Associations of weight-adjusted-waist index and depression with secondary infertility
Open accessAbstract
Background: Obesity and psychological factors were identified as risk factors for female infertility. The study investigated the correlation between WWI, depression, and secondary infertility, focusing on the potential mediating role of depression. Methods: According to the data from NHANES, this cross-sectional study used multiple regression analysis, subgroup analysis, and smooth curve fitting to explore the relationship between WWI, depression, and secondary infertility. The diagnostic ability of WWI was evaluated and compared to other obesity indicators using the ROC curve. The mediating effect test adopted the distribution of the product. Results: This study involved 2778 participants, including 381 (13.7%) women with secondary infertility. Results showed that higher WWI (OR = 1.31; 95% CI, 1.11-1.56) and depression scores (OR = 1.03; 95% CI, 1.01-1.06) were associated with secondary infertility. There was a positive correlation between WWI and secondary infertility (nonlinear p = 0.8272) and this association was still consistent in subgroups (all P for interaction> 0.05). Compared with other obesity indicators, WWI (AUC = 0.588) also shows good predictive performance for secondary infertility. Mediation analysis showed that depression mediated the relationship between 3.94% of WWI and secondary infertility, with a confidence interval of Z a * Z b excluding 0. Conclusion: WWI exhibited a relatively good correlation in predicting secondary infertility than other obesity indicators, and depression may be a mediator between WWI and secondary infertility. Focusing on the potential mediating role of depression, the risk of secondary infertility due to obesity may be beneficially reduced in women.
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The inclusion of height in the BRI formula distinguishes it from other obesity indices such as WWI or VAI, allowing it to more thoroughly reflect body composition and fat distribution.
“Additionally, the inclusion of height in the BRI formula distinguishes it from other obesity indices such as WWI or VAI, allowing it to more thoroughly reflect an individual’s body composition and fat distribution14,20,21.”
From The nonlinear association between body roundness index and infertility in married women (2025) · cites this paper as [21]
The Materials and methods section (Assessment of other obesity indicators; page unavailable) gives a BRI formula containing height and a WWI formula without it. It does not give a VAI formula or establish that including height lets BRI reflect body composition and fat distribution more thoroughly. The Results instead find WWI more predictive than BRI for secondary infertility, which does not resolve their relative ability to reflect body composition. (LLM, conf=0.86)
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- Authors
- Sun, F., Liu, M., Hu, S., Xie, R., Chen, H., Sun, Z., & Bi, H.
- Affiliations
- Jiangnan University (CN)
- University of South China (CN)
- Corresponding author
- Liu, Min
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2024-03-07
- Volume
- 15
- Pages
- 1330206-1330206
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC10956697
- OpenAlex
- W4392546731
- Cited by
- 13
- References
- 49
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 5
- FWCI
- 5.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- weight-adjusted waist index, secondary infertility, depression, obesity, female infertility, waist circumference, obesity indices, mediation, NHANES
- MeSH terms
- Cross-Sectional Studies, Depression, Female, Humans, Infertility, Female, Male, Nutrition Surveys, Obesity, Obesity, Morbid
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