Association between weight-to-waist ratio and total bone mineral density in US adults: A cross-sectional study of the National Health and Nutrition Examination Survey 2011–2018
Jing Yang, Jie Liu, Huiduo Wei, Wei Wang, Xiuting LiObjective
To investigate the association between the weight-to-waist ratio and total bone mineral density in US adults.
Methods
This cross-sectional study included 7005 adults from the National Health and Nutrition Examination Survey 2011–2018. The weight-to-waist ratio was calculated as body weight divided by waist circumference, and total bone mineral density was measured using dual-energy X-ray absorptiometry. Survey-weighted multivariable linear regression and restricted cubic spline analyses were conducted to evaluate the association between the weight-to-waist ratio and total bone mineral density after adjustment for demographic, socioeconomic, lifestyle, and clinical covariates.
Results
A higher weight-to-waist ratio was significantly associated with greater total bone mineral density across all models. In the fully adjusted model, each 1-unit increase in the weight-to-waist ratio was associated with a 0.39 g/cm 2 increase in total bone mineral density (95% confidence interval: 0.35–0.42; P < 0.001). Participants in the highest weight-to-waist ratio quartile had significantly higher total bone mineral density than those in the lowest quartile (β = 0.09, 95% confidence interval: 0.08–0.10; P < 0.001). Restricted cubic spline analysis indicated a significant positive linear association. The association was stronger in men than in women (P for interaction <0.001).
Conclusions
A higher weight-to-waist ratio was independently associated with greater total bone mineral density in US adults, particularly among men. The weight-to-waist ratio may provide complementary anthropometric information regarding skeletal health, although prospective studies are needed to confirm causality.