Waist Index May Serve as Novel Metric for DR

DR development has established determinants like elevated blood pressure and inadequate glycemic control, with growing research indicating obesity or being overweight itself is a major contributor to diabetes-related complications. In this study, the relationship between weight-adjusted waist index and women was particularly strong. Photo: Lei J, et al. Medicine. 2025;104(41):e45110. Click image to enlarge. With diabetes’ ability to cause various health issues, newfound associations with other physical characteristics could help prevent and treat diabetic retinopathy (DR) in the future. An investigation published in Medicine had researchers take data from the National Health and Nutrition Examination Survey to search for potential relationship between DR and a new metric called weight-adjusted waist index.“Historically, body mass index (BMI) has been used to measure obesity, but it fails to distinguish between muscle and fat,” they wrote. Although waist circumference is a predictor of obesity, it’s not reliable as a standalone indicator. “Visceral fat has recently been identified as a more accurate marker of adverse metabolic profiles, especially those associated with abdominal obesity,” the researchers explained in the paper. Accordingly, researchers developed the weight-adjusted waist index.Included in the research were 2,001 individuals (51.5% male; average age 59.4). Using a comprehensive model and accounting for multiple variables, an inverse relationship was observed between weight-adjusted waist index and DR (odds ratio 1.32). Among subgroup analysis, a positive link occurred with weight-adjusted waist index and DR among women, those aged 50 or older and non-Hispanic white subjects. Both a direct and inverse relationship was identified between this index and DR.This research builds on more recent reports indicating this weight index may be used as a novel metric in assessment of obesity, and a confirmed link was observed with this data between the waist index and DR. As for the strong connection between weight-adjusted waist index and DR in women, the authors of the study explain that this may be due to estrogen’s regulatory influence on adipocyte differentiation and function, as well as estrogen’s impact on microvessels through mechanisms like oxidative stress. Similarly, the correlation with increased age may be the result of the aging process impacting the index via altered lipid metabolism and fat cell distribution—especially since older age is an acknowledged risk of DR.The authors also note the growing proof connecting conventional obesity markers with DR; however, lack of clarity still exists. It is debated how much conventional metrics distinguish between fat and muscle mass, with an alternative explanation that correlations between different body measurements can make it difficult to identify biologically determined risk of diseases, thus effective disease forecast is inhibited.Related to this issue, the authors write how “in addition to waist circumference’s benefits, weight-adjusted waist index reduces its correlation with BMI, allowing it to accurately detect obesity regardless of total body weight, which is considered to be one of the major risk factors for type 2 diabetes,” adding that “the weight-adjusted waist index could be a better indicator of the metabolic syndrome and high blood pressure that are associated with DR.”To add to its benefits, the weight-adjusted waist index remains relevant to diverse racial and demographic groups and may offer greater stability and reliability in cross-racial and multicenter studies. Generally, the investigators believe that “weight-adjusted waist index shows excellent results in forecasting disease risk, making it an important tool for healthcare providers to consider.”Click here for the journal source. Lei J, Lian K, Zhou P, Peng J, Peng Q. From NHANES 2005-2017: weight-adjusted waist index and diabetic retinopathy among the general US population. Medicine. 2025;104(41):e45110.This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.