{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T22:47:42Z","timestamp":1782082062736,"version":"3.54.5"},"reference-count":37,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The present study was supported by Hebei Provincial 2024 Annual Medical Scientific Research Project Plan","award":["(NO: 20241870)"],"award-info":[{"award-number":["(NO: 20241870)"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association between the weight-to-waist ratio and total bone mineral density in US adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 7005 adults from the National Health and Nutrition Examination Survey 2011\u20132018. The weight-to-waist ratio was calculated as body weight divided by waist circumference, and total bone mineral density was measured using dual-energy X-ray absorptiometry. Survey-weighted multivariable linear regression and restricted cubic spline analyses were conducted to evaluate the association between the weight-to-waist ratio and total bone mineral density after adjustment for demographic, socioeconomic, lifestyle, and clinical covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A higher weight-to-waist ratio was significantly associated with greater total bone mineral density across all models. In the fully adjusted model, each 1-unit increase in the weight-to-waist ratio was associated with a 0.39\u2009g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      increase in total bone mineral density (95% confidence interval: 0.35\u20130.42; P\u2009&lt;\u20090.001). Participants in the highest weight-to-waist ratio quartile had significantly higher total bone mineral density than those in the lowest quartile (\u03b2\u2009=\u20090.09, 95% confidence interval: 0.08\u20130.10; P\u2009&lt;\u20090.001). Restricted cubic spline analysis indicated a significant positive linear association. The association was stronger in men than in women (P for interaction &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A higher weight-to-waist ratio was independently associated with greater total bone mineral density in US adults, particularly among men. The weight-to-waist ratio may provide complementary anthropometric information regarding skeletal health, although prospective studies are needed to confirm causality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261458670","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T06:13:46Z","timestamp":1781849626000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between weight-to-waist ratio and total bone mineral density in US adults: A cross-sectional study of the National Health and Nutrition Examination Survey 2011\u20132018"],"prefix":"10.1177","volume":"54","author":[{"given":"Jing","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Hand Surgery, Hebei Medical University Third Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Hebei Medical University Third Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiduo","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Hebei Medical University Third Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Hebei Medical University Third Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0439-5543","authenticated-orcid":false,"given":"Xiuting","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hebei Medical University Third Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_3_11_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1191501"},{"key":"e_1_3_11_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15202567"},{"key":"e_1_3_11_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2012.658110"},{"key":"e_1_3_11_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbm4.10195"},{"key":"e_1_3_11_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-023-01444-w"},{"key":"e_1_3_11_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2011.06.003"},{"key":"e_1_3_11_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-31642-4"},{"key":"e_1_3_11_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu15153492"},{"key":"e_1_3_11_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11020644"},{"key":"e_1_3_11_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-020-05556-0"},{"key":"e_1_3_11_12_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-22-0530"},{"key":"e_1_3_11_13_2","doi-asserted-by":"publisher","DOI":"10.11005\/jbm.2021.28.4.267"},{"key":"e_1_3_11_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41413-022-00222-z"},{"key":"e_1_3_11_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-025-01573-w"},{"key":"e_1_3_11_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-024-00580-1"},{"key":"e_1_3_11_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0310-7"},{"key":"e_1_3_11_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30084-1"},{"key":"e_1_3_11_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-03776-8"},{"key":"e_1_3_11_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1642801"},{"key":"e_1_3_11_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-023-01190-4"},{"key":"e_1_3_11_22_2","unstructured":"Centers for Disease Control and Prevention (CDC) National Health and Nutrition Examination Survey (NHANES). 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