Associations of body roundness index with cardiovascular disease and mortality among patients with metabolic syndrome

IF 5.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes, Obesity & Metabolism Pub Date : 2025-03-27 DOI:10.1111/dom.16346

Ziqi Chen MD, Iokfai Cheang MD, Xu Zhu MD, Qiang Qu MD, Sitong Chen MD, Yutong Xing MD, Yanli Zhou MD, PhD, Haifeng Zhang MD, PhD, Xinli Li MD, PhD

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Abstract

Aims

The prevalence of metabolic syndrome (MetS) is increasing due to ageing populations and lifestyle changes, making it crucial to understand the relationship between body fat distribution and cardiovascular outcomes. Traditional measures such as body mass index (BMI) have limitations in assessing abdominal obesity. The body roundness index (BRI), a novel anthropometric measure combining waist circumference and height, has shown promise in evaluating this risk. This study aims to explore the association between BRI and cardiovascular disease (CVD) prevalence and mortality in a nationally representative sample of US adults with MetS.

Materials and Methods

This retrospective study used data from the National Health and Nutrition Examination Surveys (NHANES) 2001–2016, including 10 527 MetS-diagnosed participants. BRI was calculated and the cohort was divided into quartiles. Logistic regression and Cox proportional hazards models assessed the relationship between BRI and CVD prevalence, all-cause mortality and cardiovascular-specific mortality. Kaplan–Meier curves and restricted cubic spline analyses visualized survival patterns and non-linear relationships, with sensitivity analysis for validation.

Results

Higher BRI quartiles were significantly associated with increased CVD prevalence (odds ratio [OR]: 1.56 [1.32–1.84], p < 0.001). In the fully adjusted model, BRI demonstrated a U-shaped relationship with all-cause and cardiovascular mortality, with a threshold value of 6.89 (p for non-linear ≤0.001). Above this threshold, each additional unit in BRI was linked to a 9% increase in cardiovascular mortality risk (hazard ratio [HR]: 1.09 [1.02–1.15], p = 0.006) and an 8% rise in overall mortality (HR: 1.08 [1.04–1.12], p < 0.001). Conversely, BMI showed a paradoxical relationship with reduced mortality risk in unadjusted models, which became insignificant after adjusting for confounders (p = 0.195; 0.144).

Conclusions

BRI might be a more reliable predictor of cardiovascular outcomes and mortality in MetS patients than BMI. The identified threshold value of BRI can assist clinicians in making accurate prognostic evaluations. However, findings may vary by age and gender, underscoring the need for further research in diverse populations.

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代谢综合征患者体圆度指数与心血管疾病和死亡率的关系

目的：由于人口老龄化和生活方式的改变，代谢综合征（MetS）的患病率正在增加，因此了解体脂分布与心血管结局之间的关系至关重要。身体质量指数（BMI）等传统测量方法在评估腹部肥胖方面存在局限性。身体圆度指数（BRI）是一种结合腰围和身高的新型人体测量指标，在评估这种风险方面显示出了希望。本研究旨在探讨在全国代表性的美国成年MetS患者样本中，BRI与心血管疾病（CVD）患病率和死亡率之间的关系。材料和方法：本回顾性研究使用2001-2016年国家健康和营养检查调查（NHANES）的数据，包括10527名met诊断的参与者。计算BRI，并将队列分为四分位数。Logistic回归和Cox比例风险模型评估了BRI与CVD患病率、全因死亡率和心血管特异性死亡率之间的关系。Kaplan-Meier曲线和受限三次样条分析可视化了生存模式和非线性关系，并进行了敏感性分析验证。结果：较高的BRI四分位数与CVD患病率增加显著相关（优势比[OR]: 1.56 [1.32-1.84], p）。结论：BRI可能比BMI更可靠地预测MetS患者的心血管结局和死亡率。确定的BRI阈值可以帮助临床医生做出准确的预后评估。然而，研究结果可能因年龄和性别而异，这强调了对不同人群进行进一步研究的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.