Diabetes Metab J.  2022 Sep;46(5):747-755. 10.4093/dmj.2021.0294.

Associations between Weight-Adjusted Waist Index and Abdominal Fat and Muscle Mass: Multi-Ethnic Study of Atherosclerosis

• Kim JY
• Choi J
• Vella CA
• Criqui MH
• Allison MA
• Kim NH

• KMID: 2533643
• DOI: http://doi.org/10.4093/dmj.2021.0294

Abstract

Background
The weight-adjusted waist index (WWI) reflected body compositional changes with aging. This study was to investigate the association of WWI with abdominal fat and muscle mass in a diverse race/ethnic population.
Methods
Computed tomography (CT) data from 1,946 participants for abdominal fat and muscle areas from the Multi-Ethnic Study of Atherosclerosis (785 Whites, 252 Asians, 406 African American, and 503 Hispanics) were used. Among them, 595 participants underwent repeated CT. The WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). The associations of WWI with abdominal fat and muscle measures were examined, and longitudinal changes in abdominal composition measures were compared.
Results
In all race/ethnic groups, WWI was positively correlated with total abdominal fat area (TFA), subcutaneous fat area, and visceral fat area, but negatively correlated with total abdominal muscle area (TMA) and abdominal muscle radiodensity (P<0.001 for all). WWI showed a linear increase with aging regardless of race and there were no significant differences in the WWI distribution between Whites, Asians, and African Americans. In longitudinal analyses, over 38.6 months of follow-up, all abdominal fat measures increased but muscle measures decreased, along with increase in WWI. The more the WWI increased, the more the TFA increased and the more the TMA decreased.
Conclusion
WWI showed positive associations with abdominal fat mass and negative associations with abdominal muscle mass, which likely reflects the abdominal compositional changes with aging in a multi-ethnic population.

Keyword

Anthropometry; Body composition; Obesity; Sarcopenia

Figure

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  Fig. 1. (A) Total abdominal fat area (TFA) and (B) total abdominal muscle area (TMA) by quartiles of weight-adjusted waist index (WWI) in adults older and younger than 65 years. aStatistically different from the 1st quartile group, bStatistically different from the 1st and 2nd quartile groups, cStatistically different from the 1st, 2nd, and 3rd quartile groups.

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  Fig. 2. Association between weight-adjusted waist index (WWI) and (A) total abdominal fat area (TFA) and (B) total abdominal muscle area (TMA).

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  Fig. 3. Distribution of body mass index (BMI) and weight-adjusted waist index (WWI) by (A) age and (B) race/ethnicity.

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  Fig. 4. The association between change of (A) weight-adjusted waist index (WWI), (B) body mass index (BMI) and age-adjusted change of body composition measures. TFA, total abdominal fat area; TMA, total abdominal muscle area.

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