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Weight-adjusted waist index and mortality in diabetic retinopathy: a NHANES 1999-2018 cohort study

Diabetol Metab Syndr. 2025 Aug 27;17(1):355. doi: 10.1186/s13098-025-01923-1.

ABSTRACT

OBJECTIVE: The weight-adjusted waist index (WWI), an innovative indicator of central obesity, is still inadequately researched in relation to diabetic complications. This study sought to elucidate the relationship between WWI and all-cause as well as cardiovascular disease (CVD) mortality in US patients with diabetic retinopathy (DR).

METHODS: We performed a retrospective cohort research with 1247 people in the United States diagnosed with diabetic retinopathy (DR). Qualified technicians collected anthropometric data using defined techniques. Mortality data was collected from participant recruitment until December 31, 2019. Cox proportional hazards models limited cubic spline curves, and Kaplan-Meier survival analysis were employed to investigate the research aims.

RESULTS: During a median follow-up of 6.75 years, there were 446 documented deaths from all causes and 163 fatalities attributed to cardiovascular events. Multivariable-adjusted Cox regression indicated a positive association between WWI and all-cause mortality (HR = 1.35, 95%CI:1.16-1.56, P < 0.001) as well as CVD mortality (HR = 1.36, 95%CI:1.07-1.73, P = 0.011). Subgroup analyses corroborated these findings, demonstrating similar relationships across various age, sex, race, and comorbidity strata.RCS analysis revealed a linear positive connection between WWI and both all-cause and cardiovascular disease mortality (P for non-linearity > 0.05).

CONCLUSIONS: Higher WWI was significantly associated with increased risk of all-cause and CVD mortality in patients with DR, suggesting a positive correlation between WWI and mortality risk in this population.

PMID:40859292 | DOI:10.1186/s13098-025-01923-1

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