Association between weight-adjusted-waist index and long-term prognostic outcomes in cardiovascular disease patients: results from the NHANES 1999–2018 study
Abstract Background As cardiovascular disease (CVD) morbidity and mortality increase yearly, this study aimed to explore the potential of the weight-adjusted-waist index (WWI) and its relation to long-term mortality in patients with CVD. Methods The diagnosis of CVD was based on standardized medical...
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BMC
2025-01-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01590-2 |
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| author | Hanbin Li Wen Zhong Hongxin Cheng Shiqi Wang Ran Li Lu Wang Chengqi He Quan Wei |
| author_facet | Hanbin Li Wen Zhong Hongxin Cheng Shiqi Wang Ran Li Lu Wang Chengqi He Quan Wei |
| author_sort | Hanbin Li |
| collection | DOAJ |
| description | Abstract Background As cardiovascular disease (CVD) morbidity and mortality increase yearly, this study aimed to explore the potential of the weight-adjusted-waist index (WWI) and its relation to long-term mortality in patients with CVD. Methods The diagnosis of CVD was based on standardized medical condition questionnaires that incorporated participants’ self-reported physician diagnoses. WWI (cm/√kg) is a continuous variable and calculated as waist circumference (WC, cm) divided by square root of body weight (kg). For analysis purposes, the participants were divided into four groups based on the quartiles (Q1 – Q4) of the WWI. The study’s primary outcome was all-cause mortality in patients with CVD, with cardiovascular mortality as the secondary outcome, and sample weights and complex survey designs were used to ensure reliable, accurate results. Results The final analysis included 4,445 study participants. In the fully adjusted model, the highest quartile (WWI > 12.05 cm/√ kg) showed a higher all-cause mortality rate compared with the lowest quartile (WWI < 11.03 cm/√ kg) (HR = 1.37, 95% CI: 1.03, 1.82, P < 0.05). The risk of all-cause mortality increased with WWI and showed a linear association in patients with congestive heart failure, heart attack (P-overall < 0.05, P − nonlinear > 0.05); WWI was nonlinearly associated with the risk of all-cause mortality in patients with coronary heart disease and angina (P-overall < 0.05, P − nonlinear < 0.05). Survival curve analysis further showed that all cause and cardiovascular mortality were higher in the high WWI group (Q4) (P < 0.001). The time-dependent receiver operating characteristic (ROC) curve showed that WWI’s area under the curves (AUC) for 5- and 10-year survival rates were 0.76 and 0.792 for all-cause mortality and 0.734 and 0.757 for CVD mortality. WWI’s AUC were higher than those of body mass index (BMI) and WC (all P < 0.01). Conclusion Our findings indicate that a high WWI is positively associated with an increased risk of all-cause mortality. Additionally, the high AUC values for WWI strengthen its potential as a meaningful prognostic marker, underscoring its utility in clinical practice for assessing long-term survival risk in patients with CVD. |
| format | Article |
| id | doaj-art-86f781ac0fab4b0b9cc1c4f9c90da5a3 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-86f781ac0fab4b0b9cc1c4f9c90da5a32025-01-19T12:33:28ZengBMCDiabetology & Metabolic Syndrome1758-59962025-01-0117111510.1186/s13098-025-01590-2Association between weight-adjusted-waist index and long-term prognostic outcomes in cardiovascular disease patients: results from the NHANES 1999–2018 studyHanbin Li0Wen Zhong1Hongxin Cheng2Shiqi Wang3Ran Li4Lu Wang5Chengqi He6Quan Wei7Rehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan UniversityRehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan UniversityRehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan UniversityRehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan UniversityRehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan UniversityRehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan UniversityRehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan UniversityRehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan UniversityAbstract Background As cardiovascular disease (CVD) morbidity and mortality increase yearly, this study aimed to explore the potential of the weight-adjusted-waist index (WWI) and its relation to long-term mortality in patients with CVD. Methods The diagnosis of CVD was based on standardized medical condition questionnaires that incorporated participants’ self-reported physician diagnoses. WWI (cm/√kg) is a continuous variable and calculated as waist circumference (WC, cm) divided by square root of body weight (kg). For analysis purposes, the participants were divided into four groups based on the quartiles (Q1 – Q4) of the WWI. The study’s primary outcome was all-cause mortality in patients with CVD, with cardiovascular mortality as the secondary outcome, and sample weights and complex survey designs were used to ensure reliable, accurate results. Results The final analysis included 4,445 study participants. In the fully adjusted model, the highest quartile (WWI > 12.05 cm/√ kg) showed a higher all-cause mortality rate compared with the lowest quartile (WWI < 11.03 cm/√ kg) (HR = 1.37, 95% CI: 1.03, 1.82, P < 0.05). The risk of all-cause mortality increased with WWI and showed a linear association in patients with congestive heart failure, heart attack (P-overall < 0.05, P − nonlinear > 0.05); WWI was nonlinearly associated with the risk of all-cause mortality in patients with coronary heart disease and angina (P-overall < 0.05, P − nonlinear < 0.05). Survival curve analysis further showed that all cause and cardiovascular mortality were higher in the high WWI group (Q4) (P < 0.001). The time-dependent receiver operating characteristic (ROC) curve showed that WWI’s area under the curves (AUC) for 5- and 10-year survival rates were 0.76 and 0.792 for all-cause mortality and 0.734 and 0.757 for CVD mortality. WWI’s AUC were higher than those of body mass index (BMI) and WC (all P < 0.01). Conclusion Our findings indicate that a high WWI is positively associated with an increased risk of all-cause mortality. Additionally, the high AUC values for WWI strengthen its potential as a meaningful prognostic marker, underscoring its utility in clinical practice for assessing long-term survival risk in patients with CVD.https://doi.org/10.1186/s13098-025-01590-2Cardiovascular diseasesWeight-adjusted-waist indexWWIAll-cause mortalityCardiovascular mortalityNHANES |
| spellingShingle | Hanbin Li Wen Zhong Hongxin Cheng Shiqi Wang Ran Li Lu Wang Chengqi He Quan Wei Association between weight-adjusted-waist index and long-term prognostic outcomes in cardiovascular disease patients: results from the NHANES 1999–2018 study Diabetology & Metabolic Syndrome Cardiovascular diseases Weight-adjusted-waist index WWI All-cause mortality Cardiovascular mortality NHANES |
| title | Association between weight-adjusted-waist index and long-term prognostic outcomes in cardiovascular disease patients: results from the NHANES 1999–2018 study |
| title_full | Association between weight-adjusted-waist index and long-term prognostic outcomes in cardiovascular disease patients: results from the NHANES 1999–2018 study |
| title_fullStr | Association between weight-adjusted-waist index and long-term prognostic outcomes in cardiovascular disease patients: results from the NHANES 1999–2018 study |
| title_full_unstemmed | Association between weight-adjusted-waist index and long-term prognostic outcomes in cardiovascular disease patients: results from the NHANES 1999–2018 study |
| title_short | Association between weight-adjusted-waist index and long-term prognostic outcomes in cardiovascular disease patients: results from the NHANES 1999–2018 study |
| title_sort | association between weight adjusted waist index and long term prognostic outcomes in cardiovascular disease patients results from the nhanes 1999 2018 study |
| topic | Cardiovascular diseases Weight-adjusted-waist index WWI All-cause mortality Cardiovascular mortality NHANES |
| url | https://doi.org/10.1186/s13098-025-01590-2 |
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