Correlation Between Waist-to-Height Ratio and Skeletal Muscle Mass in Women with Obesity: A Cross-Sectional Study

BACKGROUND Individuals of any age with obesity are at risk of developing sarcopenia. Weight-standardized skeletal muscle mass (SMM/W) is recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) to identify inadequate muscle mass for sarcopenic obesity (SO). However, the relationship of waist-to-height ratio (WHtR) with SMM/W and SO risk in obese women is unclear. The aim of this study was to evaluate the predictive value of the WHtR for SMM/W in women with obesity. MATERIAL AND METHODS This study included 300 women with obesity (mean age 34±9 years, range 18-59) without significant comorbidities who first attended the obesity clinic at Tianjin Medical University Chu Hsien-I Memorial Hospital between 2023 and 2024. Waist circumference and skeletal muscle mass were measured via bioelectrical impedance analysis, while height and weight were assessed using an ultrasonic measuring instrument. Data were collected from the YiduCloud platform. Associations between WHtR and SMM/W were examined via multiple linear regression analysis. RESULTS WHtR was negatively correlated with SMM/W (R=-0.55, P<0.001). Multiple linear regression analysis revealed that WHtR (ß=-0.102, R²=0.389, P<0.001) independently predicted SMM/W. Additionally, the natural logarithm of the homeostasis model assessment of insulin resistance (HOMA-IR) was positively correlated with WHtR (R=0.34, P<0.001) and negatively correlated with SMM/W (R=-0.15, P<0.05). CONCLUSIONS WHtR, negatively correlating with SMM/W, may help identify SO susceptibility in women with obesity.