I read with interest the paper entitled ‘Weight-adjusted Waist as an Integrated Index for Fat, Muscle and Bone Health in Adults’ by Kim et al.,¹ which utilizes the KNHANES (Korean National Health and Nutrition Examination Survey) to innovatively investigate the association between a novel index for assessing obesity, the weight-adjusted waist circumference index (WWI), and unhealthy body composition in the Korean population. WWI was found to be negatively correlated with bone and muscle mass but positively correlated with fat mass, and significantly higher outcomes of unhealthy body composition (high-fat mass, low muscle mass and low bone mass) were found in higher quartiles of WWI than in lower quartiles (18.08 [95% confidence interval, CI, 4.32–75.61] for men and 6.36 [95% CI, 3.65–11.07] for women). Tissue dysfunction in muscle, bone and fat is closely related to human health and may be a risk factor for disease and death. Compared with traditional anthropometric measures for assessing obesity, WWI can better differentiate between fat and muscle mass and may help us better identify people at risk for unhealthy body composition. All in all, I think this is a very interesting study. But I also have some questions about the study.

Firstly, in the selection of covariates, the authors adjusted for important covariates such as age, smoking status and hypertension status in this study, which is excellent, but I noticed that the authors also adjusted for dyslipidaemia (including total cholesterol, triglycerides, LDL cholesterol and HDL cholesterol) during the course of the study, so may I ask the authors if they took into account the multiple covariances?

Secondly, can the authors complement the limitations of the remaining obesity indices in their study and thus explore whether WWI has a stronger association with unhealthy body composition than when using body mass index (BMI) or waist circumference (WC)? This is because the authors also mentioned in their study that WWI has unique advantages over the traditional assessment of obesity indices. And also, the authors plotted the receiver operating characteristic curve to analyse the predictive ability of WWI, so is it possible to consider comparing WWI with other obesity indices (e.g., WC, BMI, waist-to-height ratio, a body shape index [ABSI], etc.) to observe whether it is a better predictor of unhealthy body composition?

In conclusion, my suggestion is to make an already excellent study even better, and I also hope that the authors can focus on my questions so that readers will get more accurate conclusions from the study.

我饶有兴趣地阅读了 Kim 等人撰写的题为“体重调整腰围作为成人脂肪、肌肉和骨骼健康综合指数”的论文， ¹该论文利用 KNHANES（韩国国家健康和营养检查调查）创新性地研究了评估肥胖的新指标——体重调整腰围指数（WWI）与韩国人口中不健康的身体成分之间的关​​联。研究发现，WWI 与骨骼和肌肉质量呈负相关，但与脂肪量呈正相关，并且在 WWI 较高的四分位数中发现不健康身体成分（高脂肪质量、低肌肉质量和低骨质量）的结果显着高于其他四分位数下四分位数（男性为 18.08 [95% 置信区间，CI，4.32–75.61]，女性为 6.36 [95% CI，3.65–11.07]）。肌肉、骨骼和脂肪的组织功能障碍与人类健康密切相关，可能是疾病和死亡的危险因素。与评估肥胖的传统人体测量方法相比，WWI 可以更好地区分脂肪和肌肉质量，并可能帮助我们更好地识别存在身体成分不健康风险的人。总而言之，我认为这是一项非常有趣的研究。但我对这项研究也有一些疑问。

首先，在协变量的选择上，作者在本研究中对年龄、吸烟状况和高血压状况等重要的协变量进行了调整，这非常好，但我注意到作者还对血脂异常（包括总胆固醇、甘油三酯、LDL胆固醇）进行了调整和高密度脂蛋白胆固醇）在研究过程中，所以我可以问作者是否考虑了多重协方差？

其次，作者是否可以补充研究中其余肥胖指数的局限性，从而探讨第一次世界大战是否与使用体重指数（BMI）或腰围（WC）时的不健康身体成分有更强的关联？这是因为作者在研究中也提到WWI相对于传统的肥胖指数评估具有独特的优势。并且，作者绘制了受试者工作特征曲线来分析WWI的预测能力，因此是否可以考虑将WWI与其他肥胖指数（例如WC、BMI、腰围身高比、体型指数等）进行比较？ ABSI]等）观察它是否能更好地预测不健康的身体成分？

总之，我的建议是让一项已经很优秀的研究变得更好，也希望作者能够关注我的问题，以便读者从研究中得到更准确的结论。