Central Obesity as an Independent Predictor of Early Cardiovascular Dysfunction in Young Adults: Pathophysiological Mechanisms and Preventive Strategies

Q: What are the key findings of this study?

Waist circumference per 1 SD increase strongly predicted BMI-defined obesity (OR 345.5, 95% CI 182.4–654.6; p < 0.001) in US adults aged 18–60 years.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Central obesity and early cardiovascular dysfunction (n=1794). Intervention: Waist circumference (per 1 SD increase) / Central obesity (WC >102 cm in men, >88 cm in women) vs. Lower waist circumference / No central obesity. Primary outcome: BMI-defined obesity (BMI ≥ 30 kg/m²) (OR 345.5, 95% CI 182.4-654.6, p=<0.001).

Q: What does this research mean for the field?

Waist circumference is a dominant independent predictor of BMI-defined obesity and associated cardiovascular risk in adults aged 18 to 60 years. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the relationship between central obesity and cardiovascular health and determine whether waist circumference independently predicts obesity beyond standard markers like age, sex, and body mass index.

doi:10.25258/ijddt.16.77s.168

October 23, 2026International Journal of Drug Delivery TechnologyOpen Access

Central Obesity as an Independent Predictor of Early Cardiovascular Dysfunction in Young Adults: Pathophysiological Mechanisms and Preventive Strategies

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Key result

Higher waist circumference linked to ~346-fold higher odds of obesity per SD in US adults.

OR 345.5
95% CI 182.4-654.6
P<0.001
n=1,794

Why the study?

This study aimed to analyze obesity and its effect on cardiovascular health, examining central obesity as a factor beyond commonly considered predictors like age, sex, and BMI.

Does central obesity (waist circumference) independently predict BMI-defined obesity as a marker of early cardiometabolic disease in adults aged 18–60 years?

Key Points

To evaluate the relationship between central obesity and cardiovascular health and determine whether waist circumference independently predicts obesity beyond standard markers like age, sex, and body mass index.
Analyzed cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018 cycle, including 1,794 adults aged 18 to 60 years.
Performed multivariable binary logistic regression to evaluate waist circumference as an independent predictor of BMI-defined obesity (BMI ≥ 30 kg/m²), adjusting for age and sex, with model calibration evaluated using the McFadden pseudo R².
Central obesity was present in 60.4% of participants (1,083 of 1,794), with centrally obese participants showing significantly higher waist circumference (111.2 ± 14.6 cm vs. 87.7 ± 8.8 cm; p < 0.001) and BMI (34.1 ± 6.8 kg/m² vs. 25.2 ± 4.8 kg/m²; p < 0.001) than those without central obesity, while age did not differ (50.7 ± 6.3 years vs. 50.5 ± 6.1 years; p = 0.533).
The prevalence of central obesity increased across waist circumference quartiles, rising from 5.2% in quartile 1 (mean WC 82.6 cm) to 39.6% in quartile 4 (mean WC 125.8 cm).
Multivariable logistic regression demonstrated excellent fit (McFadden pseudo R² = 0.689), identifying waist circumference as the primary predictor of obesity (OR = 345.5 per 1 SD, 95% CI: 182.4–654.6; p < 0.001), alongside female sex (OR = 6.67, 95% CI: 4.40–10.10; p < 0.001) and age (OR = 0.75 per 1 SD, 95% CI: 0.62–0.91; p = 0.003).

Study Design

Type

Cross-Sectional (n=1,794)

Multicenter

Yes

Structured PICO

Does central obesity (waist circumference) independently predict BMI-defined obesity as a marker of early cardiometabolic disease in adults aged 18–60 years?

P

Population

1,794 US adults aged 18–60 years (mean age 50.6 years, 52.4% female) from the cross-sectional NHANES 2017–2018 survey evaluated for central obesity and BMI-defined obesity.

E

Exposure

Exposure: Central obesity defined by World Health Organization (WHO) waist circumference criteria (>102 cm for men and >88 cm for women), and continuous waist circumference (evaluated per 1 standard deviation increase and across quartiles Q1–Q4).

C

Comparator

No central obesity (n=711; waist circumference ≤102 cm for men and ≤88 cm for women).

O

Outcome

BMI-defined obesity (BMI ≥ 30 kg/m²) serving as a marker of early cardiometabolic disease.surrogate

Main Result

Odds Ratio: 345.5 (95% CI 182.4–654.6)

p-value: p=<0.001

In a cross-sectional analysis of 1,794 US adults aged 18–60 years from NHANES 2017–2018, central obesity was present in 60.4% of participants and waist circumference was strongly associated with BMI-defined obesity (OR 345.5 per 1 SD increase), highlighting the importance of measuring waist circumference to identify cardiometabolic risk.

Limitations

Cross-sectional design precludes establishing causal relationships
Reliance on BMI-defined obesity as a surrogate outcome rather than direct echocardiographic or arterial stiffness measures in the NHANES dataset
Single-timepoint measurement of waist circumference subject to potential measurement error
Sample restricted to US adults aged 18 to 60 years, limiting generalizability to other countries and ethnic groups
Unmeasured confounding from diet, physical activity, socioeconomic status, and medication use

Implication

Supports routine waist circumference assessment; extends cross-sectional evidence but leaves open prospective cardiovascular validation.

Abstract

Aim:The main goal of this study is to analyze obesity and its effect on cardiovascular health.This study shows that central obesity is an important factor for predicting cardiovascular health beyond factors that we commonly consider, like age, sex, and most specifically BMI. Methods:Data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 cycle were used.A total of 1,794 adults aged 18-60 years were included in the final sample.Multivariable binary logistic regression was implemented to study the independent relationship between waist circumference and obesity defined by BMI, with age and sex being the other variables.Model fit was evaluated using the McFadden pseudo R-squared statistic. Results:Participants with central obesity had much higher BMI and waist circumference compared with non-obese participants.There was no significant age difference between obese and non-obese participants.Waist circumference was the dominant factor affecting obesity.Waist circumference was divided into quartiles, and its relationship with central obesity was analyzed in 4 quartiles.This analysis showed the number of centrally obese people rising from 5.2% in Q1 to 39.6% in Q4.Overall model fit was excellent (McFadden pseudo R² = 0.689). Conclusion:Central obesity has a powerful relationship with cardiovascular diseases.Along with considering the common factors, waist circumference should also be considered as it directly increases the risk of having heart disease.Having a proper diet, exercise routine, and taking medications can help reduce these risks.

Discussion

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Cite This Study

A 2026 study conducted a cross-sectional in Central obesity and early cardiovascular dysfunction (n=1,794). Waist circumference (per 1 SD increase) / Central obesity (WC >102 cm in men, >88 cm in women) vs. Lower waist circumference / No central obesity was evaluated on BMI-defined obesity (BMI ≥ 30 kg/m²) (OR 345.5, 95% CI 182.4-654.6, p=<0.001). Waist circumference per 1 SD increase strongly predicted BMI-defined obesity (OR 345.5, 95% CI 182.4–654.6; p < 0.001) in US adults aged 18–60 years.

synapsesocial.com/papers/6ae28f09cbadf70daf6c43d5 https://doi.org/10.25258/ijddt.16.77s.168

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Central Obesity as an Independent Predictor of Early Cardiovascular Dysfunction in Young Adults: Pathophysiological Mechanisms and Preventive Strategies

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Central Obesity as an Independent Predictor of Early Cardiovascular Dysfunction in Young Adults: Pathophysiological Mechanisms and Preventive Strategies

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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