Association of weight-adjusted waist index with preserved ratio impaired spirometry and all-cause mortality

BackgroundPreserved ratio impaired spirometry (PRISm) is considered an early indicator of chronic obstructive pulmonary disease (COPD). This study aimed to investigate the association between weight-adjusted waist index (WWI) and PRISm, and the impact of WWI on all-cause mortality in U.S. adults wit...

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Main Authors: Xin Jiao, Linqi Huang, Luoqi Lin, Fanggang Zhu, Feiting Fan, Jingmin Xiao, Lei Wu, Lin Lin, Yuanbin Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1594453/full
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author Xin Jiao
Xin Jiao
Xin Jiao
Linqi Huang
Luoqi Lin
Luoqi Lin
Luoqi Lin
Fanggang Zhu
Fanggang Zhu
Fanggang Zhu
Feiting Fan
Feiting Fan
Feiting Fan
Jingmin Xiao
Jingmin Xiao
Jingmin Xiao
Lei Wu
Lei Wu
Lei Wu
Lin Lin
Lin Lin
Lin Lin
Yuanbin Chen
Yuanbin Chen
Yuanbin Chen
author_facet Xin Jiao
Xin Jiao
Xin Jiao
Linqi Huang
Luoqi Lin
Luoqi Lin
Luoqi Lin
Fanggang Zhu
Fanggang Zhu
Fanggang Zhu
Feiting Fan
Feiting Fan
Feiting Fan
Jingmin Xiao
Jingmin Xiao
Jingmin Xiao
Lei Wu
Lei Wu
Lei Wu
Lin Lin
Lin Lin
Lin Lin
Yuanbin Chen
Yuanbin Chen
Yuanbin Chen
author_sort Xin Jiao
collection DOAJ
description BackgroundPreserved ratio impaired spirometry (PRISm) is considered an early indicator of chronic obstructive pulmonary disease (COPD). This study aimed to investigate the association between weight-adjusted waist index (WWI) and PRISm, and the impact of WWI on all-cause mortality in U.S. adults with and without PRISm.MethodsThis combined cross-sectional and cohort study analyzed data from 9,841 participants in the 2007–2012 National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression assessed the association between WWI and PRISm. Kaplan–Meier survival curves and weighted Cox regression evaluated the effect of WWI on all-cause mortality. Restricted cubic spline (RCS) analysis explored both linear and nonlinear relationships between WWI and outcomes.ResultsAfter covariate adjustment, each unit increase in WWI was associated with a 45% reduced risk of PRISm (ORs = 0.55; 95% CIs: 0.47–0.65). RCS analysis revealed a nonlinear WWI-PRISm relationship (p for nonlinearity = 0.0012). In the PRISm population, each WWI unit increase associated with an 88% higher adjusted all-cause mortality risk (HRs = 1.88; 95% CIs: 1.38–2.56). A U-shaped curve characterized the nonlinear WWI-mortality association in PRISm (p for nonlinearity = 0.0025), whereas positive linear trends were observed in non-PRISm individuals and overall.ConclusionLower WWI levels were linked to an elevated PRISm risk, highlighting central obesity’s role in respiratory health. Maintaining an optimal WWI may mitigate mortality risk in adults with PRISm, emphasizing the need for targeted weight management.
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spelling doaj-art-876a7b7bbdf04764ab33fdf2ebcd5c132025-08-20T02:26:28ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-05-011210.3389/fnut.2025.15944531594453Association of weight-adjusted waist index with preserved ratio impaired spirometry and all-cause mortalityXin Jiao0Xin Jiao1Xin Jiao2Linqi Huang3Luoqi Lin4Luoqi Lin5Luoqi Lin6Fanggang Zhu7Fanggang Zhu8Fanggang Zhu9Feiting Fan10Feiting Fan11Feiting Fan12Jingmin Xiao13Jingmin Xiao14Jingmin Xiao15Lei Wu16Lei Wu17Lei Wu18Lin Lin19Lin Lin20Lin Lin21Yuanbin Chen22Yuanbin Chen23Yuanbin Chen24State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaState Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, ChinaState Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, ChinaState Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, ChinaState Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, ChinaState Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, ChinaState Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, ChinaState Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, ChinaBackgroundPreserved ratio impaired spirometry (PRISm) is considered an early indicator of chronic obstructive pulmonary disease (COPD). This study aimed to investigate the association between weight-adjusted waist index (WWI) and PRISm, and the impact of WWI on all-cause mortality in U.S. adults with and without PRISm.MethodsThis combined cross-sectional and cohort study analyzed data from 9,841 participants in the 2007–2012 National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression assessed the association between WWI and PRISm. Kaplan–Meier survival curves and weighted Cox regression evaluated the effect of WWI on all-cause mortality. Restricted cubic spline (RCS) analysis explored both linear and nonlinear relationships between WWI and outcomes.ResultsAfter covariate adjustment, each unit increase in WWI was associated with a 45% reduced risk of PRISm (ORs = 0.55; 95% CIs: 0.47–0.65). RCS analysis revealed a nonlinear WWI-PRISm relationship (p for nonlinearity = 0.0012). In the PRISm population, each WWI unit increase associated with an 88% higher adjusted all-cause mortality risk (HRs = 1.88; 95% CIs: 1.38–2.56). A U-shaped curve characterized the nonlinear WWI-mortality association in PRISm (p for nonlinearity = 0.0025), whereas positive linear trends were observed in non-PRISm individuals and overall.ConclusionLower WWI levels were linked to an elevated PRISm risk, highlighting central obesity’s role in respiratory health. Maintaining an optimal WWI may mitigate mortality risk in adults with PRISm, emphasizing the need for targeted weight management.https://www.frontiersin.org/articles/10.3389/fnut.2025.1594453/fullpreserved ratio impaired spirometryweight-adjusted waist indexNHANESmortalityobesity
spellingShingle Xin Jiao
Xin Jiao
Xin Jiao
Linqi Huang
Luoqi Lin
Luoqi Lin
Luoqi Lin
Fanggang Zhu
Fanggang Zhu
Fanggang Zhu
Feiting Fan
Feiting Fan
Feiting Fan
Jingmin Xiao
Jingmin Xiao
Jingmin Xiao
Lei Wu
Lei Wu
Lei Wu
Lin Lin
Lin Lin
Lin Lin
Yuanbin Chen
Yuanbin Chen
Yuanbin Chen
Association of weight-adjusted waist index with preserved ratio impaired spirometry and all-cause mortality
Frontiers in Nutrition
preserved ratio impaired spirometry
weight-adjusted waist index
NHANES
mortality
obesity
title Association of weight-adjusted waist index with preserved ratio impaired spirometry and all-cause mortality
title_full Association of weight-adjusted waist index with preserved ratio impaired spirometry and all-cause mortality
title_fullStr Association of weight-adjusted waist index with preserved ratio impaired spirometry and all-cause mortality
title_full_unstemmed Association of weight-adjusted waist index with preserved ratio impaired spirometry and all-cause mortality
title_short Association of weight-adjusted waist index with preserved ratio impaired spirometry and all-cause mortality
title_sort association of weight adjusted waist index with preserved ratio impaired spirometry and all cause mortality
topic preserved ratio impaired spirometry
weight-adjusted waist index
NHANES
mortality
obesity
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1594453/full
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