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Cited by 91Body Composition Measurement TechniquesDiabetes, Cardiovascular Risks, and LipoproteinsObesity, Physical Activity, Diet

Association of the Weight-Adjusted-Waist Index With Risk of All-Cause Mortality: A 10-Year Follow-Up Study

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Cai, Shuang, Zhou, Lin, Zhang, Yue, Cheng, Bokai, Zhang, Anhang, Sun, Jin, Li, Man, Su, Yongkang +5 more·2022·Frontiers in Nutrition
DOI 10.3389/fnut.2022.894686PMC PMC9174751
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Abstract

Background: To explore the relationship between weight-adjusted-waist index (WWI) and the risk of all-cause mortality in one urban community-dwelling population in China. Methods: This is a prospective cohort study with a sample of 1,863 older adults aged 60 years or over in Beijing who completed baseline examinations in 2009–2010 and a 10-year follow-up in 2020. WWI was calculated as waist circumference (cm) divided by the square root of weight (kg). Cox regression analysis was performed to investigate the significance of the association of WWI with all-cause mortality. The area under the receiver operating characteristic (ROC) curves were used to compare the ability of each obesity index to predict mortality. Results: During a median follow-up of 10.8 years (1.0 to 11.3 years), 339 deaths occurred. After adjusted for covariates, the hazard ratios (HRs) for all-cause mortality progressively increased across the tertile of WWI. Compared with the lowest WWI category (tertile1 <10.68 cm/√kg), with WWI 10.68 to 11.24cm/√kg, and≥11.25 cm/√kg, the HRs (95% confidence intervals (CIs)) for all-cause mortality were 1.58 (1.12–2.22), and 2.66 (1.80–3.92), respectively. In stratified analyses, the relationship between WWI and the risk of all-cause mortality persisted. The area under ROC for WWI was higher for all-cause mortality than BMI, WHtR, and WC. Conclusion: WWI was associated with a higher risk for all-cause mortality, and the association was more robust with the highest WWI category.

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  • BMI is limited in its ability to differentiate between lean and fat tissues.

    “While BMI is a common measure of obesity, it is limited in its ability to differentiate between lean and fat tissues10,11.”

    From The nonlinear association between body roundness index and infertility in married women (2025) · cites this paper as [10]

    The Introduction calls BMI a widely used measure of obesity and says it cannot distinguish visceral fat from fat in other areas. That supports the general point that BMI has limitations, but it does not state the specific claimed limitation: distinguishing lean tissue from fat tissue. The Discussion addresses fat and muscle mass in relation to WWI, not BMI. (LLM, conf=0.82)

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Cited by

Sorted by citations

Authors
Cai, S., Zhou, L., Zhang, Y., Cheng, B., Zhang, A., Sun, J., Li, M., Su, Y., Bao, Q., Zhang, Y., Ma, S., Zhu, P., & Wang, S.
Affiliations
Chinese PLA General Hospital (CN)
Corresponding author
  • Zhu, Ping
  • Wang, Shuxia
ORCID
Venue
Frontiers in Nutrition
Publisher
Frontiers Media SA
Published
2022-05-25
Volume
9
Pages
894686-894686
ISSN
2296-861X (ISSN-L)
DOI
10.3389/fnut.2022.894686
PMC
PMC9174751
OpenAlex
W4281557831
Cited by
91
References
11
Citations by year
2026: 10 · 2025: 32 · 2024: 30 · 2023: 16 · 2022: 3
FWCI
12.54
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Chinese People's Liberation Army
Topics
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
weight-adjusted waist index, all-cause mortality, waist circumference, obesity indices, older adults, community-dwelling population, body mass index, waist-to-height ratio, mortality prediction, urban population

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