Is weight-adjusted waist index more strongly associated with diabetes than body mass index and waist circumference?: Results from the database large community sample study

Background The uncertainty regarding the correlation between the weight-adjusted waist index (WWI) and diabetes within the National Health and Nutrition Examination Survey (NHANES) necessitates further exploration. As indicators of obesity, the differences in the intensity of association between WWI, body mass index (BMI), and waist circumference (WC) with diabetes are worth exploring. This investigation is undertaken to elucidate the association between WWI and diabetes in the NHANES dataset and to compare the extent to which BMI, WC, and WWI were closely associated with diabetes. Then, choose an obesity index that is more strongly associated with diabetes. Methods A comprehensive cross-sectional stratified survey of 7,973 participants from the 2017–2020 NHANES was conducted. WWI is an anthropometric measure based on WC and weight. The formula is WWI (cm/√kg) = WC/√weight. The association between WWI and diabetes was investigated using weighted multiple logistic regression, smooth curve fitting, stratified analysis, and interaction testing. Results The participants’ average age was 50.84±17.34 years, and 50.68% of them were female. The detection rate of diabetes was 15.11%. This positive association was particularly notable among non-diabetic patients. For each unit increase in BMI and WC as continuous variables, the likelihood of developing diabetes in the fully adjusted model increased by 5% (OR = 1.05; 95%CI, 1.03–1.07) and 3% (OR = 1.03; 95%CI, 1.02–1.04), respectively, but for each one-unit increase in WWI, the likelihood of developing diabetes increased by 111% (OR = 2.11; 95% CI, 1.68–2.65). Tests of interactions revealed that in various subgroups, the association between diabetes and WWI remained steady. Conclusions We analyzed 2017–2020 NHANES data to explore the link between WWI and diabetes, finding a consistent positive correlation. The correlation between WWI and diabetes was stronger than that between WC and BMI. WWI seems to offer better potential aid in disease prevention and diagnosis.