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Zhu M, Wang X, Peng Z, Yan W, Deng Q, Li M, Liu N, Zhang L. The role of the estimated glomerular filtration rate and body roundness index in the risk assessment of uric acid-lowering therapy-resistant gout in U.S. adults: evidence from the National Health and Nutrition Examination Survey (2007-2018). Ren Fail 2025; 47:2441398. [PMID: 39910828 PMCID: PMC11803761 DOI: 10.1080/0886022x.2024.2441398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 12/05/2024] [Accepted: 12/06/2024] [Indexed: 02/07/2025] Open
Abstract
OBJECTIVE To explore the risk factors for uric acid-lowering therapy-resistant gout (UALT-RG) and its relationships with the estimated glomerular filtration rate (eGFR), body roundness index (BRI), and visceral adiposity index (VAI) via 2007-2018 National Health and Nutrition Examination Survey (NHANES) data. METHODS We calculated the BRI using waist circumference and standing height; the VAI using triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and body mass index (BMI); and the eGFR from serum creatinine levels. We also collected gout data. We explored the relationships of the eGFR, BRI, and VAI with UALT-RG risk via univariable and multivariable weighted logistic regression, trend analysis, and restricted cubic splines. RESULTS Among the 1,811 patients with gout, ∼9.08% had UALT-RG; these patients were more likely to have obesity, comorbid diabetes (36% [27-47%] vs. 25% [22-28%]) or impaired kidney function (eGFR < 60 mL/min/1.73 m2, 34.5% [27-43%] vs. 22.5% [20-26%]); be former smokers; and take colchicine (10% [5.6-19%] vs. 4.3% [2.8-6.7%]). Logistic regression and trend analysis suggested that an elevated BRI and decreased eGFR were independent risk factors and potential screening indicators for UALT-RG. Restricted cubic spline analysis revealed a negative linear trend between the eGFR and UALT-RG risk (p-overall < 0.0001) and a significant positive correlation between the BRI and UALT-RG risk (p-overall < 0.0001). CONCLUSION An increased BRI and decreased eGFR may be independent risk factors and assessment indicators for UALT-RG in U.S. adults. It is necessary to monitor serum urate levels more closely and conduct early multidisciplinary comanagement when gout is comorbid with visceral obesity and chronic kidney disease stages 3-5.
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Affiliation(s)
- Mengyuan Zhu
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, Yunnan, P. R. China
| | - Xingqiang Wang
- Department of Rheumatology, The No. 1 Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan, P. R. China
- Yunnan Provincial Clinical Medicine Research Center of Rheumatism in TCM, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan, P. R. China
| | - Zining Peng
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, Yunnan, P. R. China
| | - Weitian Yan
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, Yunnan, P. R. China
| | - Qian Deng
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, Yunnan, P. R. China
| | - Meihui Li
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, Yunnan, P. R. China
| | - Nian Liu
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, Yunnan, P. R. China
- Yunnan Provincial Clinical Medicine Research Center of Rheumatism in TCM, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan, P. R. China
| | - Ling Zhang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, Yunnan, P. R. China
- Yunnan Provincial Clinical Medicine Research Center of Rheumatism in TCM, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan, P. R. China
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Yang Y, Shi X, Wang X, Huang S, Xu J, Xin C, Li Z, Wang Y, Ye Y, Liu S, Zhang W, Lv M, Tang X. Prognostic effect of body roundness index on all-cause mortality among US older adults. Sci Rep 2025; 15:17843. [PMID: 40404734 PMCID: PMC12098855 DOI: 10.1038/s41598-025-02598-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Accepted: 05/14/2025] [Indexed: 05/24/2025] Open
Abstract
The Body Rounds Index (BRI) is an anthropometric indicator specifically developed to evaluate an individual's obesity level, particularly emphasizing central or abdominal obesity. This study aimed to explore the relationship between BRI and all-cause mortality in older U.S. adults. The research sample comprised individuals aged 65 and older from the National Health and Nutrition Examination Survey (NHANES), eligible for mortality analyses between 1999 and 2018. We utilized Cox regression analyses, restricted cubic spline (RCS), threshold effects analysis, Kaplan-Meier curves, and subgroup analyses were conducted to assess how the BRI correlates with all-cause mortality among older adults in the U.S. To further ensure the robustness of our findings, we conducted sensitivity analyses. Among 5371 U.S. older adults (age ≥ 65), with an average age of 72.45 (standard deviation [SD]:5.65) years, 2884 (60%) were women. During the follow-up period, there were 2781 deaths from all causes among the 5371 participants. After adjusting for all covariates, a U-shaped association was identified between BRI and the all cause mortality. Compared to a BRI of less than 4.457, a BRI between 4.457 and 5.538 was associated with a 19% reduction in the likelihood of mortality from any cause (HR = 0.81, 95% CI = 0.69-0.95). A BRI between 5.538 and 6.888 was linked to a 8% reduction in mortality risk (HR = 0.92, 95% CI = 0.79-1.07), while a BRI exceeding 6.888 showed a 1% increase in this risk (HR = 1.01, 95% CI = 0.87-1.17). RCS analysis indicated a U-shaped relationship between BRI and all-cause mortality. The turning point was located at 4.546, with correlations observed both before and after this point. This NHANES-based study highlights the U-shaped relationship between BRI and all-cause mortality among U.S. older adults, suggesting that the BRI has predictive value for mortality outcomes. The findings offer compelling support for utilizing BRI as a non-invasive mortality risk screening tool.
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Affiliation(s)
- Yiling Yang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China
| | - Xiaomin Shi
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China
| | - Xiaohong Wang
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China
| | - Shu Huang
- Department of Gastroenterology, Lianshui County People' Hospital, Huaian, China
- Department of Gastroenterology, Lianshui People' Hospital of Kangda College Affiliated to Nanjing Medical University, Huaian, China
| | - Jia Xu
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China
| | - Chen Xin
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China
| | - Ziyan Li
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China
| | - Yizhou Wang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China
| | - Yusong Ye
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China
| | - Sha Liu
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China
| | - Wei Zhang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China
| | - Muhan Lv
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China.
| | - Xiaowei Tang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan, China.
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Kong Y, Luo Q, Zhang Q, Wei Q. Association of the body roundness index with new-onset cardiovascular disease in middle-aged and older adults with and without diabetes: evidence from the China Health and Retirement Longitudinal Study. Diabetol Metab Syndr 2025; 17:142. [PMID: 40296132 PMCID: PMC12036263 DOI: 10.1186/s13098-025-01705-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Accepted: 04/17/2025] [Indexed: 04/30/2025] Open
Abstract
BACKGROUND Among noncommunicable diseases, cardiovascular disease (CVD) is the leading cause of mortality and morbidity. In China, diabetes is renowned for its high incidence rate, and the body roundness index (BRI) is an emerging indicator for assessing obesity, particularly abdominal obesity. High BRI may lead to new-onset CVD events. However, the relationships between the BRI and new-onset CVD in individuals with or without diabetes remain unclear. METHODS Data for this analysis were extracted from the China Health and Retirement Longitudinal Study (CHARLS). Our research utilized a cohort that was meticulously assessed over a period from 2011 to 2018, encompassing a comprehensive follow-up of 17,708 participants. Ultimately, this study focused on a subset of 6,737 individuals aged 45 years or older. Methodological approaches include Cox regression, Kaplan-Meier survival analysis, restricted cubic splines (RCS) analysis, receiver operating characteristic (ROC) curve analysis, subgroup analysis, and mediation analysis to explore the relationships of interest. RESULTS This study included 6,737 participants, all of whom were above the age of 45. Our findings revealed that within this demographic group, 1,481 (22.0%) patients experienced new-onset CVD. The Kaplan-Meier survival analysis further revealed that the group characterized by non-diabetes mellitus (Non-DM) had the lowest cumulative incidence of CVD compared with the diabetes mellitus (DM) group. Multivariate Cox regression revealed that in the fully adjusted model (Model 3) (HR = 1.122, 95% CI = 1.080 to 1.167), BRI was associated with the risk of CVD in the Non-DM group during the three-wave follow-up. RCS analysis revealed a positive, linear-like dose‒dependent relationship between BRI and new-onset CVD in Non-DM patients (P = 0.007, P for nonlinearity = 0.938). Smoking could affect the ability of the BRI to predict the incidence rate of CVD in the total population and in the population without diabetes (P interaction = 0.007). Moreover, the mediating effect of the BRI on new-onset CVD among diabetic patients was particularly pronounced in the long term, exceeding 4 years. CONCLUSIONS Our findings demonstrate a significant association between the BRI and CVD risk in non-diabetic individuals, with diabetes influencing the incidence and risk of new-onset CVD in middle-aged and elderly Chinese populations through the BRI playing a mediating role. As an obesity indicator, the BRI provides a valuable tool for early detection and intervention of CVD. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Youli Kong
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qian Luo
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qing Zhang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Quan Wei
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Wu Q, Yu L, Yu Q. Association Between a Body Shape Index and Body Roundness Index with Prevalence of Psoriasis: A Cross-Sectional Population-Based Study. Clin Cosmet Investig Dermatol 2025; 18:627-638. [PMID: 40124931 PMCID: PMC11929514 DOI: 10.2147/ccid.s512864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Accepted: 03/14/2025] [Indexed: 03/25/2025]
Abstract
Background Previous studies have suggested an intimate association between obesity and psoriasis. This study aimed to evaluate and compare the association between traditional and novel obesity biomarkers - waist circumference (WC), body mass index (BMI), a body shape index (ABSI), and body roundness index (BRI) - and the risk of psoriasis. Methods This cross-sectional study utilized data from the 2003-2006 and 2011-2014 National Health and Nutrition Examination Survey. The association between obesity biomarkers and psoriasis risk was evaluated using multivariate logistic regression and smoothed curve fitting. The diagnostic performance of various biomarkers for identifying psoriasis were calculated and compared using receiver-operating characteristic curves. Results Overall, 12,406 participants without psoriasis, 287 with mild psoriasis, and 68 with moderate-severe psoriasis, were included. Compared to the lowest quartile of WC, BMI, and BRI, higher quartiles were associated with significantly higher risks of psoriasis (all P for trend < 0.05). The area under the curve for identifying psoriasis was highest for BRI, which was comparable to WC (0.581 vs 0.575, P=0.34) but significantly higher than that of ABSI (0.581 vs 0.546, P=0.04) and BMI (0.581 vs 0.569, P=0.007). The association between BRI and psoriasis risk was not influenced by participant's age, sex, smoking status, physical activity, hypertension and diabetes status. Conclusion BRI is positively associated with risk of psoriasis and outperforms BMI and ABSI in identifying psoriasis. Given the cross-sectional design of this study, future research employing prospectively designed longitudinal studies is necessary to validate our findings.
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Affiliation(s)
- Qianjie Wu
- Department of Nursing, The Affiliated Suqian First People’s Hospital of Nanjing Medical University, Suqian, Jiangsu Province, People’s Republic of China
| | - Ling Yu
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Qianqian Yu
- Department of Pediatrics, The Affiliated Suqian First People’s Hospital of Nanjing Medical University, Suqian, Jiangsu Province, People’s Republic of China
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Hajihashemi P, Mohammadifard N, Bateni M, Haghighatdoost F, Boshtam M, Najafian J, Sadeghi M, Shabani N, Sarrafzadegan N. Comparing the association of novel Anthropometric and atherogenicity indices with all-cause, cardiovascular and non-cardiovascular mortality in a general population of Iranian adults. Am J Prev Cardiol 2025; 21:100936. [PMID: 39967963 PMCID: PMC11833613 DOI: 10.1016/j.ajpc.2025.100936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2025] Open
Abstract
Background The association of novel anthropometrics and novel atherogenicity indices with mortality remains uncertain. Objective To compare the association of novel anthropometrics and atherogenicity indices with all-cause, cardiovascular (CVD), and non-CVD mortality in Iranian adults. Methods Utilizing data from Isfahan Cohort Study, 5432 participants aged older than 35 years were enrolled. Three anthropometrics indices including a body shape index (ABSI), body roundness index (BRI) and abdominal volume index (AVI), and three atherogenicity indices including atherogenic index of plasma (AIP), Castelli risk index (CRI) and the cholesterol index (CI) were calculated. Cox proportional hazards regression models were used to explore the association between indices and mortality. Results After a median follow-up of 11.25 years, the ABSI was independently associated with increased risk of all-cause mortality (HRQ4 vs. Q1 = 1.43, 95 % CI: 1.07, 1.92; P trend = 0.02). A positive, independent association was also observed between CRI-II (HRQ4 vs. Q1 = 1.49, 95 % CI: 0.99, 2.25; P trend = 0.04) and AIP (HRQ4 vs. Q1 = 1.81, 95 % CI: 1.92, 2.27; P trend = 0.01) and CVD mortality. For non-CVD mortality, despite a direct link for ABSI (HRQ4 vs. Q1 = 1.92, 95 % CI: 1.32, 2.80; P trend = 0.001), an inverse association was found for CI (HRQ4 vs. Q1 = 0.68, 95 % CI: 0.49, 0.95; P trend = 0.007). Conclusion Amongst various investigated anthropometric indices, ABSI was directly related to all-cause and non-CVD mortality. However, atherogenicity indices including CRI-II and AIP could predict the incidence risk of CVD mortality among Iranians. Further studies are warranted to confirm these findings.
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Affiliation(s)
- Parisa Hajihashemi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahare Bateni
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Boshtam
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jamshid Najafian
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloufar Shabani
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Guo A, Chen P, Cao J, Wu C, Ding S. Association between sex steroid hormones and α-klotho: Results from the NHANES 2013-2016 and Mendelian randomization study. Exp Gerontol 2025; 201:112699. [PMID: 39900258 DOI: 10.1016/j.exger.2025.112699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Revised: 01/30/2025] [Accepted: 01/31/2025] [Indexed: 02/05/2025]
Abstract
PURPOSE This study aimed to explore the association and causal links between sex steroid hormones and the anti-aging protein α-Klotho, extending to investigate the mediation effects of potential mediators. METHODS Based on data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016, this study performed weighted multivariable-adjusted logistic regression to evaluate the association between sex steroid hormones and α-Klotho. Then, utilizing summary data from genome-wide association studies (GWAS), a bidirectional two-sample Mendelian randomization (MR) was conducted to assess the causal relationship between sex steroid hormones and α-Klotho. Finally, mediation analysis was conducted to delineate the influence of five identified potential mediators on the sex steroid hormones-α-Klotho association. RESULTS In men, significant positive correlations with α-Klotho were consistent across both unadjusted and fully adjusted models for total testosterone (TT), bio-available testosterone (Bio-T), estradiol (E2) and sex hormone-binding globulin (SHBG) (Model 3: TT: β = 3.54, 95 % CI: 1.63-5.44, P = 0.0003; Bio-T: β = 1.74, 95 % CI: 0.73-2.74, P = 0.0007; E2: β = 0.25, 95 % CI: 0.11-0.38, P = 0.0003; SHBG: β = 0.95, 95 % CI: 0.63-1.27, P < 0.0001); In premenopausal women, we detected a potential nonlinear relationship between TT levels and α-Klotho, with α-Klotho levels rising to a peak at a TT level of 72.2 ng/mL, after which they declined. Furthermore, results from MR analyses reaffirmed positive associations of TT and Bio-T with α-Klotho in men (TT: β = 3.54, 95 % CI: 1.63-5.44, P = 0.0003; Bio-T: β = 1.74, 95 % CI: 0.73-2.74, P = 0.0007). Finally, significant mediation effects were observed for uric acid (β = 0.27, 95 % CI: 0.15-0.67, P < 0.0001) and creatinine (β = 0.05, 95 % CI: 0.01-0.16, P = 0.0060), accounting for 26.7 % and 5.23 % of the total mediation effect, respectively. CONCLUSION In conclusion, our results demonstrate that both TT and Bio-T enhance the expression of α-Klotho in men. The positive association observed may be partly mediated by uric acid and creatinine.
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Affiliation(s)
- Andong Guo
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
| | - Pengcheng Chen
- Department of Endocrinology & Metabolism, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Jishuang Cao
- Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China
| | - Chenrui Wu
- Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China
| | - Sentai Ding
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China; Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China.
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Guo A, Cao J, Wu C, Ding S. Uric acid mediates the association between testosterone and α-Klotho among males: results from the NHANES 2013-2016. Int Urol Nephrol 2025; 57:939-946. [PMID: 39487906 DOI: 10.1007/s11255-024-04262-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Accepted: 10/23/2024] [Indexed: 11/04/2024]
Abstract
PURPOSE This study initially conducted a cross-sectional analysis to examine the association between total testosterone (TT), uric acid, and Klotho. The investigation examined whether uric acid mediates the association between TT and Klotho in males. METHODS Based on data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016, this study performed weighted multivariable-adjusted linear regression to evaluate the association between TT, uric acid, and α-Klotho. Then, mediation analysis was conducted to delineate the potential mediating role of uric acid in the TT-Klotho association. RESULTS Multivariable linear regression analyses revealed inverse relationships between TT and uric acid (β = - 2.75, 95% CI: - 4.21, 1.28, p < 0.001) and between uric acid and α-Klotho (β = - 4.80, 95% CI: - 6.47, - 3.13, p < 0.001). Conversely, a positive correlation existed between TT and α-Klotho (β = 5.38, 95% CI: 2.23, 8.53, p < 0.001). Updated subgroup analyses show that the association strength between α-Klotho, TT, and uric acid levels was consistent across various population settings without significant variations. Restricted cubic spline analysis identified a non-linear association between TT and uric acid with an inflection point at 201 ng/mL. Mediation analysis confirmed uric acid-mediated 18.59% of the association between TT and α-Klotho (p < 0.001), highlighting its significant intermediary role. CONCLUSION This study elucidates the complex interrelationship between TT, uric acid, and α-Klotho, highlighting uric acid's significant mediating role. These findings provide novel insights into the hormonal and metabolic mechanisms underlying age-related processes and longevity.
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Affiliation(s)
- Andong Guo
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Jishuang Cao
- Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China
| | - Chenrui Wu
- Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China
| | - Sentai Ding
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
- Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China.
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Zhang J, Zhang H. The association of body roundness index and body mass index with frailty and all-cause mortality: a study from the population aged 40 and above in the United States. Lipids Health Dis 2025; 24:30. [PMID: 39885516 PMCID: PMC11783752 DOI: 10.1186/s12944-025-02450-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Accepted: 01/21/2025] [Indexed: 02/01/2025] Open
Abstract
BACKGROUND The relationship between body roundness index (BRI), a new obesity index, and frailty has not been established. This study aims to compare the associations of traditional obesity index body mass index (BMI) and BRI with frailty and the risk of all-cause mortality. METHODS The clinical data of 15,157 participants over 40 years old from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018 were analyzed. Based on weighted logistic regression, COX regression and restricted cubic spline, the associations of BRI and BMI with the odds of frailty and the risk of all-cause mortality were estimated. The receiver operating characteristic curve (ROC) and concordance index were used to evaluate the ability of BRI and BMI to predict frailty and survival. RESULTS Weighted logistic regression showed that the odds of frailty showed a trend of increasing with the increase of BRI and BMI (P for trend < 0.0001, respectively). After adjusting for all confounding factors, the association between BRI and frailty was stronger (OR: 1.20, 95% CI: 1.13-1.27, P < 0.0001), and the association between BMI and frailty was slightly weaker (OR: 1.14, 95% CI: 1.08-1.21, P < 0.0001). ROC showed that the area under the curve (AUC) of BRI for predicting frailty was 0.628, while the AUC of BMI was 0.603, and the difference between the two was significant (PDeLong < 0.001). In addition, in survival analysis, BRI and BMI showed a significant U-shaped association with the risk of all-cause mortality. Piecewise regression based on the inflection point shows that when BRI < 7.33, an increase in BRI reduces the risk of all-cause mortality (HR: 0.85, 95% CI: 0.78-0.92, P < 0.0001), while when BRI ≥ 7.33, an increase in BRI increases the risk of all-cause mortality (HR: 1.19, 95% CI: 1.03-1.38, P = 0.02); when BMI < 33.57, an increase in BMI reduces the risk of all-cause mortality (HR: 0.84, 95% CI: 0.78-0.91, P < 0.0001), and when BMI ≥ 33.57, an increase in BRI increases the risk of all-cause mortality (HR: 1.18, 95% CI: 1.04-1.34, P = 0.01). Moreover, the time-dependent c-index curve showed that the ability of BRI to predict the risk of all-cause mortality in frail people was comparable to that of BMI. CONCLUSION In the American population over 40 years old, both BRI and BMI are independently and positively associated with frailty. Moreover, BRI has a stronger ability to predict frailty than BMI. In addition, both BRI and BMI have a U-shaped association with the risk of all-cause mortality in frail individuals, and the two have comparable abilities to predict the risk of all-cause mortality.
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Affiliation(s)
- Jianqiang Zhang
- Department of Medical Intensive Care Unit, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
- Department of Neurology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Huifeng Zhang
- Department of Cardiovascular, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
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Zhang X, Nie Y, Li D, Zhou C. Association between anthropometric indices and hypertension: identifying optimal cutoff points for U.S. adults across different populations. Front Pharmacol 2024; 15:1503059. [PMID: 39726779 PMCID: PMC11669579 DOI: 10.3389/fphar.2024.1503059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2024] [Accepted: 11/29/2024] [Indexed: 12/28/2024] Open
Abstract
Objective This study compares the relationships between five anthropometric indices, a body shape index (ABSI), body roundness index (BRI), waist circumference (WC), body mass index (BMI) and waist-to-height ratio (WHtR), and hypertension, assessing their predictive capacities. The aim is to determine the specific numerical changes in hypertension incidence, systolic blood pressure (SBP) and diastolic blood pressure (DBP) for each increase in standard deviation of these indices, and to identify the optimal predictive indicators for different populations, including the calculation of cutoff values. Methods This study used data from the NHANES datasets spanning 2007 to 2018. Logistic regression analysis was used to quantify the associations between these anthropometric indices and hypertension, calculating β coefficients and odds ratios (ORs). Receiver operating characteristic (ROC) analysis was used to evaluate the predictive ability of each index for hypertension. Results For each increase in standard deviation in WC, BMI, WHtR, ABSI and BRI, the prevalence of hypertension increased by 33% (95% CI: 27%-40%), 32% (95% CI: 26%-38%), 35% (95% CI: 28%-42%), 9% (95% CI: 4%-16%) and 32% (95% CI: 26%-38%), respectively. The SBP correspondingly increased by 2.36 mmHg (95% CI: 2.16-2.56), 2.41 mmHg (95% CI: 2.21-2.60), 2.48 mmHg (95% CI: 2.28-2.68), 0.42 mmHg (95% CI: 0.19-0.66) and 2.46 mmHg (95% CI: 2.26-2.66), respectively. Similarly, DBP increased by 1.83 mmHg (95% CI: 1.68-1.98), 1.72 mmHg (95% CI: 1.58-1.87), 1.72 mmHg (95% CI: 1.57-1.88), 0.44 mmHg (95% CI: 0.27-0.62) and 1.64 mmHg (95% CI: 1.48-1.79). In the youth and middle-aged groups, WC had the best predictive ability, with AUCs of 0.749 and 0.603, respectively. Among the elderly group, the AUCs for all five indices ranged between 0.5 and 0.52. Conclusion Increases in WC, BMI, WHtR and BRI are significantly associated with higher incidences of hypertension and increases in SBP and DBP, while the impact of ABSI on blood pressure is relatively weak. Stratified analysis indicates significant age-related differences in the predictive value of these indices, with the strongest associations observed in the youth group, followed by the middle age group, and the weakest in the elderly. WC demonstrates excellent predictive ability across youth populations.
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Affiliation(s)
- Xueliang Zhang
- Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yan Nie
- Department of Pharmacy, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Dan Li
- Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Chunhua Zhou
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of the Technology Innovation Center for Artificial Intelligence in Clinical Pharmacy of Hebei Province, Shijiazhuang, China
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Wang W, Hou S, Wang K, Ling B, Yu H. Association of body roundness index with female infertility: 2013-2018 NHANES. Front Nutr 2024; 11:1416637. [PMID: 39545053 PMCID: PMC11561710 DOI: 10.3389/fnut.2024.1416637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 10/10/2024] [Indexed: 11/17/2024] Open
Abstract
Aim This study aims to understand the association between body roundness index (BRI) and female infertility prevalence. Infertility is a public health concern with significant implications for individuals' well-being and rights. Methods All individuals who completed the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2018 were initially included in this cross-sectional study. Following the screening, 2,777 eligible participants were selected for analysis from the original pool of 10,375 participants. Trained operators conducted anthropometric measurements, including height, weight, and waist circumference. The BRI was then calculated based on established research. Data from infertility status questionnaires were gathered from the NHANES database for all participants, with self-reported infertility serving as the study outcome. Multivariable logistic regression and restricted cubic splines (RCS) were employed to investigate the relationship between BRI and infertility. Subgroup analyses were also conducted to further explore the association between BRI and infertility. Results Upon analyzing the baseline characteristics of all women in the study, notable distinctions were identified in the clinical and demographic features between fertile and infertile women. Our investigation revealed a positive correlation between BRI and the likelihood of infertility in both weighted and unweighted multiple logistic regression models. Additionally, BRI exhibited a significant association with infertility in both continuous and categorical forms. Utilizing RCS curves, we noted a linear escalation in the prevalence of infertility with rising BRI values. Subgroup analyses provided further clarity on these observations. Conclusion Our study demonstrates a statistically significant positive correlation between BRI and the prevalence of infertility across diverse populations, suggesting potential implications for infertility prevention and treatment. Future prospective cohort studies will explore this association and understand the underlying mechanisms.
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Affiliation(s)
- Wenhui Wang
- Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Shengdi Hou
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, China
- Graduate School, Capital Medical University, Beijing, China
| | - Kun Wang
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, China
| | - Bin Ling
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, China
| | - Huan Yu
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, China
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Wu J, Lu D, Chen X. Association of body roundness index with abdominal aortic calcification among middle aged and elderly population: findings from NHANES. Front Cardiovasc Med 2024; 11:1475579. [PMID: 39450238 PMCID: PMC11499151 DOI: 10.3389/fcvm.2024.1475579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2024] [Accepted: 09/23/2024] [Indexed: 10/26/2024] Open
Abstract
Aim We aim to investigate the association between body roundness index (BRI) and abdominal aortic calcification (AAC) among middle aged and elderly US residents. Methods This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 cycle, including 3,079 middle-aged and elderly participants aged 40 and above. AAC scores for these participants were assessed using dual-energy x-ray absorptiometry (DXA). BRI was calculated from participants' height and waist circumference, with all measurements conducted by trained surveyors using standardized methods. The relationship between BRI and AAC was analyzed using weighted multivariate logistic regression, adjusting for confounding variable. Additionally, restricted cubic splines (RCS) analysis was also employed. Results We found that those with AAC were significantly older and had a higher prevalence of smoking and chronic kidney disease (CKD) prevalence compared to those without AAC. Using weighted multivariable logistic regression, we determined that an increase of one unit in BRI was associated with a 22% higher risk of AAC. Additionally, higher BRI quartiles (Q2, Q3, Q4) showed significantly increased risks of AAC compared to the lowest quartile. Visualization using RCS indicated a gradual increase in AAC risk with higher BRI, which plateaued beyond a BRI of 7.2. This relationship was significant across different age and gender group. Conclusion There is a positive association between abdominal obesity (as measured by BRI) and AAC in the middle-aged and elderly population. This suggests the impact of abdominal obesity on vascular health and that this factor should be considered in public health strategies.
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Affiliation(s)
- Ji Wu
- Department of Thyroid Breast Surgery, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
- Department of Hand and Foot Surgery, Affiliated Huishan Hospital of Xinglin College, Nantong University, Wuxi Huishan District People's Hospital, Wuxi, China
| | - Daojun Lu
- Department of Hand and Foot Surgery, Affiliated Huishan Hospital of Xinglin College, Nantong University, Wuxi Huishan District People's Hospital, Wuxi, China
| | - Xiang Chen
- Department of Thyroid Breast Surgery, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
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Rezaei M, Ghadamgahi F, Jayedi A, Arzhang P, Yekaninejad MS, Azadbakht L. The association between food insecurity and obesity, a body shape index and body roundness index among US adults. Sci Rep 2024; 14:23631. [PMID: 39384863 PMCID: PMC11464524 DOI: 10.1038/s41598-024-74108-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 09/23/2024] [Indexed: 10/11/2024] Open
Abstract
Research has established a positive association between food insecurity and obesity, typically assessed by body mass index (BMI); However, studies examining the relationship between food insecurity and measures of body fat content and distribution are lacking. The aim of this study was to examine the association between food insecurity and obesity ([BMI] ≥ 30 kg/m2) and body fat indicators assessed by body roundness index ([BRI] > 6.72) and a body shape index ([ABSI] > 0.08). This is a cross-sectional study using NHANES data 2007-2020. Household food security was assessed by U.S. Food Security Survey Module questionnaire. Multivariable-adjusted binary logistic regression analyses were used to calculate odds ratios and 95% CIs. Compared to those with full food security, the adjusted ORs for obesity were 1.28 (95% CI:1.18, 1.39), 1.40 (95% CI:1.28, 1.53), and 1.43 (95% CI:1.30, 1.57) for those with marginal, low and very low food security, respectively. The corresponding ORs for high BRI were, respectively, 1.39 (95% CI:1.26, 1.52), 1.50 (95% CI:1.36, 1.66), and 1.60 (95% CI:1.43, 1.78). Similar results were observed for ABSI. The analyses of BMI suggested a potential sex difference, as significant associations were found in women, but not in men. This study confirms previous evidence of the positive association between food insecurity and obesity among US adults.
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Affiliation(s)
- Mahsa Rezaei
- Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Ghadamgahi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Pishva Arzhang
- Qods Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Yang ZJ, Liu Y, Liu YL, Qi B, Yuan X, Shi WX, Miao L. Osteoarthritis and hypertension: observational and Mendelian randomization analyses. Arthritis Res Ther 2024; 26:88. [PMID: 38632649 PMCID: PMC11022320 DOI: 10.1186/s13075-024-03321-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The association between osteoarthritis (OA) and hypertension is a subject of ongoing debate in observational research, and the underlying causal relationship between them remains elusive. METHODS This study retrospectively included 24,871 participants in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020. Weighted logistic regression was performed to investigate the connection between OA and hypertension. Additionally, Mendelian randomization (MR) analysis was conducted to explore the potential causal relationship between OA and hypertension. RESULTS In the NHANES data, after adjusting for multiple confounding factors, there was no significant relationship between OA and hypertension (OR 1.30, 95% CI, 0.97-1.73, P = 0.089). However, among males, OA appeared to be associated with a higher risk of hypertension (OR 2.25, 95% CI, 1.17-4.32, P = 0.019). Furthermore, MR results indicate no relationship between multiple OA phenotypes and hypertension: knee OA (IVW, OR 1.024, 95% CI: 0.931-1.126, P = 0.626), hip OA (IVW, OR 0.990, 95% CI: 0.941-1.042, P = 0.704), knee or hip OA (IVW, OR 1.005, 95% CI: 0.915-1.105, P = 0.911), and OA from UK Biobank (IVW, OR 0.796, 95% CI: 0.233-2.714, P = 0.715). Importantly, these findings remained consistent across different genders and in reverse MR. CONCLUSIONS Our study found that OA patients had a higher risk of hypertension only among males in the observational study. However, MR analysis did not uncover any causal relationship between OA and hypertension.
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Affiliation(s)
- Zhi-Jie Yang
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Yuan Liu
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Yan-Li Liu
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Bin Qi
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Xin Yuan
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Wan-Xin Shi
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Liu Miao
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China.
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