Chinese General Practice ›› 2026, Vol. 29 ›› Issue (16): 2198-2204.DOI: 10.12114/j.issn.1007-9572.2025.0420

Special Issue: 内分泌代谢性疾病最新文章合辑 社区卫生服务最新研究合辑

• Original Research • Previous Articles     Next Articles

Association between Weight-adjusted Waist Index and Comorbidity of Hypertension, Diabetes and Dyslipidemia in Community-dwelling Adults

  

  1. Department of Chronic Non-communicable Disease Comprehensive Control, Chronic Diseases Prevention and Treatment Institute in Bao'an District, Shenzhen 518100, China
  • Received:2025-08-14 Revised:2026-01-10 Published:2026-06-05 Online:2026-05-21
  • Contact: XU Ying

社区成年人体重调整腰围指数与高血压、糖尿病和血脂异常共病的关联研究

  

  1. 518100 广东省深圳市宝安区慢性病防治院慢性病综合防制科
  • 通讯作者: 徐英
  • 作者简介:

    作者贡献:

    徐萍负责数据收集、采集、清洗、统计学分析、绘制图表和论文起草;马艳、黄莉、何梅亮负责动员、组织、协调研究对象和调查实施;侯云凤、王德旺、孙盼盼、刘峥负责数据收集、采集、样品转运;郭艳芳负责项目点现场协调;徐英负责文章的质量控制与审查,对文章整体负责,监督管理。

  • 基金资助:
    深圳市科技计划项目(JCYJ20250604185826035); 2024年宝安区医疗卫生科研项目(2024JD222); 2022年宝安区医疗卫生科研项目(2022JD124); 宝安区医学重点学科(慢性非传染性疾病防控)

Abstract:

Background

Hypertension, diabetes and dyslipidemia exhibit high prevalence rates in the population and frequently coexist as comorbidity within individuals. The weight-adjusted waist index (WWI) represents a novel obesity assessment metric; however, its association with the comorbidity of the three diseases remains inadequately studied.

Objective

To investigate the association and predictive role of WWI for the comorbidity of hypertension, diabetes and dyslipidemia among community-dwelling adults.

Methods

Based on the Chronic Disease and Risk Factor Surveillance, a cross-sectional survey was conducted using multi-stage random sampling method among permanent residents aged ≥18 years in Bao'an District from October to December 2023. Data were collected through questionnaires, physical examinations, and laboratory biochemical tests, based on which the WWI was calculated, and the comorbidity of hypertension, diabetes and dyslipidemia was documented. Logistic regression was employed to analyze the association between WWI and the comorbidity of the three diseases. Restricted cubic spline (RCS) analysis was applied to explore the dose-response relationship between WWI and the comorbidity. Stratified analyses were conducted by sex, age and BMI, and interactions were explored. Receiver operating characteristic (ROC) curves were used to evaluate and compare the predictive performance of WWI, BMI and waist circumference (WC) for these diseases comorbidities, utilizing DeLong's test comparing differences in area under the curve (AUC).

Results

A total of 1 882 individuals were surveyed, after excluding participants with missing key indicators such as height, body mass and WC, a final total of 1 846 participants were included in the analysis. The comorbidity rates of hypertension, diabetes and dyslipidemia was 17.06% (315/1 846). The Logistic regression analysis results indicated that, after full adjusting for covariates, each 1-unit increase in WWI was associated with a 174% increased risk of the comorbidity (OR=2.74, 95%CI=2.08-3.59, P<0.05). Compared with the Q1 group (WWI<9.69 cm/), the risk of comorbidity increased progressively in the Q2 (9.69 cm/ ≤WWI<10.19 cm/), Q3 (10.19 cm/ ≤WWI<10.66 cm/), and Q4 (WWI≥10.66 cm/) groups, with OR values of 2.62 (95%CI=1.26-5.42, P<0.05), 4.68 (95%CI=2.31-9.48, P<0.05), and 8.09 (95%CI=3.95-16.56, P<0.05), respectively. RCS analysis revealed a significant linear dose-response relationship between WWI and the risk of comorbidity (Poverall<0.001, Pnonlinear=0.079). Subgroup analysis revealed that, with the exception of the BMI<24.00 kg/m2 stratum, individuals in the highest WWI quartile (Q4) exhibited a significantly increased risk of the comorbidity across the following strata: male, female, age<45 years, age≥45 years and BMI≥24.00 kg/m2 (all P<0.05). Interaction analysis showed a significant interaction between WWI and age, with a stronger association between WWI and the comorbidity in the <45 years group compared to the ≥45 years group (P=0.003). The ROC analysis yielded that among males, the AUC (95%CI) for WWI, BMI and WC in predicting the risk of the comorbidity were 0.742 (95%CI=0.705-0.778), 0.705 (95%CI=0.667-0.742), and 0.738 (95%CI=0.702-0.774), respectively. Among females, the corresponding AUC (95%CI) for WWI, BMI and WC were 0.806 (95%CI=0.768-0.844), 0.717 (95%CI=0.669-0.765), and 0.804 (95%CI= 0.766-0.842). In the female population, WWI demonstrated significantly higher predictive accuracy than BMI (Z=-3.134, P=0.002).

Conclusion

WWI exhibits a significant positive and linear dose-response association with comorbidity of the three diseases, demonstrating favorable predictive efficacy. As a novel obesity metric, WWI offers valuable insights for the early prevention and intervention targeting this comorbidity.

Key words: Hypertension, Diabetes, Dyslipidemia, Weight-adjusted waist index, Comorbidity

摘要:

背景

高血压、糖尿病和血脂异常(以下统称为"三高")在人群中患病率较高,且常以共病形式存在于同一个体中,体重调整腰围指数(WWI)是一种新型肥胖评价指标,其与"三高"共病的关联研究缺乏。

目的

探讨社区成年人WWI与"三高"共病的关联性,并分析其预测作用。

方法

依托慢性病及危险因素监测,于2023年10—12月采用多阶段随机抽样方法对深圳市宝安区18岁及以上常住居民开展调查。通过问卷调查、体格检查和实验室生化检测收集数据,并计算WWI,记录"三高"共病情况。应用Logistic回归分析探讨社区人群WWI与"三高"共病的关联,采用限制性立方样条(RCS)探讨WWI与"三高"共病间的剂量反应关系。按性别、年龄和BMI进行分层分析,并探索交互作用。通过受试者工作特征(ROC)曲线评估WWI、BMI和腰围(WC)对"三高"共病的预测能力,并采用Delong检验比较ROC曲线下面积(AUC)的差异。

结果

本次监测共调查1 882人,排除身高、体重、WC等关键指标缺失者后,最终纳入1 846名调查对象,社区成年人"三高"共病患病率为17.06%(315/1 846)。Logistic回归分析结果显示,调整协变量后,WWI每增加1个单位,"三高"共病风险增加174%(OR=2.74,95%CI=2.08~3.59,P<0.05);与WWI Q1组(WWI<9.69 cm/)相比,WWI Q2组(9.69 cm/≤WWI<10.19 cm/)、Q3组(10.19 cm/≤WWI<10.66 cm/)、Q4组(WWI≥10.66 cm/)患"三高"共病风险依次升高,OR值分别为2.62(95%CI=1.26~5.42,P<0.05)、4.68(95%CI=2.31~9.48,P<0.05)、8.09(95%CI=3.95~16.56,P<0.05)。RCS分析表明,WWI与"三高"共病风险呈线性剂量反应关系(Poverall<0.001,Pnonlinear=0.079)。亚组分析显示,除BMI<24.00 kg/m2分层外,男性、女性、<45岁、≥45岁、BMI≥24.00 kg/m2分层的WWI Q4组人群患"三高"共病风险均升高(P<0.05);交互作用显示,WWI与年龄存在交互作用,<45岁人群WWI与"三高"共病的关联性高于≥45岁人群(P=0.003)。ROC曲线结果显示,男性人群中,WWI、BMI、WC预测"三高"共病风险的AUC(95%CI)分别为0.742(95%CI=0.705~0.778)、0.705(95%CI=0.667~0.742)、0.738(95%CI=0.702~0.774);女性人群中,WWI、BMI、WC预测"三高"共病风险的AUC(95%CI)分别为0.806(95%CI=0.768~0.844)、0.717(95%CI=0.669~0.765)、0.804(95%CI=0.766~0.842);在女性人群中,WWI的预测能力优于BMI(Z=-3.134,P=0.002)。

结论

WWI与社区成年人"三高"共病呈显著正相关,且呈线性剂量反应关系,对"三高"共病具有较好预测能力。作为一种新型肥胖评估指标,WWI为"三高"共病的早期预防和干预提供了新思路。

关键词: 高血压, 糖尿病, 血脂异常, 体重调整腰围指数, 共病现象