Association between body roundness index and stroke results from the 1999-2018 NHANES

Abstract

Importance

Obesity, especially visceral obesity, is a controllable risk factor associated with the incidence of stroke. The body roundness index (BRI) bridges the gap between traditional anthropometric methods of assessing fat distribution to predict the percentage of body fat and visceral adipose tissue, which can be used to decipher its population-based characteristics and potential association with stroke.

Objective

The negative impact of accumulated visceral obesity on cerebrovascular health has been widely documented. However, the association between BRI and stroke has never been reported before. The purpose of this study was to elucidate the connection between BRI and the general incidence of stroke in the US population.

Design, Setting, and Participants

This cohort study extracted cross-sectional data from 39,454 U.S. adults (aged ≥20 years) from documents related to the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2018.

Methods

We evaluated the relationship between BRI and stroke using weighted logistic regression analysis, and we looked at any possible nonlinear relationships using restricted cubic spline (RCS) regression. Additionally, subgroup analysis and interaction tests were carried out.

Results

The study involved 39,454 participants, of whom 1,427 (3.6 %) had a stroke. Fully adjusted logistic regression models showed that BRI was positively associated with stroke, with a 5.7 % increase in stroke incidence per unit increase in BRI (OR = 1.057, 95 % CI = 1.009,1.108, P = 0.020). RCS analysis revealed a nonlinear association, suggesting an elevated risk of stroke before the inflection point of 8.489. This positive correlation was consistent across settings, according to subgroup analyses and interaction tests (P > 0.05 for all interactions).

Conclusions and relevance

There is a nonlinear positive correlation between BRI and stroke, according to this national cohort study. These results support the use of the BRI as a screening tool for assessing stroke risk; yet, because cross-sectional studies have inherent limitations, more thorough research is required until the BRI has been consistently validated in additional independent cohorts.