Association between weight-adjusted waist index and the risk of cardiovascular and cerebrovascular diseases in prediabetic and diabetic patients in the United States: A Cross-Sectional Study

Objective: To examine the association between weight-adjusted waist index (WWI) and the risk of cardiovascular and cerebrovascular diseases (CCDs) in prediabetic and diabetic patients in the United States. Methods: This study included 18,007 participants from the National Health and Nutrition Examination Survey (NHANES) 2003-2018. Weighted multivariate logistic regression models and smoothed fit curves were employed to assess the association between WWI and CCDs among participants diagnosed with prediabetes and diabetes, and subgroup analysis was used to reflect the interaction of different covariates. Results: In the fully adjusted categorical model, the highest tertiary subgroup of WWI (T3) exhibited a significantly elevated risk of CCDs in comparison to the lowest tertiary subgroup of WWI (T1): hypertension，1.17-fold increase (2.17 [1.91,2.45], P < 0.0001); coronary heart disease, 0.64-fold increase (1.64 [1.22,2.21], P < 0.002); stroke, 0.9-fold increase (1.90 [1.39,2.59], P < 0.0001); heart failure, 0.97-fold increase (1.97 [1.47,2.64], P < 0.0001); angina, 0.72-fold increase (1.72 [1.27,2.31], P < 0.001); and heart attack, 0.95-fold increase (1.95 [ 1.46,2.59], P < 0.0001). The results indicate that there is a positive association between WWI and the risk of CCDs in prediabetic and diabetic patients. This finding is consistent with the results of the smoothed fit curves. In the subgroup analyses, in addition to consistency with the overall population results, we identified some interactions in the age subgroups. Conclusion: WWI was found to be positively associated with the risk of developing CCDs in prediabetic and diabetic patients in the United States.