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. 2023 Apr 25:14:1128076.
doi: 10.3389/fendo.2023.1128076. eCollection 2023.

Relationship between weight-adjusted-waist index and erectile dysfunction in the United State: results from NHANES 2001-2004

Shangqi Cao  1 , Xu Hu  1 , Yanxiang Shao  1 , Yaohui Wang  1 , Yaxiong Tang  1 , Shangqing Ren  2 , Xiang Li  1
Affiliations

Relationship between weight-adjusted-waist index and erectile dysfunction in the United State: results from NHANES 2001-2004

Shangqi Cao et al. Front Endocrinol (Lausanne). .

Abstract

Objective: The purpose of this study is to examine the association between a novel adiposity parameter, the weight-adjusted-waist index (WWI), and erectile dysfunction (ED).

Methods: According to National Health and Nutrition Examination Survey (NHANES) 2001-2004, a total of 3884 participants were categorized as ED and non-ED individuals. WWI was calculated as waist circumference (WC, cm) divided by the square root of weight (kg). Weighted univariable and multivariable logistic regression models were conducted to assess the correlation between WWI and ED. Smooth curve fitting was utilized to examine the linear association. The receiver operating characteristic (ROC) curve and DeLong et al.'s test were applied to compare the area under curve (AUC) value and predictive power among WWI, body mass index (BMI), and WC for ED.

Results: WWI was positively related to ED with the full adjustment [odds ratio (OR)=1.75, 95% confidence interval (95% CI): 1.32-2.32, p=0.002]. After converting WWI to a categorical variable by quartiles (Q1-Q4), compared to Q1 the highest WWI quartile was linked to an obviously increased likelihood of ED (OR=2.78, 95% CI: 1.39-5.59. p=0.010). Subgroup analysis revealed the stability of the independent positive relationship between WWI and ED. It was shown that WWI had a stronger prediction for ED (AUC=0.745) than BMI (AUC=0.528) and WC (AUC=0.609). Sensitivity analysis was performed to verify the significantly positive connection between WWI and stricter ED (OR=2.00, 95% CI: 1.36-2.94, p=0.003).

Conclusion: An elevated WWI was related to higher risks of ED in the United State adults, and a stronger predictive power of WWI for ED was observed than BMI and WC.

Keywords: National Health and Nutrition Examination Survey; cross-sectional study; erectile dysfunction; obesity; the weight-adjusted-waist index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the sample selection process.
Figure 2
Figure 2
Smooth curve fitting for WWI and ED. The area between the upper and lower blue dotted lines is on behalf of 95% CI. The red dotted line indicates that the positive linear association between WWI and ED is proven by generalized additive model.
Figure 3
Figure 3
Subgroup analysis for the relationship between weight-adjusted-waist index and erectile dysfunction. All factors including age, a history of hypertension, diabetes, high cholesterol, and CVD had no impact on the independent positive association between WWI and ED. All subgroups were adjusted for age, race, body mass index, education level, marital status, the family poverty income ratio, smoking status, alcohol intaking, vigorous activity, moderate activity, diabetes, hypertension, high cholesterol, and cardiovascular disease, except the stratification factor itself.
Figure 4
Figure 4
Receiver operating characteristic (ROC) curve analysis for predicting ED. Delong et al.’s method for comparison of area under curve (AUC) value between WWI and BMI, WC.
Figure 5
Figure 5
Smooth curve fitting for WWI and stricter ED. The area between the upper and lower blue dotted lines is on behalf of 95% CI. The red dotted line indicates that the positive linear association between WWI and stricter ED is proven by generalized additive model.
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