Exploring the connection between life’s crucial 9 and metabolic syndrome: the weight-adjusted waist index as a mediating factor
- 1Linfen Central Hospital
- 2Faculty of Pharmacy, Naval Medical University
Abstract
Background Research has shown that the health status of the cardiovascular system and obesity may be associated with Metabolic Syndrome (MetS) to some extent. However, the exact nature of the relationship between the three has not yet been established. Life’s Crucial 9 (LC9) represents a contemporary metric for comprehensive cardiovascular health evaluation. Separately, the Weight-Adjusted Waist Index (WWI) serves as an emerging anthropometric indicator that differs fundamentally from BMI by normalizing waist circumference through weight standardization, leading to its growing adoption in current research. This study sought to elucidate the association between LC9 and MetS and to evaluate the potential role of WWI in the association. Methods This investigation drew upon data from the National Health and Nutrition Examination Survey (NHANES) to conduct a cross-sectional analysis. The association between LC9 and MetS was assessed through multiple analytical techniques, employing multivariate logistic regression, restricted cubic splines (RCS), and subgroup stratification. Furthermore, mediation modeling was implemented to quantify the extent to which WWI might account for the observed relationship. Results This study included 25,399 participants, among whom 7,811 reported MetS events. After adjusting for all variables using multivariate logistic regression, each 10-unit increase in LC9 was associated with a 31% reduction in the prevalence of MetS (OR = 0.69, 95% CI: 0.66 to 0.72), while each 1-unit increase in WWI was associated with a 1.11-fold increase in the prevalence of MetS (OR = 2.11, 95% CI: 1.94 to 2.29). Consistent results were observed when LC9 and WWI were adjusted to tertiles, with P for trend < 0.001. Analysis using RCS indicated a linear negative correlation between LC9 and the prevalence of MetS. Mediation analysis indicated that WWI statistically accounted for 32.73% of the observed association between LC9 and MetS (p < 0.001). Conclusion This study demonstrates a significant inverse association between LC9 and MetS, with WWI statistically accounting for a substantial portion of this association. These results highlight the interplay between cardiovascular health metrics and metabolic disorders, thereby suggesting that favorable body composition profiles are associated with lower MetS prevalence in the context of higher cardiovascular health.
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BibTeX
@article{wang2026exploring,
title = {{Exploring the connection between life’s crucial 9 and metabolic syndrome: the weight-adjusted waist index as a mediating factor}},
author = {Jiahao Wang and Lei Ren and Yongli Han and Lunuan Wang and Chengdong Sun and Rong Jiang and Shuming Guo},
journal = {Journal of Health, Population and Nutrition},
year = {2026},
month = jul,
doi = {10.1186/s41043-026-01384-w},
url = {https://doi.org/10.1186/s41043-026-01384-w},
note = {CC BY},
}
RIS
TY - JOUR
TI - Exploring the connection between life’s crucial 9 and metabolic syndrome: the weight-adjusted waist index as a mediating factor
AU - Jiahao Wang
AU - Lei Ren
AU - Yongli Han
AU - Lunuan Wang
AU - Chengdong Sun
AU - Rong Jiang
AU - Shuming Guo
PY - 2026
DA - 2026/07/01
JO - Journal of Health, Population and Nutrition
DO - 10.1186/s41043-026-01384-w
UR - https://doi.org/10.1186/s41043-026-01384-w
AB - Background Research has shown that the health status of the cardiovascular system and obesity may be associated with Metabolic Syndrome (MetS) to some extent. However, the exact nature of the relationship between the three has not yet been established. Life’s Crucial 9 (LC9) represents a contemporary metric for comprehensive cardiovascular health evaluation. Separately, the Weight-Adjusted Waist Index (WWI) serves as an emerging anthropometric indicator that differs fundamentally from BMI by normalizing waist circumference through weight standardization, leading to its growing adoption in current research. This study sought to elucidate the association between LC9 and MetS and to evaluate the potential role of WWI in the association. Methods This investigation drew upon data from the National Health and Nutrition Examination Survey (NHANES) to conduct a cross-sectional analysis. The association between LC9 and MetS was assessed through multiple analytical techniques, employing multivariate logistic regression, restricted cubic splines (RCS), and subgroup stratification. Furthermore, mediation modeling was implemented to quantify the extent to which WWI might account for the observed relationship. Results This study included 25,399 participants, among whom 7,811 reported MetS events. After adjusting for all variables using multivariate logistic regression, each 10-unit increase in LC9 was associated with a 31% reduction in the prevalence of MetS (OR = 0.69, 95% CI: 0.66 to 0.72), while each 1-unit increase in WWI was associated with a 1.11-fold increase in the prevalence of MetS (OR = 2.11, 95% CI: 1.94 to 2.29). Consistent results were observed when LC9 and WWI were adjusted to tertiles, with P for trend < 0.001. Analysis using RCS indicated a linear negative correlation between LC9 and the prevalence of MetS. Mediation analysis indicated that WWI statistically accounted for 32.73% of the observed association between LC9 and MetS (p < 0.001). Conclusion This study demonstrates a significant inverse association between LC9 and MetS, with WWI statistically accounting for a substantial portion of this association. These results highlight the interplay between cardiovascular health metrics and metabolic disorders, thereby suggesting that favorable body composition profiles are associated with lower MetS prevalence in the context of higher cardiovascular health.
SN - 2072-1315
ER -