AbstractWeight-adjusted waist index (WWI) is a new marker of central obesity. This study explored the association of WWI with all-cause and cardiovascular disease (CVD) mortality in individuals with diabetes or prediabetes. 6551 participants with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES) records between 2005 and 2018 were included.

摘要体重调整腰围指数（WWI）是中心性肥胖的新标志。这项研究探讨了第一次世界大战与糖尿病或糖尿病前期患者的全因和心血管疾病（CVD）死亡率的关系。纳入了2005年至2018年间国家健康与营养调查（NHANES）记录的6551名糖尿病或前驱糖尿病患者。

The association of WWI with all-cause and CVD mortality was assessed using Kaplan-Meier survival analysis, Cox proportional hazards model (Cox regression), and restricted cubic spline (RCS). The predictive value of WWI for mortality was analyzed using time-dependent receiver operating characteristic curves (ROC).

使用Kaplan-Meier生存分析，Cox比例风险模型（Cox回归）和限制性三次样条（RCS）评估WWI与全因死亡率和CVD死亡率的关系。使用时间依赖性受试者工作特征曲线（ROC）分析WWI对死亡率的预测价值。

There were 1083 all-cause deaths and 360 CVD deaths. Multivariable-adjusted Cox regression analyses showed WWI was positively correlated with the risk of all-cause and CVD mortality in subjects with diabetes or prediabetes. Multivariate-adjusted RCS analyses showed a linear and positive correlation of WWI with all-cause mortality risk, and a nonlinear relationship with CVD mortality, with a threshold of 12.35.

共有1083例全因死亡和360例CVD死亡。多变量校正Cox回归分析显示，WWI与糖尿病或糖尿病前期患者的全因和心血管疾病死亡率呈正相关。多变量调整后的RCS分析显示，WWI与全因死亡风险呈线性正相关，与CVD死亡率呈非线性关系，阈值为12.35。

The area under the curve (AUC) for 3, 5, and 10-years survival for all-cause mortality was 0.795, 0.792, and 0.812, respectively, and for CVD mortality was 0.815, 0.833, and 0.831, respectively. WWI is a valuable predictor of all-cause mortality risk in patients with diabetes and prediabetes, and a valuable predictor of CVD mortality risk when patients with diabetes and prediabetes are considered as a whole..

全因死亡率的3年、5年和10年生存率的曲线下面积（AUC）分别为0.795、0.792和0.812，CVD死亡率分别为0.815、0.833和0.831。WWI是糖尿病和糖尿病前期患者全因死亡风险的有价值预测指标，也是糖尿病和糖尿病前期患者整体考虑时心血管疾病死亡风险的有价值预测指标。。

IntroductionDiabetes mellitus (DM) is a significant and growing public health issue worldwide. Studies estimate that over 500 million people aged 20–80 years are affected by diabetes globally, with this figure predicted to rise to 783.2 million1. DM can lead to vascular complications and is a significant cause of cardiovascular disease (CVD)2.

引言糖尿病（DM）是全球范围内一个重要且不断增长的公共卫生问题。研究估计，全球有超过5亿20-80岁的人受到糖尿病的影响，预计这一数字将上升到7.832亿1。DM可导致血管并发症，是心血管疾病（CVD）的重要原因2。

CVD is a major cause of mortality globally, the number of people with CVD, exceeded 250 million worldwide in 2019, and the figure of deaths has risen by 6.5 million3. Notably, CVD continues to be a major cause of mortality in diabetic patients in the world4,5. People with DM tend to suffer from a higher risk of CVD and a worse outcome, manifesting higher rates of CVD and all-cause mortality.

心血管疾病是全球死亡的主要原因，2019年全球心血管疾病患者人数超过2.5亿，死亡人数增加了650万3。值得注意的是，心血管疾病仍然是世界上糖尿病患者死亡的主要原因4,5。糖尿病患者往往患有更高的心血管疾病风险和更差的结果，表现出更高的心血管疾病率和全因死亡率。

In 2018, all-cause mortality and CVD mortality rates for males with DM were 27.8 and 7.5 per 1,000 person-years, respectively, compared with 29.5 and 7.1 per 1,000 person-years for females6. A four-fold increase in CVD-related mortality has been reported in people with DM in comparison with people without DM.

。据报道，与没有DM的人相比，DM患者的心血管疾病相关死亡率增加了四倍。

All-cause mortality is also increased in people with DM compared with people without DM7. Given the high morbidity and mortality associated with both DM and CVD, identifying modifiable risk factors affecting the prognosis of individuals with diabetes or prediabetes is critical to preventing DM complications and reducing mortality.The correlation between obesity and the development of DM and CVD is well recognized.

与没有DM7的人相比，DM患者的全因死亡率也有所增加。鉴于糖尿病和心血管疾病的高发病率和死亡率，确定影响糖尿病或糖尿病前期患者预后的可改变风险因素对于预防糖尿病并发症和降低死亡率至关重要。肥胖与糖尿病和心血管疾病发展之间的相关性已得到公认。

Abdominal obesity, in particular, is known to be an essential risk factor for DM and its complications, including diabetic kidney disease, osteoporosis, and CVD8. Several obesity indexes, including body mass index (BMI), waist circumference (WC), triglyceride-glucose index and visceral adiposity index, have been used in previous.

特别是腹部肥胖，已知是糖尿病及其并发症（包括糖尿病肾病，骨质疏松症和CVD8）的重要危险因素。。

Data availability

数据可用性

All data can be downloaded from the official NHANES website, and the data that support the findings of this study are available from the corresponding author upon reasonable request.

所有数据均可从NHANES官方网站下载，支持本研究结果的数据可根据合理要求从通讯作者处获得。

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Lu，C。Y。等人。肥胖指数与糖尿病患者总死亡率和心血管死亡率的风险：台湾的一项长期随访研究。心血管。糖尿病22（1），345（2023）。文章

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Ades，P.A。＆Savage，P.D。肥胖悖论：感知与知识。梅奥临床。第85（2）条，第112-114（2010）条。文章

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Download referencesAcknowledgementsThe authors are grateful to the participants and staff of NHANES for their valuable contributions to this study. We thank Bullet Edits Limited for the linguistic editing and proofreading of the manuscript.Author informationAuthors and AffiliationsDepartment of Endocrinology Genetic Metabolism, Gansu Provincial Maternity and Child-care Hospital (Gansu Provincial Central Hospital), Lanzhou, 730000, Gansu, People’s Republic of ChinaYirong WangLanzhou University, Lanzhou, Gansu, People’s Republic of ChinaPingping Zhao, Tianqi Du, Qi zhou & Yirong WangAuthorsPingping ZhaoView author publicationsYou can also search for this author in.

下载参考文献致谢作者感谢NHANES的参与者和工作人员对本研究的宝贵贡献。我们感谢Bullet Edits Limited对稿件的语言编辑和校对。作者信息作者和所属单位甘肃省妇幼保健院内分泌遗传代谢科（甘肃省中央医院），兰州，730000，甘肃，中华人民共和国易容网兰州大学，兰州，甘肃，中华人民共和国赵平平，杜天齐，齐州和王易容作者赵平平观点作者出版物您也可以在中搜索这位作者。

PubMed Google ScholarTianqi DuView author publicationsYou can also search for this author in

PubMed Google ScholarTianqi DuView作者出版物您也可以在

PubMed Google ScholarQi zhouView author publicationsYou can also search for this author in

PubMed Google ScholarQi zhouView作者出版物您也可以在

PubMed Google ScholarYirong WangView author publicationsYou can also search for this author in

PubMed Google ScholarYirong WangView作者出版物您也可以在

PubMed Google ScholarContributionsPP Z and YR W conceived and designed the study. PP Z, TQ D and Q Z collected clinical and biochemical data. PP Z, TQ D, Q Z and YR W contributed to the statistical analysis, results interpretation, drafting and revising the paper.Corresponding authorCorrespondence to.

PubMed Google ScholarContributionsPP Z和YR W构思并设计了这项研究。PP Z，TQ D和Q Z收集临床和生化数据。PP Z，TQ D，Q Z和YR W为统计分析，结果解释，起草和修订论文做出了贡献。对应作者对应。

Yirong Wang.Ethics declarations

王怡荣。道德宣言

Ethics approval and consent to participate

道德批准和同意参与

The National Center for Health Statistics and Ethics Review approved the NHANES protocol and all participants provided written informed consent.

国家卫生统计和道德审查中心批准了NHANES协议，所有参与者均提供了书面知情同意书。

Competing interests

相互竞争的利益

The authors declare no competing interests.

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Reprints and permissionsAbout this articleCite this articleZhao, P., Du, T., zhou, Q. et al. Association of weight-adjusted-waist index with all-cause and cardiovascular mortality in individuals with diabetes or prediabetes: a cohort study from NHANES 2005–2018.

转载和许可本文引用本文Zhao，P.，Du，T.，zhou，Q。等人。体重调整腰围指数与糖尿病或糖尿病前期患者全因死亡率和心血管死亡率的关系：NHANES 2005-2018年的队列研究。

Sci Rep 14, 24061 (2024). https://doi.org/10.1038/s41598-024-74339-yDownload citationReceived: 19 June 2024Accepted: 25 September 2024Published: 14 October 2024DOI: https://doi.org/10.1038/s41598-024-74339-yShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsWeight-adjusted-waist indexDiabetesAll-cause mortalityCardiovascular mortality

关键词重量调整腰围指数糖尿病所有原因死亡率心血管死亡率