Weight-adjusted-waist index is positively associated with fecal incontinence: a cross-sectional study

Abstract Introduction Fecal incontinence (FI), a prevalent condition affecting approximately 7.7% of the global population and 8.3% of Americans, significantly impairs quality of life. Although FI is closely associated with obesity, the specific impact of weight-adjusted waist index (WWI) on FI rema...

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Main Authors: Ying Zhang, Wenting Hu, Zhilian Zhou, Xiuming Wang, ChanChan Lin
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Journal of Health, Population and Nutrition
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Online Access:https://doi.org/10.1186/s41043-025-01050-7
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author Ying Zhang
Wenting Hu
Zhilian Zhou
Xiuming Wang
ChanChan Lin
author_facet Ying Zhang
Wenting Hu
Zhilian Zhou
Xiuming Wang
ChanChan Lin
author_sort Ying Zhang
collection DOAJ
description Abstract Introduction Fecal incontinence (FI), a prevalent condition affecting approximately 7.7% of the global population and 8.3% of Americans, significantly impairs quality of life. Although FI is closely associated with obesity, the specific impact of weight-adjusted waist index (WWI) on FI remains unclear. This study aimed to investigate the association between this novel anthropometric indicator, WWI, and FI among American adults. Methods This cross-sectional study enrolled 12,922 participants from the National Health and Nutrition Examination Survey (NHANES). WWI was calculated as waist circumference (cm) divided by the square root of weight (kg). FI was defined as any involuntary loss of mucus, liquid, or solid stool in the past month, assessed via the NHANES Bowel Health Questionnaire. Weighted multivariable logistic regression analyses were performed to evaluate the association between WWI and FI. Furthermore, we utilized smoothing curve fitting to elucidate potential linear relationships. The predictive performance of WWI, body mass index (BMI), and waist circumference (WC) in relation to FI was assessed using the receiver operating characteristic curve analysis and DeLong’s non-parametric test. Results The overall prevalence of FI was 8.14%. Weighted multivariable logistic regression analyses indicated that each one-unit increase in WWI was associated with a 36% higher prevalence of FI (OR = 1.36, 95% CI:1.20–1.55; P < 0.001). When WWI was categorized into tertiles and compared to the lowest tertile, the highest tertile maintained a positive association with FI (OR = 1.63, 95% CI:1.31–2.02; P < 0.001). Smoothing curve fitting revealed a linear dose–response relationship between WWI and FI. Subgroup analysis indicated no significant interactions (all P > 0.05). Additionally, our results suggested that the correlation between WWI and FI was stronger than that between BMI or WC and FI. Conclusions WWI is independently associated with FI, suggesting its potential utility in clinical assessment. WWI may refine risk stratification in obesity management strategies.
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spelling doaj-art-4634824c206440d79b707d970cfdbbb52025-08-24T11:35:36ZengBMCJournal of Health, Population and Nutrition2072-13152025-08-0144111210.1186/s41043-025-01050-7Weight-adjusted-waist index is positively associated with fecal incontinence: a cross-sectional studyYing Zhang0Wenting Hu1Zhilian Zhou2Xiuming Wang3ChanChan Lin4Department of Anorectal Surgery, Chengdu Integrated TCM (Traditional Chinese Medicine) & Western Medicine Hospital, Chengdu First People’s HospitalDepartment of Neurology, Chengdu Integrated TCM & Western Medicine Hospital, Chengdu First People’s HospitalDepartment of Intensive Care Unit, Wenjiang Traditional Chinese Medicine Hospital of ChengduDepartment of Anorectal Surgery, Chengdu Integrated TCM (Traditional Chinese Medicine) & Western Medicine Hospital, Chengdu First People’s HospitalDepartment of Gastroenterology, Quanzhou First Hospital Affiliated to Fujian Medical UniversityAbstract Introduction Fecal incontinence (FI), a prevalent condition affecting approximately 7.7% of the global population and 8.3% of Americans, significantly impairs quality of life. Although FI is closely associated with obesity, the specific impact of weight-adjusted waist index (WWI) on FI remains unclear. This study aimed to investigate the association between this novel anthropometric indicator, WWI, and FI among American adults. Methods This cross-sectional study enrolled 12,922 participants from the National Health and Nutrition Examination Survey (NHANES). WWI was calculated as waist circumference (cm) divided by the square root of weight (kg). FI was defined as any involuntary loss of mucus, liquid, or solid stool in the past month, assessed via the NHANES Bowel Health Questionnaire. Weighted multivariable logistic regression analyses were performed to evaluate the association between WWI and FI. Furthermore, we utilized smoothing curve fitting to elucidate potential linear relationships. The predictive performance of WWI, body mass index (BMI), and waist circumference (WC) in relation to FI was assessed using the receiver operating characteristic curve analysis and DeLong’s non-parametric test. Results The overall prevalence of FI was 8.14%. Weighted multivariable logistic regression analyses indicated that each one-unit increase in WWI was associated with a 36% higher prevalence of FI (OR = 1.36, 95% CI:1.20–1.55; P < 0.001). When WWI was categorized into tertiles and compared to the lowest tertile, the highest tertile maintained a positive association with FI (OR = 1.63, 95% CI:1.31–2.02; P < 0.001). Smoothing curve fitting revealed a linear dose–response relationship between WWI and FI. Subgroup analysis indicated no significant interactions (all P > 0.05). Additionally, our results suggested that the correlation between WWI and FI was stronger than that between BMI or WC and FI. Conclusions WWI is independently associated with FI, suggesting its potential utility in clinical assessment. WWI may refine risk stratification in obesity management strategies.https://doi.org/10.1186/s41043-025-01050-7Fecal incontinenceWeight-adjusted-waist indexNHANESObesity
spellingShingle Ying Zhang
Wenting Hu
Zhilian Zhou
Xiuming Wang
ChanChan Lin
Weight-adjusted-waist index is positively associated with fecal incontinence: a cross-sectional study
Journal of Health, Population and Nutrition
Fecal incontinence
Weight-adjusted-waist index
NHANES
Obesity
title Weight-adjusted-waist index is positively associated with fecal incontinence: a cross-sectional study
title_full Weight-adjusted-waist index is positively associated with fecal incontinence: a cross-sectional study
title_fullStr Weight-adjusted-waist index is positively associated with fecal incontinence: a cross-sectional study
title_full_unstemmed Weight-adjusted-waist index is positively associated with fecal incontinence: a cross-sectional study
title_short Weight-adjusted-waist index is positively associated with fecal incontinence: a cross-sectional study
title_sort weight adjusted waist index is positively associated with fecal incontinence a cross sectional study
topic Fecal incontinence
Weight-adjusted-waist index
NHANES
Obesity
url https://doi.org/10.1186/s41043-025-01050-7
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AT xiumingwang weightadjustedwaistindexispositivelyassociatedwithfecalincontinenceacrosssectionalstudy
AT chanchanlin weightadjustedwaistindexispositivelyassociatedwithfecalincontinenceacrosssectionalstudy