intervals (CIs)) for all-cause mortality were 1.58 (1.12-2.22), and 2.66 (1.80-3.92), respectively. In stratified analyses, the relationship between WWI and the risk of all-cause mortality persisted. The area under ROC for WWI was higher for all-cause mortality than BMI, WHtR, and WC.

Conclusion: WWI was associated with a higher risk for all-cause mortality, and the association was more robust with the highest WWI category.

Keywords: 10-year follow-up; all-cause mortality; obesity; older people; weight-adjusted waist index.