journal article·2025-01-27Open access

Weight-Adjusted Waist Index as a New Useful Tool for Assessing Body Composition and Risk of Metabolic Disorders in Adult Women

Martina Gažarová, Laura Hačková, Zoia Sharlovych, Petra Lenártová, Mária Kijovská, Jana Pastrnáková, Tetiana Kutiuhova

Applied Sciences· Volume 15· Issue 3

Abstract

(1) Background: Commonly used anthropometric indices have limitations that discriminate their relevance. The subject of this research was to evaluate the health risks associated with body composition using the new weight-adjusted waist index (WWI). (2) Materials and Methods: The research group consisted of two hundred and thirty-nine Caucasian women. Body composition was analyzed by the MF-BIA method using InBody 970. The WWI was calculated as waist circumference divided by the square root of weight. Biochemical parameters (lipid profile, glucose, hs-CRP and uric acid) were analyzed using a Biolis 24i Premium biochemical analyser. One-factor variance analysis, a post-hoc test, Pearson correlation analysis and WWI quartiles were used for the statistical evaluation. (3) Results: The results showed significant differences between WWI quartiles. Compared to the lowest quartile, participants in the highest quartile groups had the highest values of body weight (58.49 vs. 87.17 kg; p < 0.001), waist circumference (WC) (76.47 vs. 109.45 cm; p < 0.001), body mass index (BMI) (20.65 vs. 32.06 kg/m2; p < 0.001), waist-to-hip ratio (WHR) (0.84 vs. 1.03; p < 0.001), waist-to-height ratio (WHtR) (0.46 vs. 0.66; p < 0.001), fat-free mass (FFM) (44.97 vs. 49.12 kg; p < 0.001), fat mass (FM) (13.52 vs. 38.05 kg; p < 0.001) and visceral fat area (VFA) (56.94 vs. 150.62 cm2; p < 0.001), confirming a higher risk of obesity. The women in the highest quartile had significantly higher values of total cholesterol (TC), triglycerides (TG), glucose (GLU), uric acid (UA), high-sensitivity C-reactive protein (hs-CRP) and systolic and diastolic blood pressure (BP). The correlations showed a strong positive relationship of the WWI with WC (r = 0.924), VFA (r = 0.907) and FM (r = 0.901) and a strong negative relationship with %FFM (r = −0.9) and %SMM (skeletal muscle mass) (r = −0.887). The correlation analysis also confirmed a strong positive association with WHR (r = 0.964), WHtR (r = 0.944), FMI (r = 0.902) and BMI (r = 0.863). (4) Conclusions: Our results confirmed that the WWI is a useful tool for assessing fat and muscle components, as well as for assessing health risks.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Body Composition Measurement Techniques · Nutrition and Health in Aging

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Institute of Nutrition and Genomics, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, 949 76 Nitra, Slovakia

Department of General Nursing, International Academy of Applied Sciences in Lomza, 19, Studencza Str., 18-400 Lomza, Poland

Department of the Basics of Information Technologies in Medicine, Public Institution “Kryvyi Rih Professional Medical College” of Dnipropetrovsk Regional Council, 14, Medical St., 50051 Kryvyi Rih, Ukraine

Funding

Cultural Educational Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic · European Regional Development Fund

References (65)

Show source-provided references
1. Obesity and associated lifestyle behaviours in Iran: Findings from the first national non-communicable disease risk factor surveillance survey10.1017/S1368980007000262 ↗
2. Urbanization and non- communicable risk factors in the capital city of 6 big provinces of Iran
3. Gažarová, M., Bihari, M., Lorková, M., Lenártová, P., and Habánová, M. (2022). The Use of Different Anthropometric Indices to Assess the Body Composition of Young Women in Relation to the Incidence of Obesity; Sarcopenia and the Premature Mortality Risk. Int. J. Environ. Res. Public Health, 19.10.3390/ijerph191912449 ↗
4. Contemporary medical, device, and surgical therapies for obesity in adults10.1016/S0140-6736(22)02403-5 ↗
5. The weight-adjusted-waist index predicts all-cause and cardiovascular mortality in general US adults10.1016/j.clinsp.2023.100248 ↗
6. Obesity Statistics10.1016/j.pop.2015.10.001 ↗
7. Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat10.1093/ajcn/75.4.683 ↗
8. Park, Y., Kim, N.H., Kwon, T.Y., and Kim, S.G. (2018). A novel adiposity index as an integrated predictor of cardiometabolic disease morbidity and mortality. Sci. Rep., 8.10.1038/s41598-018-35073-4 ↗
9. Diagnostic performance of body mass index to identify obesity as defined by body adiposity: A systematic review and meta-analysis10.1038/ijo.2010.5 ↗
10. Weight-adjusted waist as an integrated index for fat, muscle and bone health in adults10.1002/jcsm.13302 ↗
11. Measuring obesity in the absence of a gold standard10.1016/j.ehb.2015.02.002 ↗
12. Weight-adjusted waist index reflects fat and muscle mass in the opposite direction in older adults10.1093/ageing/afaa208 ↗
13. Body Mass Index: Obesity, BMI, and Health: A Critical Review10.1097/NT.0000000000000092 ↗
14. Shen, Y., Wu, Y., Fu, M., Zhu, K., and Wang, J. (2023). Association between weight-adjusted- waist index with hepatic steatosis and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2020. Front. Endocrinol., 14.10.3389/fendo.2023.1159055 ↗
15. Associations between weight-adjusted waist index and fractures: A population-based study10.1186/s13018-023-03776-8 ↗
16. Yu, L., Chen, Y., Xu, M., Li, R., Zhang, J., Zhu, S., He, Z., Chen, M., and Wang, G. (2023). Association of weight-adjusted-waist index with asthma prevalence and the age of first asthma onset in United States adults. Front. Endocrinol., 14.10.3389/fendo.2023.1116621 ↗
17. Qin, Z., Chang, K., Yang, Q., Yu, Q., Liao, R., and Su, B. (2022). The association between weight-adjusted-waist index and increased urinary albumin excretion in adults: A population-based study. Front. Nutr., 9.10.3389/fnut.2022.941926 ↗
18. Weight-adjusted waist index is an independent predictor of all-cause and cause-specific mortality in patients with asthma10.1016/j.hrtlng.2024.07.002 ↗
19. Association between Weight-Adjusted Waist Index and depressive symptoms: A nationally representative cross-sectional study from NHANES 2005 to 201810.1016/j.jad.2024.01.104 ↗
20. Assessment of the BMI; WHR and W/Ht in pre- and post-menopausal women10.2478/v10044-008-0004-6 ↗
21. World Health Organization (2008). Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation, World Health Organization.
22. World Health Organization (2024, November 11). Obesity and Overweight. Available online: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
23. (2024, November 29). Diet, Anthropometry and Physical Activity Measurement Toolkit. Available online: https://www.measurement-toolkit.org/anthropometry/introduction/anthropometry.
24. Visceral Adiposity Index: A reliable indicator of visceral fat function associated with cardiometabolic risk10.2337/dc09-1825 ↗
25. Associations of body adiposity index; waist circumference; and body mass index in young adults10.1016/j.clnu.2018.03.014 ↗
26. Krakauer, N.Y., and Krakauer, J.C. (2012). A new body shape index predicts mortality hazard independently of body mass index. PLoS ONE, 7.10.1371/journal.pone.0039504 ↗
27. (2024, November 14). Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults. Canberra: National Health and Medical Research Council, Available online: https://www.nhmrc.gov.au/about-us/publications/clinical-practice-guidelines-management-overweight-and-obesity.
28. Metabolic syndrome—A new world-wide definition. A Consensus Statement from the International Diabetes Federation10.1111/j.1464-5491.2006.01858.x ↗
29. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value10.1017/S0954422410000144 ↗
30. Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population10.1186/1476-511X-10-183 ↗
31. Increased length of hospital stay in underweight and overweight patients at hospital admission: A controlled population study10.1016/j.clnu.2004.08.012 ↗
32. Obesity paradox in cancer: New insights provided by body composition10.3945/ajcn.113.071399 ↗
33. Sarcopenic obesity: A critical appraisal of the current evidence10.1016/j.clnu.2012.06.010 ↗
34. Relationship between “a body shape index (ABSI)” and body composition in obese patients with type 2 diabetes10.1186/s13098-018-0323-8 ↗
35. Body composition assessment for the definition of cardiometabolic risk
36. Body fat distribution, incident cardiovascular disease, cancer, and all-cause mortality10.1016/j.jacc.2013.06.027 ↗
37. Sarcopenia and Sarcopenic Obesity and Mortality Among Older People10.1001/jamanetworkopen.2024.3604 ↗
38. Differences in sarcopenia indices in elderly Japanese women and their relationships with obesity classified according to waist circumference, BMI, and body fat percentage10.1186/s40101-024-00370-7 ↗
39. Associations Between Measures of Sarcopenic Obesity and Risk of Cardiovascular Disease and Mortality: A Cohort Study and Mendelian Randomization Analysis Using the UK Biobank10.1161/JAHA.118.011638 ↗
40. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement10.1016/j.clnu.2021.11.014 ↗
41. Accuracy of body mass index in diagnosing obesity in the adult general population10.1038/ijo.2008.11 ↗
42. Association of body mass index (BMI) and percent body fat among BMI-defined non-obese middle-aged individuals: Insights from a population-based Canadian sample10.17269/CJPH.107.5652 ↗
43. Associations between weight-adjusted waist index and abdominal fat and muscle mass: Multi-ethnic study of atherosclerosis10.4093/dmj.2021.0294 ↗
44. Ye, J., Hu, Y., Chen, X., Yin, Z., Yuan, X., Huang, L., and Li, K. (2023). Association between the weight-adjusted waist index and stroke: A cross-sectional study. BMC Public Health, 23.10.1186/s12889-023-16621-8 ↗
45. Fang, H., Xie, F., Li, K., Li, M., and Wu, Y. (2023). Association between weight-adjusted-waist index and risk of cardiovascular diseases in United States adults: A cross-sectional study. BMC Cardiovasc. Disord., 23.10.1186/s12872-023-03452-z ↗
46. Association of weight-adjusted-waist index with incident hypertension: The rural Chinese cohort study10.1016/j.numecd.2020.05.033 ↗
47. Cai, S., Zhou, L., Zhang, Y., Cheng, B., Zhang, A., Sun, J., Li, M., Su, Y., Bao, Q., and Zhang, Y. (2022). Association of the weight-adjusted-waist index with risk of all-cause mortality: A 10-year follow-up study. Front. Nutr., 9.10.3389/fnut.2022.894686 ↗
48. Assessment of existing anthropometric indices for screening sarcopenic obesity in older adults10.1017/S0007114522001817 ↗
49. Li, X., Wang, L., Zhou, H., and Xu, H. (2023). Association between weight-adjusted-waist index and chronic kidney disease: A cross-sectional study. BMC Nephrol., 24.10.1186/s12882-023-03316-w ↗
50. Cao, S., Hu, X., Shao, Y., Wang, Y., Tang, Y., Ren, S., and Li, X. (2023). Relationship between weight-adjusted-waist index and erectile dysfunction in the United State: Results from NHANES 2001–2004. Front. Endocrinol., 14.10.3389/fendo.2023.1128076 ↗
51. Zhang, M., Zhao, Y., Wang, G., Zhang, H., Ren, Y., Wang, B., Zhang, L., Yang, X., Han, C., and Pang, C. (2016). Body mass index and waist circumference combined predicts obesity-related hypertension better than either alone in a rural Chinese population. Sci. Rep., 6.10.1038/srep31935 ↗
52. Adipose; bone and muscle tissues as new endocrine organs: Role of reciprocal regulation for osteoporosis and obesity development10.1515/hmbci-2013-0070 ↗
53. Muscle, Bone, and Fat Crosstalk: The Biological Role of Myokines, Osteokines, and Adipokines10.1007/s11914-020-00599-y ↗
54. Sarcopenia: Revised European consensus on definition and diagnosis10.1093/ageing/afy169 ↗
55. Osteosarcopenia: Where bone, muscle, and fat collide10.1007/s00198-017-4151-8 ↗
56. Is There Enough Evidence for Osteosarcopenic Obesity as a Distinct Entity? A Critical Literature Review10.1007/s00223-019-00561-w ↗
57. Decreasing Lean Body Mass with Age: Challenges and Opportunities for Novel Therapies10.3803/EnM.2017.32.4.422 ↗
58. Body composition and its association with cardiometabolic risk factors in the elderly: A focus on sarcopenic obesity10.1016/j.archger.2012.09.007 ↗
59. Sarcopenia, Frailty, and Diabetes in Older Adults10.4093/dmj.2016.40.3.182 ↗
60. Study of conicity index, body mass index and waist circumference as predictors of coronary artery disease
61. Wedell-Neergaard, A.-S., Eriksen, L., Grønbæk, M., Pedersen, B.K., Krogh-Madsen, R., and Tolstrup, J. (2018). Low fitness is associated with abdominal adiposity and low-grade inflammation independent of BMI. PLoS ONE, 13.10.1371/journal.pone.0190645 ↗
62. Cardiovascular diseases and metabolic abnormalities associated with obesity: What is the role of inflammatory responses? A systematic review10.1016/j.mvr.2020.104023 ↗
63. Lipid metabolism and carcinogenesis; cancer development
64. Zhao, P., Du, T., Zhou, Q., and Wang, Y. (2024). 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. Sci. Rep., 14.10.1038/s41598-024-74339-y ↗
65. The effect of hyperlipidemia on overall survival in patients with cancer was differentiated by BMI and hyperlipidemia type10.1186/s12986-024-00811-1 ↗