基于美国NHANES数据库分析体质量调整腰围指数与前列腺癌的相关性

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ABSTRACT：ObjectiveTo investigate the association between the weight-adjusted waist index （WWI） and prostate cancer （PCa）in order to provide reference for the screening and diagnosis of PCa.MethodsData of 18 732 men aged ⩾20 years were obtained from theUS National Health andNutrition Examination Survey（NHANES）conducted between199 and 2018. TherelationshipbetweenWWIandPCa was asssed usingamultivariate logisticregressionmodel.Astratifiedanalysis was performed acrossfour time periods：199—2006，2007—2010，2011—2014，and2015—2018.Restricted cubic splines（RCS）and subgroup analyses wereemployed to evaluate thepotentialnonlinearasociations andinteractions between WWIandPCa risk. The receiver operating characteristic（ROC）curve was utilized to compare the predictive performance of WWI with other obesity-related indicators，includingwaist-to-heightratio（WtHR），bodymassindex（BMI），waistcircumference，andbody weight.ResultsIn the fully adjusted model，each 1-unit increase in WWI was associated with a 74% higher risk of PCa（ OR= （204号 1.74，95%CI：1.44-2.11 P<0.001 . Individuals in the highest quartile of WWI had nearly five times greater odds of PCa （20 compared to those in the lowest quartile （OR=4.96，95%CI：2.69-9.15 P<0.001 ）.Theobserved association remained consistent across allfour survey cycles.RCS analysis revealed a nonlinear positive asociation between WWI and PCa risk. Threshold analysis indicated that when WWI⩾9.97 ，there was a significant positive correlation with PCa risk （ OR=1.39，95% （20 CI：1.18-1.64 P<0.001 ）.Subgroup analyses confirmed the robustness of this association across different demographic and clinical subpopulations.Furthermore，WWI demonstrated superior discriminatory ability for predicting PCa compared to WtHR ， BMI，waist circumference，and body weight （AUC=0.706，0.608，0.509，0.594，0.488， P<0.001 ）.ConclusionFor the generalmale population in the US，WWIserves as an independent risk factorforPCa.This assciation has remained stable over 1999—2018，and WWIoutperforms conventional obesity indicators intermsof predictive acuracy.Therefore，individuals with WWI⩾9.97 should be prioritized for prostate-specific antigen （PSA） screening，which may enhance current screening and diagnostic strategies.

KEY WORDS： weight-adjusted waist index；prostate cancer;central obesity； National Health and Nutrition Examination Survey（NHANES）

摘要：目的分析体质量调整腰围指数（WWI）与前列腺癌（PCa）之间的关联，以期为PCa的筛查和诊断提供参考。（剩余15628字）