Weight-adjusted waist index shows promise in predicting stroke
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Key takeaways:
- Every unit increase in the new measure of obesity was linked to a 25% increase in stroke prevalence.
- Given its usefulness, researchers said the measure “deserves the attention of health care professionals.”
A higher weight-adjusted waist index was associated with a greater prevalence and risk for stroke, according to findings published in BMC Public Health.
BMI and waist circumference have previously served as indicators of obesity, but “those indicators cannot be used to differentiate between fat and muscle mass,” Jiayi Ye, from West China Hospital at Sichuan University in China, and colleagues wrote.
“Recent studies have proposed that body composition and fat distribution can be used to more accurately assess poor metabolic characteristics,” they wrote. “The weight-adjusted waist index (WWI), a new type of obesity index, standardizes waist circumference with weight, incorporating the strengths of waist circumference while dampening the connection with BMI.”
WWI can serve as an indicator of CVD, but the researchers wrote that there has been no prior research on the measurement’s associations with stroke.
To fill in these literature gaps and establish possible links, they analyzed National Health and Nutrition Examination Survey 2011-2020 datasets, compiling data from 23,389 participants (mean age, 49 years; 51.2% women).
The overall prevalence of stroke was 3.82%, and it increased in those with higher WWI scores.
Ye and colleagues found that there was a positive association between WWI and stroke (OR = 1.25; 95% CI, 1.05-1.48) in an adjusted model, with a 25% increase in prevalence for every unit increase in WWI.
Additionally, individuals in the highest quartile of WWI had a 62% higher likelihood of having a stroke compared with those in the lowest quartile (OR = 1.62; 95% CI, 1.06-2.48).
The researchers highlighted several possibilities for the correlation.
“The increased WWI might be a reflection of malfunction in adipose tissue, thereby promoting the production and release of various proinflammatory cytokines,” they wrote. “These cytokines are involved in all stages of the formation, progression, erosion and rupture of atherosclerotic plaques, which leads to thrombo-embolic events.”
Ye and colleagues wrote that WWI, as an indicator of obesity, could more accurately predict stroke risk factors like diabetes and metabolic syndrome.
They also highlighted WWI’s direct and specific way of assessing central obesity compared with other indicators, its stability, reliability and its applicability for other races and ethnicities.
“In summary, WWI is simple to calculate, economical and practical, with superior performance in predicting disease risk, and deserves the attention of health care professionals,” they wrote.
Perspective
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This was an important study that helped clarify and solidify the numerous health risks associated with central obesity. There have been small studies positing that higher oxidative stress factors and proinflammatory cytokines associated with central obesity lead to increased health risks, but there have not been very many clear studies translating those findings into a population-based metric. Furthermore, despite certain confounding variables, the fact remains that central obesity is demonstrably associated with an increased risk of health problems, debility and death.
I think it’s important to understand that although WWI serves as a better indicator of a patient’s state of health, fitness and future disease risk, the BMI metric should not be eliminated — at least not yet. In current clinical practice, BMI is often used as a starting point for conversations with patients regarding health and wellness, and for now, it serves as a simpler data point — more understandable for patients. It would be interesting to see how WWI could and should be more globally integrated into clinical practice and platforms, in addition to the BMI metric.
This study gives a much better understanding of central obesity and the risks it entails for patients. The yielded conclusions will improve clinical practice and patients’ awareness of health and wellness. For now, BMI is an oversimplified benchmark and WWI is shifting the paradigm.
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