ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Reproduction
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1588965
This article is part of the Research TopicVascular Dysfunction and Endocrine DisordersView all 12 articles
The association between obesity-related indicators and female infertility: the United States National Health and Nutrition Examination Survey, 2013-2018
Provisionally accepted
- Harbin Medical University, Harbin, China
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Background: Infertility is a public health issue closely related to obesity. However, the relationship between obesity-related indicators and infertility is currently uncertain. The present study aimed to explore the association between obesity-related indicators and female infertility.: This cross-sectional study included data for 2,875 adult females aged 20-45 years from the National Health and Nutrition Examination Survey conducted between 2013 and 2018. Logistic regression models, restricted cubic spline (RCS), and receiver operating characteristic (ROC) analyses were used to evaluate the relationship between obesity-related indicators [body shape index (ABSI), weight-adjusted waist index (WWI), body roundness index (BRI), waist-to-height ratio (WHtR), non-HDL cholesterol to HDL cholesterol ratio (NHHR), relative fat mass (RFM), body mass index (BMI), and waist circumference (WC)] and female infertility.Results: Adult females were divided into five groups based on their ABSI, WWI, BRI, WHtR, NHHR, RFM, BMI, and WC. Individuals in the highest quintile for ABSI, WWI, BRI, WHtR, NHHR, RFM, BMI, and WC had a higher risk of infertility compared to those in the lowest quintile. The respective adjusted odds ratio values were 1.65 (95% confidence interval (CI), 1.14 to 2.42), 1.71 (95% CI, 1.15 to 2.57), 2.09 (95% CI, 1.39 to 3.19), 2.09 ( 95% CI, 1.39 to 3.19), 1.71 (95% CI, 1.14 to 2.59), 2.09 (95% CI, 1.39 to 3.19), 2.10 (95% CI, 1.40 to 3.18), and 2.28 (95% CI, 1.52 to 3.47). The p for trend values were 0.027, <0.001, <0.001, <0.001, 0.002, <0.001, <0.001, and <0.001after controlling for a series of confounding factors. RCS analyses showed a linear correlation between ABSI, WWI, BRI, WHtR, RFM, BMI, and WC and infertility (P nonlinear > 0.05). A nonlinear association was observed between NHHR and infertility (P nonlinear = 0.006). The ROC curve demonstrated that BRI, WHtR, RFM, and WC exhibited relatively high diagnostic efficiency for infertility, particularly among women aged 20-35 years.The WHtR, RFM, WC, and BRI are superior to BMI in predicting and diagnosing infertility, particularly among individuals aged 20-35 years. To confirm these findings, future studies, such as mendelian randomization or cohort studies, are warranted.
Keywords: Obesity, Infertility, National Health and Nutrition Examination Survey, Restricted cubic splines analysis, receiver operating characteristic analysis
Received: 06 Mar 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Yu, Wu, Sun, Cao and Y. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jing Y, Harbin Medical University, Harbin, China
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