Skip to content
PaperFren

Cardiovascular

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

Ye J · BMC Public Health · 2023

Metadata + PaperFren explanation · cc by · source: Europe PMC

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.

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.

Key findings

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).

Methodology

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.

Limitations

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.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsStroke Risk Markersconcept

    A larger weight-adjusted waist index associates with higher stroke odds in US survey data.

    In US NHANES adults (2011–2020), higher weight-adjusted waist index was associated with higher odds of self-reported stroke after multivariable adjustment (about 25% higher odds per 1-unit WWI; highest vs lowest quartile OR about 1.62).

    Evidence for the claim as stated.

  • QualifiesStroke Risk Markersconcept

    A more inflammatory diet score associates with higher stroke odds in related survey data.

    In a related NHANES analysis, higher dietary inflammatory index quartiles were associated with higher stroke odds (highest vs lowest quartile OR about 1.87), with a nonlinear pattern and a LASSO-based nomogram AUC near 80%.

    Scope note — different exposure — central adiposity (WWI), not DII

    Limits the claim's scope: a different population, assay, or outcome.

  • QualifiesStroke Risk Markersconcept

    These markers flag observational risk — they are not proven treatment targets.

    In the prospective 45 and Up Study, current smoking was associated with elevated risks across many CVD subtypes including stroke, with especially large relative risks for peripheral arterial disease; former smokers showed intermediate risks, consistent with risk reduction after quitting.

    Scope note — observational design — cross-sectional self-reported stroke odds

    Limits the claim's scope: a different population, assay, or outcome.

  • SupportsStroke Risk Markersconcept

    WWI and DII both associate with stroke in NHANES, but they measure different exposures (central adiposity vs dietary inflammatory load). Neither analysis falsifies the other; treating them as a head-to-head disagreement confuses two questions that happen to share a survey outcome.

    Evidence for the claim as stated.

  • SupportsStroke Risk Markersconcept

    NHANES stroke associations are cross-sectional and self-reported; 45 and Up smoking estimates are prospective event risks. A stronger causal reading is more defensible for the smoking cohort design than for the NHANES odds ratios—without requiring the NHANES associations to be “wrong.”

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

  • Scope difference — different assays, populations, or outcomes

    WWI and DII both associate with stroke in NHANES, but they measure different exposures (central adiposity vs dietary inflammatory load). Neither analysis falsifies the other; treating them as a head-to-head disagreement confuses two questions that happen to share a survey outcome.

    Also on this tension

  • Scope difference — different assays, populations, or outcomes

    NHANES stroke associations are cross-sectional and self-reported; 45 and Up smoking estimates are prospective event risks. A stronger causal reading is more defensible for the smoking cohort design than for the NHANES odds ratios—without requiring the NHANES associations to be “wrong.”

Related papers in this topic

Same topic cluster — not a recommendation engine.