Abstract
Objective: The weight-adjusted-waist index (WWI) is an innovative measure of obesity that appears to surpass body mass index (BMI) in assessing lean body mass and fat mass. This study aimed to evaluate the relationship between WWI and arterial stiffness in hypertensive adults in the United States. Design and method: This study included 9,753 adults diagnosed with hypertension from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2016. The WWI was computed by dividing waist circumference (WC) by the square root of body weight, with arterial stiffness (represented by estimated pulse wave velocity, ePWV) as the outcome. Weighted multiple linear regression and smooth curve fitting were used to test for linear and nonlinear associations. Threshold effects were determined using a two-part linear regression model. Additionally, subgroup analyses and interaction tests were conducted. Results: Among the participants included, the mean WWI was 11.32 ± 0.76. After multivariable adjustment, WWI showed a significant nonlinear association with ePWV. A U-shaped association between WWI and ePWV was observed. Specifically, WWI below the threshold (WWI < 10.41) was negatively associated with arterial stiffness [β=-0.50, 95%CI:(-0.57, -0.43)], while WWI above the threshold (WWI > 10.41) was positively associated with arterial stiffness [β=0.09, 95%CI:(0.07-0.11)]. Conclusions: Our study indicates a U-shaped association between WWI and arterial stiffness among hypertensive adults in the United States. However, this needs to be confirmed in large clinical trials.
Published Version
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