体质量调整腰围指数在肥胖相关疾病风险预测及评估中应用的研究进展

doi:10.13481/j.1671-587X.20250332

摘要/Abstract

摘要：

与传统肥胖评价指标比较，体质量调整腰围指数（WWI）是将腰围（WC）与体质量的平方根相结合，能够更加准确反映肥胖患者腹部脂肪堆积与体质量变化的关系，并预测2型糖尿病（T2DM）、高尿酸血症、心力衰竭、腹主动脉钙化（AAC）、男性勃起功能障碍（ED）、骨关节炎（OA）、哮喘、痴呆和脑卒中等肥胖相关疾病发生风险，WWI可能是中国成年高血压患者左心室肥厚（LVH）的独立决定因素和脑卒中的独立危险因素。现结合近年来国内外相关研究，分析WWI与内分泌代谢病（CVD）、心血管疾病、生殖系统疾病、神经系统疾病、哮喘、骨关节疾病和非酒精性肝纤维化（NAFLD）等肥胖相关疾病风险评估及预测的相关性，旨在为进一步研究肥胖相关疾病的评估及预测提供参考。

关键词: 体质量调整腰围指数, 肥胖, 肥胖相关疾病, 腹部脂肪堆积, 风险预测

Abstract:

Compared with traditional obesity evaluation indexes， the weight-adjusted waist index （WWI） is a combination of waist circumference （WC） and the square root of body mass.WWI can accurately reflect the relationship between abdominal fat accumulation and body mass changes in the obese patients， and it can predict the risk of obesity-related diseases， such as type 2 diabetes mellitus （T2DM）， hyperuricemia， heart failure， abdominal aortic calcification （AAC）， erectile dysfunction （ED） in the males，osteoarthritis（OA）， asthma， dementia and stroke， and may be an independent determinant of left ventricular hypertrophy （LVH） and an independent risk factor for stroke in Chinese adult hypertensive patients. The correlations between WWI and the risk assessment and prediction of obesity-related diseases， such as endocrine metabolic diseases， cardiovascular diseases（CVD）， reproductive diseases， neurological diseases， asthma， osteoarthritis， and non-alcoholic liver fibrosis （NAFLD）， were now analysed in cornbination of the recent domestic and international related studies， with the aim of providing references for the further study of the assessment and prediction of obesity-related diseases.

Key words: Weight-adjusted waist index, Obesity, Obesity-related diseases, Abdominal-fat accumulation, Risk prediction

中图分类号:

R589.2

王琦,姜玲玉,刘向荣. 体质量调整腰围指数在肥胖相关疾病风险预测及评估中应用的研究进展[J]. 吉林大学学报(医学版), 2025, 51(3): 848-854.

Qi WANG,Lingyu JIANG,Xiangrong LIU. Research progress in application of weight-adjusted waist circumference index in risk prediction and evaluation of obesity-related diseases[J]. Journal of Jilin University(Medicine Edition), 2025, 51(3): 848-854.

参考文献 52

[1]	WARD Z J， BLEICH S N， CRADOCK A L， et al. Projected U.S. state-level prevalence of adult obesity and severe obesity［J］. N Engl J Med， 2019， 381（25）： 2440-2450.
[2]	AHIRWAR R， MONDAL P R. Prevalence of obesity in India： a systematic review［J］. Diabetes Metab Syndr， 2019， 13（1）： 318-321.
[3]	ZHU J J， ZHANG Y， WU Y L， et al. Obesity and dyslipidemia in Chinese adults： a cross-sectional study in Shanghai， China［J］. Nutrients， 2022， 14（11）： 2321.
[4]	TIAN X， WANG H. Projecting national-level prevalence of general obesity and abdominal obesity among Chinese adults with aging effects［J］. Front Endocrinol （Lausanne）， 2022， 13： 849392.
[5]	KHAN I， CHONG M， LE A， et al. Surrogate adiposity markers and mortality［J］. JAMA Netw Open， 2023， 6（9）： e2334836.
[6]	DRAMÉ M， GODAERT L. The obesity paradox and mortality in older adults： a systematic review［J］. Nutrients， 2023， 15（7）： 1780.
[7]	TUTOR A W， LAVIE C J， KACHUR S， et al. Updates on obesity and the obesity paradox in cardiovascular diseases［J］. Prog Cardiovasc Dis， 2023， 78： 2-10.
[8]	PARK Y， KIM N H， KWON T Y， et al. A novel adiposity index as an integrated predictor of cardiometabolic disease morbidity and mortality［J］. Sci Rep， 2018， 8（1）： 16753.
[9]	LIU H Y， MA Y， SHI L G. Higher weight-adjusted waist index is associated with increased likelihood of kidney stones［J］. Front Endocrinol （Lausanne）， 2023， 14： 1234440.
[10]	KHALIL W J， AKEBLERSANE M， KHAN A S， et al. Environmental pollution and the risk of developing metabolic disorders： obesity and diabetes［J］. Int J Mol Sci， 2023， 24（10）： 8870.
[11]	MICIĆ D， POLOVINA S， MICIĆ D， et al. Endocrine disrupting chemicals and obesity： the evolving story of obesogens［J］. Acta Endocrinol （Buchar）， 2021， 17（4）： 503-508.
[12]	BOUTARI C， DEMARSILIS A， MANTZOROS C S. Obesity and diabetes［J］. Diabetes Res Clin Pract， 2023， 202： 110773.
[13]	TONG Y， XU S， HUANG L L， et al. Obesity and insulin resistance： pathophysiology and treatment［J］. Drug Discov Today， 2022， 27（3）： 822-830.
[14]	YU S S， WANG B， GUO X F， et al. Weight-adjusted-waist index predicts newly diagnosed diabetes in Chinese rural adults［J］. J Clin Med， 2023， 12（4）： 1620.
[15]	SUN H X， LI Y， SHI J， et al. Weight-adjusted waist index is not superior to conventional anthropometric indices for predicting type 2 diabetes： a secondary analysis of a retrospective cohort study［J］. Fam Pract， 2023， 40（5/6）： 782-788.
[16]	LI X M， ZHAO D， WANG H K. Association between weight-adjusted waist index and risk of diabetes mellitus type 2 in United States adults and the predictive value of obesity indicators［J］. BMC Public Health， 2024， 24（1）： 2025.
[17]	DING Y Y， XU Z H， ZHOU X， et al. Association between weight-adjusted-waist index and the risk of hyperuricemia in adults： a population-based investigation［J］. Front Endocrinol （Lausanne）， 2023， 14： 1236401.
[18]	ZHAO P X， SHI W D， SHI Y M， et al. Positive association between weight-adjusted-waist index and hyperuricemia in patients with hypertension： The China H-type hypertension registry study［J］. Front Endocrinol （Lausanne）， 2022， 13： 1007557.
[19]	LI H， FANG G W， HUANG C C， et al. Association between the weight-adjusted waist index and serum uric acid： a cross-sectional study［J］. Int J Clin Pract， 2023， 2023： 8215866.
[20]	KOLIAKI C， LIATIS S， KOKKINOS A. Obesity and cardiovascular disease： revisiting an old relationship［J］. Metabolism， 2019， 92： 98-107.
[21]	FANG H Y， XIE F， LI K， et al. Association between weight-adjusted-waist index and risk of cardiovascular diseases in United States adults： a cross-sectional study［J］. BMC Cardiovasc Disord， 2023， 23（1）： 435.
[22]	DING C C， SHI Y M， LI J P， et al. Association of weight-adjusted-waist index with all-cause and cardiovascular mortality in China： a prospective cohort study［J］. Nutr Metab Cardiovasc Dis， 2022， 32（5）： 1210-1217.
[23]	ZHANG D L， SHI W R， DING Z H， et al. Association between weight-adjusted-waist index and heart failure： Results from National Health and Nutrition Examination Survey 1999-2018［J］. Front Cardiovasc Med， 2022， 9： 1069146.
[24]	TAO Z X， ZUO P F， MA G S. Association of weight-adjusted waist index with cardiovascular disease and mortality among metabolic syndrome population［J］. Sci Rep， 2024， 14（1）： 18684.
[25]	LI Q M， QIE R R， QIN P， et al. Association of weight-adjusted-waist index with incident hypertension： The Rural Chinese Cohort Study［J］. Nutr Metab Cardiovasc Dis， 2020， 30（10）： 1732-1741.
[26]	WANG J， YANG Q Y， CHAI D J， et al. The relationship between obesity associated weight-adjusted waist index and the prevalence of hypertension in US adults aged≥60 years： a brief report［J］. Front Public Health， 2023， 11： 1210669.
[27]	CAI S， ZHU T Y， DING Y， et al. The relationship between the weight-adjusted-waist index and left ventricular hypertrophy in Chinese hypertension adults［J］. Hypertens Res， 2023， 46（1）： 253-260.
[28]	QIN Z， DU D R， LI Y P， et al. The association between weight-adjusted-waist index and abdominal aortic calcification in adults aged ≥ 40 years： results from NHANES 2013-2014［J］. Sci Rep， 2022， 12（1）： 20354.
[29]	XIE F， XIAO Y， LI X Z， et al. Association between the weight-adjusted-waist index and abdominal aortic calcification in United States adults： Results from the national health and nutrition examination survey 2013-2014［J］. Front Cardiovasc Med， 2022， 9： 948194.
[30]	GENCHI V A， ROSSI E， LAURIOLA C， et al. Adipose tissue dysfunction and obesity-related male hypogonadism［J］. Int J Mol Sci， 2022， 23（15）： 8194.
[31]	GHADERPOUR S， GHIASI R， HEYDARI H， et al. The relation between obesity， kisspeptin， leptin， and male fertility［J］. Horm Mol Biol Clin Investig， 2021， 43（2）： 235-247.
[32]	ELLIOTT V， WALDROP S W， WIROMRAT P， et al. The interaction of obesity and reproductive function in adolescents［J］. Semin Reprod Med， 2022， 40（1/2）： 53-68.
[33]	BARBAGALLO F， VIGNERA S L， CANNARELLA R， et al. Obesity and male reproduction： do sirtuins play a role？［J］. Int J Mol Sci， 2022， 23（2）： 973.
[34]	OBRADOVIC M， SUDAR-MILOVANOVIC E， SOSKIC S， et al. Leptin and obesity： role and clinical implication［J］. Front Endocrinol （Lausanne）， 2021， 12： 585887.
[35]	CAO S Q， HU X， SHAO Y X， et al. Relationship between weight-adjusted-waist index and erectile dysfunction in the United State： results from NHANES 2001-2004［J］. Front Endocrinol （Lausanne）， 2023， 14： 1128076.
[36]	WEN Z J， LI X. Association between weight-adjusted-waist index and female infertility： a population-based study［J］. Front Endocrinol （Lausanne）， 2023， 14： 1175394.
[37]	HE Q Y， CHEN C， BAI S F. The association between weight-adjusted-waist index and self-reported infertility among women of reproductive age in the United States［J］. J Obstet Gynaecol Res， 2023， 49（12）： 2929-2937.
[38]	WANG X H， YANG S， HE G S， et al. The association between weight-adjusted-waist index and total bone mineral density in adolescents： NHANES 2011-2018［J］. Front Endocrinol （Lausanne）， 2023， 14： 1191501.
[39]	KIM K J， SON S， KIM K J， et al. Weight-adjusted waist as an integrated index for fat， muscle and bone health in adults［J］. J Cachexia Sarcopenia Muscle， 2023， 14（5）： 2196-2203.
[40]	LIN Y X， LIANG Z J， ZHANG A X， et al. Relationship between weight-adjusted waist index and osteoporosis in the senile in the United States from the national health and nutrition examination survey， 2017-2020［J］. J Clin Densitom， 2023， 26（2）： 101361.
[41]	WANG X H， XIE L， YANG S. Association between weight-adjusted-waist index and the prevalence of rheumatoid arthritis and osteoarthritis： a population-based study［J］. BMC Musculoskelet Disord， 2023， 24（1）： 595.
[42]	MORYS F， DADAR M， DAGHER A. Association between midlife obesity and its metabolic consequences， cerebrovascular disease， and cognitive decline［J］. J Clin Endocrinol Metab， 2021， 106（10）： e4260-e4274.
[43]	ZHANG W D E， TRAN V， VINH A， et al. Pathophysiological links between obesity and dementia［J］. Neuromolecular Med， 2023， 25（4）： 451-456.
[44]	WANG S S， ZHANG Q H， HOU T T， et al. Differential associations of 6 adiposity indices with dementia in older adults： the MIND-China study［J］. J Am Med Dir Assoc， 2023， 24（9）： 1412-1419.e4.
[45]	ZHOU W， XIE Y Y， YU L L， et al. Positive association between weight-adjusted-waist index and dementia in the Chinese population with hypertension： a cross-sectional study［J］. BMC Psychiatry， 2023， 23（1）： 519.
[46]	YE J Y， HU Y J， CHEN X R， et al. Association between the weight-adjusted waist index and stroke： a cross-sectional study［J］. BMC Public Health， 2023， 23（1）： 1689.
[47]	SHARMA V， COWAN D C. Obesity， inflammation， and severe asthma： an update［J］. Curr Allergy Asthma Rep， 2021， 21（12）： 46.
[48]	YU L S， CHEN Y， XU M， et al. Association of weight-adjusted-waist index with asthma prevalence and the age of first asthma onset in United States adults［J］. Front Endocrinol （Lausanne）， 2023， 14： 1116621.
[49]	HAN X X， HE X F， HAO G， et al. The association of asthma duration with body mass index and Weight-Adjusted-Waist index in a nationwide study of the U.S. adults［J］. Eur J Med Res， 2023， 28（1）： 122.
[50]	POUWELS S， SAKRAN N， GRAHAM Y， et al. Non-alcoholic fatty liver disease （NAFLD）： a review of pathophysiology， clinical management and effects of weight loss［J］. BMC Endocr Disord， 2022， 22（1）： 63.
[51]	SHEN Y， WU Y H， FU M H， et al. Association between weight-adjusted-waist index with hepatic steatosis and liver fibrosis： a nationally representative cross-sectional study from NHANES 2017 to 2020［J］. Front Endocrinol （Lausanne）， 2023， 14： 1159055.
[52]	HU Q G， HAN K X， SHEN J P， et al. Association of weight-adjusted-waist index with non-alcoholic fatty liver disease and liver fibrosis： a cross-sectional study based on NHANES［J］. Eur J Med Res， 2023， 28（1）： 263.