Association between weight‐adjusted‐waist index and incident carotid atherosclerosis in the general adult population in Chinese communities: Evidence from the REACTION cohort study

AIMS: This study aimed to examine the relationship between weight-adjusted-waist index (WWI) and the risk of carotid atherosclerosis (CAS) in the general adult population in Chinese communities. MATERIALS AND METHODS: A total of 4671 participants in the prospective REACTION study who attended consecutive health examinations in 2012 and 2018, had no history of CAS. Participants were divided into three groups according to tertiles of WWI: T1 (≤9.88), T2 (9.89 ~ 10.42), T3 (≥10.43). Cox proportional hazard models were used to evaluate the relationship between WWI and CAS by calculating hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analysis and sensitivity analyses were used to verify the stability of the relationship between WWI and CAS. RESULTS: After a median follow-up of 6.62 years, a total of 2806 new CAS events occurred. Participants in the CAS group were significantly older than those in the non-CAS group (median age 56 vs. 52 years, p < 0.001), and a higher proportion of males (38.1% vs. 17.5%, p < 0.001). After adjustment for potential confounders, Cox regression models showed that participants in the Q2 and Q3 groups had significantly higher risks of CAS than those in the Q1 group. The HRs (95% CIs) for CAS in the Q2 and Q3 groups were 1.171 (1.066, 1.287) and 1.473 (1.333, 1.627), respectively. WWI was significantly associated with increased CAS risk. CONCLUSIONS: High WWI is associated with a higher risk of CAS, which implies that WWI might be a reliable indicator to identify high-risk populations of CAS among the general adult population in Chinese communities.