Maojun Liu, Junyu Pei, Cheng Zeng, Ying Xin, Peiqi Tang, Xinqun Hu
Journal: Nutrition journal 2025;24(1):184
PMID: 41408264
People with type 2 diabetes (T2DM) are at much higher risk of developing cardiovascular disease, including heart attacks and strokes. Excess body fat, especially around the abdomen, is known to increase this risk. However, common measures such as body mass index (BMI) do not always accurately reflect harmful fat distribution. The Weight-Adjusted Waist Index (WWI) is a newer measurement that combines waist circumference with body weight to better estimate unhealthy fat accumulation.This observational study aimed to investigate whether WWI is linked to future cardiovascular events in people with T2DM, and whether it can help predict risk more accurately. The researchers used data from the ACCORD study (Action to Control Cardiovascular Risk in Diabetes), a large clinical trial involving adults with T2DM.
The results showed that individuals with higher WWI had a significantly increased risk of experiencing these serious cardiovascular events. The relationship remained consistent even after adjusting for other known risk factors such as age, sex, blood pressure, and cholesterol. Additional analyses across different subgroups confirmed the strength and consistency of the findings.
In conclusion, a higher WWI is strongly associated with increased cardiovascular risk in people with T2DM. WWI may provide additional predictive value beyond traditional measures like BMI. Healthcare professionals may consider incorporating WWI into routine assessments to identify high-risk individuals and guide early intervention strategies aimed at reducing abdominal fat and improving cardiometabolic health.
AIMS
This study aimed to investigate the association between the weight-adjusted waist circumference index (WWI) and cardiovascular outcomes in patients with T2DM.
METHODS
Using Cox proportional hazards regression models to determine the impact of WWI on cardiovascular event. Nonlinear associations were explored through restricted cubic splines (RCS) and smooth curve fitting (SCF), and the integrity of these findings was supported by subgroup and sensitivity analyses.
RESULTS
An elevation in WWI was linked to a significant rise in the likelihood of major adverse cardiovascular events (MACEs), composite cardiovascular outcomes MSD, including myocardial infarction, stroke, and any death, congestive heart failure (CHF), and total mortality (TM). An increase of per 1 standard deviations (SD) in WWI corresponded to a 7% heightened risk of MACEs (HR: 1.07, 95% CI: 1.02, 1.13), a 9% greater risk of MSD (HR: 1.09, 95% CI: 1.04, 1.13), a 20% greater risk of CHF (HR: 1.20, 95% CI: 1.10, 1.30), and a 11% increase in TM (HR: 1.11, 95% CI: 1.06, 1.17). RCS and SCF analysis revealed a nonlinear correlation between WWI and the risks of CHF and TM. Subgroup analyses demonstrated that WWI more accurately predicted CHF risk in patients whose duration of diabetes was under 10 years. Sensitivity analyses reinforced the reliability of these results.The integration of WWI into conventional predictive models improved the accuracy of these outcomes.
CONCLUSIONS
WWI is closely associated with future cardiovascular outcomes and TM in patients with T2DM.WWI serves as an autonomous predictor of both future cardiovascular events and TM among patients with T2DM, outperforming traditional obesity indices in predictive ability. CLINICAL TRIAL URLS: https://clinicaltrials.gov/ct2/show/NCT00000620.
© 2025. The Author(s).
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