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Higher weight-adjusted waist index ties to more stroke in NHANES

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In 23,389 US NHANES adults (2011–2020), higher weight-adjusted waist index (WWI) associated with greater stroke prevalence—fully adjusted OR 1.25 per unit and 62% higher odds in the top vs bottom quartile.

Source

Association between the weight-adjusted waist index and stroke: a cross-sectional study

Ye J · BMC Public Health · 2023

doi.org/10.1186/s12889-023-16621-8Read the full paper ↗124 citationscc by

Study at a glance

Design
Cross-sectional — NHANES 2011–2020; WWI vs self-reported stroke
N
N=23389 · After excluding missing weight, waist, or stroke data; 893 (3.82%) with stroke
Population
US NHANES participants with weight, waist circumference, and stroke data
Outcome
Odds of self-reported stroke per WWI unit and by WWI quartile

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

Cross-sectional analysis of NHANES 2011–2020 after excluding missing weight, waist circumference, or stroke data (final n=23,389). WWI = waist circumference (cm) / √weight (kg). Stroke was self-reported; multivariable logistic regression and quartile trend tests adjusted for demographics and cardiometabolic covariates.

What they found

Stroke prevalence 3.82% (893 cases). Fully adjusted model: each 1-unit WWI increase linked to 25% higher stroke odds [OR 1.25 (1.05, 1.48)]. Highest vs lowest WWI quartile OR 1.62 (1.06, 2.48). Association held across sex, age, race, education, diabetes, hypertension, CHD, and cancer subgroups (all P interaction > 0.05).

The limits

What it doesn't show

Cross-sectional NHANES data cannot prove WWI causes stroke. Stroke was self-reported without subtype detail, and residual confounding remains possible. Mean participant age ~49 years yields low baseline stroke prevalence, limiting power for subgroup effects.

Key terms

WWI
Weight-adjusted waist index = WC (cm) / √body weight (kg); higher = more central adiposity.
NHANES
US National Health and Nutrition Examination Survey with complex survey weights.
Quartile analysis
WWI split into four groups; Q4 >11.67 cm/√kg vs Q1 <10.51.
Odds ratio (OR)
Multivariable logistic regression effect estimate for stroke prevalence.
Central obesity
Abdominal fat distribution WWI aims to capture beyond BMI alone.
Self-reported stroke
Participant answered yes to physician-diagnosed stroke question.

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How many NHANES participants were analyzed?

Common questions

How is WWI calculated?

Waist circumference in cm divided by the square root of weight in kg.

How many participants were analyzed?

23,389 NHANES participants with complete WWI and stroke data.

What was stroke prevalence?

3.82% (893 participants).

Did the association differ by sex?

No—interaction tests were non-significant across subgroups.

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