International Journal of COPD (May 2025)
Weight-Adjusted Waist Index as a Novel Predictor of Chronic Obstructive Pulmonary Disease: Evidence from NHANES 2013-2018
Abstract
Hongjin Wang,1,* Weiming Chen,2,* Feilong Guo,2,* Zengkai Xu,1 Xin Luo,1 Jiahuang Wu,1 Yong Zhu,2 Zhisheng Wang1 1Department of Cardiovascular Surgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, People’s Republic of China; 2Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhisheng Wang, Email [email protected] Yong Zhu, Email [email protected]: Chronic obstructive pulmonary disease (COPD) is a major global health burden. The weight-adjusted waist index (WWI), a novel adiposity metric, may improve COPD risk prediction, but its association remains underexplored.Methods: Using the National Health and Nutrition Examination Survey (NHANES) 2013– 2018 data (n=15,278), we assessed the WWI-COPD relationship via multivariable logistic regression, ROC analysis, and subgroup evaluations.Results: Higher WWI tertiles correlated with elevated COPD incidence. After full adjustment, each WWI unit increase linked to 70% higher COPD risk (OR=1.70, 95% CI: 1.48– 1.95). Participants in the highest quartile of WWI faced a 290% increased risk compared to the lowest quartile (OR=3.90, 95% CI: 2.60– 5.86). WWI (AUC=0.707) outperformed BMI (AUC=0.525) and waist circumference (AUC=0.609) in COPD prediction. A nonlinear threshold effect emerged at WWI=12.54. Subgroup analyses confirmed robustness across demographics.Conclusion: WWI is a simple, cost-effective tool for early COPD detection, outperforming BMI and waist circumference, especially in resource-limited settings, enabling timely intervention and reducing disease burden.Keywords: weight-adjusted-waist index, chronic obstructive pulmonary disease, obesity, NHANES, cross-sectional study
