Association between the weight-adjusted-waist index and cardiovascular disease among US adults: Results from the National Health and Nutrition Examination Survey 2009-2016

Background As a new obesity-related index, the weight-adjusted-waist index (WWI) appears to be a good predictor of cardiovascular disease (CVD) in East Asian populations. This study aimed to evaluate the association between WWI and the risk of CVD in United States (US) adults. Methods The data were obtained from the 2009–2016 National Health and Nutrition Examination Survey (NHANES). WWI was calculated as waist circumference divided by the square root of weight, and CVD was ascertained based on self-reported physician diagnoses. Multivariable regression analysis and subgroup analysis were performed to evaluate the association between WWI and CVD. Results A total of 21,040 participants were included, with the mean age being 47.11 ± 16.79 years. There was a positive linear relationship between WWI and the odds of CVD ( P = 0.310). After adjusting for all covariates, each unit of increased WWI was associated with a 48% increased risk of CVD (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.25–1.74). Moreover, compared with the lowest quintile (< 10.3 cm/√kg), the multivariable-adjusted OR was 3.18 (95% CI: 1.81–5.60) in the highest quintile (≥ 11.8 cm/√kg). Besides, subgroup analyses showed that stronger associations between WWI and CVD were detected in participants younger than 50 years of age ( P for interaction < 0.001). Conclusions High levels of WWI were significantly associated with an increased risk of CVD in US adults, particularly in people under 50 years of age. These findings indicate that WWI may be an intervention indicator to reduce the risk of CVD in the general adult population.