Predictive role of weight-adjusted waist index in diabetic peripheral neuropathy among patients with type 2 diabetes mellitus

Obesity is a known risk factor for diabetic peripheral neuropathy (DPN), but the relationship between body mass index (BMI) and DPN remains controversial. This study explores the relationship between weight-adjusted waist index (WWI) and DPN in Chinese patients with Type 2 Diabetes Mellitus (T2DM), with the goal of establishing WWI as an effective tool for the early detection and risk stratification of DPN. A total of 1790 participants were included. The relationships between WWI, BMI, WC, and DPN were analyzed using logistic regression, restricted cubic spline, and subgroup analysis, with ROC-AUC used to assess the diagnostic performance of the obesity indices. During this cross-sectional study, a total of 895 cases of DPN were recorded. Each 1-SD increase in WWI was associated with an increased risk of DPN in Model 1 (OR: 1.72, 95% CI: 1.37-2.16), Model 2 (OR: 1.41, 95% CI: 1.10-1.80), and Model 3 (OR: 1.37, 95% CI: 1.06-1.77). A linear relationship was observed between WWI and DPN when WWI was greater than 10.757 cm/√kg (OR: 1.375, 95% CI: 1.115-1.7). BMI was nonlinearly associated with DPN (p-nonlinear < 0.05), and age significantly modified the relationship between BMI and DPN. ROC analysis indicated that WWI had superior diagnostic performance compared to BMI and WC. WWI is linearly and independently associated with DPN and demonstrates greater stability and predictive value than BMI and WC. Therefore, WWI may serve as a more reliable indicator for identifying individuals at risk for DPN.