Capacity of a body shape index and body roundness index to identify diabetes mellitus in Han Chinese people in Northeast China: a cross-sectional study

Association of body roundness index with uterine fibroids in women of childbearing age: a cross-sectional analysis of NHANES 1999-2006

BACKGROUND AND AIM

Previous studies have shown an association between obesity and uterine fibroids (UF). Body roundness index (BRI) is an anthropometric measure associated with obesity. However, the association with UF has not been thoroughly elucidated, and further investigation is required to explore the possible link. Our study investigated the possible link between BRI and UF in women aged 20 to 44 years, with a view to providing effective scientific evidence for health management and disease prevention in this population.

METHODS

This cross-sectional study analysis included data from 4043 women of childbearing age from the National Health and Nutrition Examination Survey (NHANES) database 1999-2006.We applied multiple regression analysis to study the association between BRI and UF, subgroup analysis was used to ensure broad applicability and representativeness of conclusions, and finally linear correlation between BRI and UF was explored by smooth curve fitting.

RESULTS

This study involved 4,043 female participants aged 20-44 years, of whom 331 (8.19%) had fibroids. After controlling for all potential confounders, each additional unit of BRI increased the prevalence of UF by 7% (OR = 1.07,95% CI: 1.01,1.12), Sensitivity analysis by dividing BRI into four groups found a 54% increase in the prevalence of UF within the fourth quartile (Q4) of BRI compared with the first quartile (Q1) of BRI (OR = 1.54, 95% CI: 1.08, 2.20).The link between BRI and UF maintained in subgroup analyses. Furthermore, the study showed a linear positive correlation between BRI and the probability of UF prevalence.

CONCLUSIONS

Higher levels of BRI may be linked to a higher prevalence of UF, according to studies conducted on American women of childbearing age. The study's conclusions highlight how important BRI is for managing and preventing UF.

Association between body roundness index and obstructive sleep apnea: a cross-sectional study from the NHANES (2005-2008 to 2015-2020)

BACKGROUND

Obstructive sleep apnea (OSA) is linked to obesity, and the body roundness index (BRI) is an innovative measure of obesity that more accurately reflects visceral and total body fat. The relationship between BRI and the likelihood of OSA is unclear, so we aimed to investigate the association between BRI and the prevalence of OSA.

METHODS

We used data from the National Health and Nutrition Examination Survey (NHANES; 2005-2008 to 2015-2020) to conduct a cross-sectional study involving 24,476 individuals aged 18 years or older. OSA was assessed using three standardized NHANES questionnaire items measuring monthly daytime sleepiness, weekly apnea events, and habitual snoring frequency. A formula that uses the height and waist measures from the body measurements is used to calculate the BRI. Covariates, including sex, age, race/ethnicity, education level, marital status, poverty-income ratio (PIR), alcohol consumption, smoking status, high blood pressure (HBP), diabetes, and sleep duration were controlled using multivariate logistic regression models. Subgroup analyses, interaction tests, and smoothed curve fitting were also performed.

RESULTS

After controlling for confounders, BRI showed a positive correlation with OSA. Among the 24,476 participants aged 18 and older, 11,856 were diagnosed with OSA. The full model revealed a significant positive association between BRI and OSA incidence (OR = 1.11, 95% CI: 1.08-1.14, p < 0.0001). Participants in the highest percentile of BRI had an 87% greater likelihood of developing OSA compared to those in the lowest percentile (OR = 1.87, 95% CI: 1.62-2.16, p < 0.0001).

CONCLUSION

BRI levels have shown a favorable correlation with the rising rates of OSA in the United States. The BRI serves as a straightforward anthropometric predictor of OSA.

Development and validation of machine learning models for predicting low muscle mass in patients with obesity and diabetes

BACKGROUND AND AIMS

Low muscle mass (LMM) is a critical complication in patients with obesity and diabetes, exacerbating metabolic and cardiovascular risks. Novel obesity indices, such as the body roundness index (BRI), conicity index, and relative fat mass, have shown promise for assessing body composition. This study aimed to investigate the associations of these indices with LMM and to develop machine learning models for accurate and accessible LMM prediction.

METHOD

Data from NHANES 2011-2018 (n = 2,176) were analyzed. Obesity was defined by body fat percentage, and LMM was determined using skeletal muscle mass index thresholds adjusted for BMI. Predictive models were developed using logistic regression, random forest, and other algorithms, with feature selection via LASSO regression. Validation included NHANES 2005-2006 data (n = 310). Model performance was evaluated using AUROC, Brier scores, and SHapley Additive exPlanations (SHAP) for feature importance.

RESULTS

BRI was independently associated with LMM (odds ratio 1.39, 95% confidence interval 1.22-1.58; P < 0.001). Eight features were included in the random forest model, which achieved excellent discrimination (AUROC = 0.721 in the validation set) and calibration (Brier score = 0.184). Feature importance analysis highlighted BRI, creatinine, race, age, and HbA1c as key contributors to the model's predictive performance. SHAP analysis emphasized BRI's role in predicting LMM. An online prediction tool was developed.

CONCLUSIONS

BRI is a significant predictor of LMM in patients with obesity and diabetes. The random forest model demonstrated strong performance and offers a practical tool for early LMM detection, supporting clinical decision-making and personalized interventions.

Joint association of triglyceride glucose index (TyG) and body roundness index (BRI) with stroke incidence: a national cohort study

BACKGROUND

Insulin resistance (IR), as quantified by the triglyceride glucose (TyG) index, and visceral obesity, as assessed by the body roundness index (BRI), have been identified as pivotal risk factors for stroke. However, the combined impact of these two indicators on stroke risk has not been thoroughly investigated. This study aims to investigate both the separate and combined associations, as well as potential interactions, between the TyG index and/or BRI with respect to stroke incidence.

METHODS

This cohort study encompassed 6621 respondents who were free of stroke at baseline from the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized based on the median values of the TyG index or/and BRI. Cox proportional hazards regression models were employed to examine the associations between the TyG index alone, BRI alone, and their combined effects on stroke incidence. Both additive and multiplicative interaction effects were further estimated.

RESULTS

Among 6621 participants aged 45 years or older, the mean (SD) age was 58.06 (8.57) years, with 2951 (44.6%) being male. During a follow-up period of up to 9 years, 743 individuals experienced stroke events. Compared to participants with low TyG index and low BRI, the adjusted hazard ratios (HRs) were as follows: 1.36 (95% confidence interval [CI] 1.05-1.75) for high TyG index alone, 1.61 (95% CI 1.27-2.05) for high BRI alone, and 1.78 (95% CI 1.40-2.26) for high TyG index and high BRI. Neither additive nor multiplicative interactions between BRI and TyG for incident stroke were statistically significant. The combination of TyG and BRI enhanced the predictive capability for stroke compared to either biomarker alone.

CONCLUSION

We discovered that both the TyG index and BRI are strongly associated with stroke incidence. The joint assessment of TyG and BRI enhances the predictive capability for stroke, underscoring the critical role of IR and visceral adiposity in the identification and screening of stroke risk.

Effectiveness of body roundness index for the prediction of nonalcoholic fatty liver disease: a systematic review and meta-analysis

BACKGROUND

Several anthropometric indices, such as body mass index and waist circumference, have been used as clinical screening tools for the prediction of nonalcoholic fatty liver disease (NAFLD). To further refine these clinical tools for NAFLD, the body roundness index (BRI) has recently been evaluated. In this systematic review and meta-analysis, the objective was to evaluate the relationship and predictive capability of the BRI in identifying NAFLD.

METHODS

A comprehensive search was conducted in PubMed, Embase, Web of Science, and Scopus up to December 31, 2024. Eligibility criteria included observational studies on adults (≥ 18 years old) with measured BRI and its association with NAFLD. The Joanna Briggs Institute tool was used for risk of bias assessment. Meta-analyses used random-effects models to pool data on mean difference, odds ratio, sensitivity, specificity, and the area under the curve (AUC), with heterogeneity and publication bias assessed.

RESULTS

Ten studies involving 59,466 participants were included. The pooled mean difference in BRI between the NAFLD and non-NAFLD groups was 1.73 (95% confidence interval [CI]: 1.31-2.15). The pooled sensitivity and specificity of BRI for diagnosing NAFLD were 0.806 and 0.692, respectively. The pooled AUC for BRI was 0.803 (95% CI: 0.775-0.830), indicating good diagnostic accuracy. Unlike subgroup analysis by country, subgroup analysis by sex showed no significant differences. Higher BRI values were associated with increased odds of NAFLD (pooled OR = 2.87, 95% CI: 1.39; 5.96). Studies provided mixed results on the predictive ability of BRI compared to other indices like body mass index, mostly favoring BRI over conventional indices.

CONCLUSION

BRI demonstrates a good diagnostic performance for NAFLD, suggesting it may be a valuable clinical tool for NAFLD assessment. Further research is necessary to validate these findings and strengthen the evidence base.

Association between novel adiposity parameters and hyperuricemia: a cross-sectional study

Objectives

Body mass index (BMI) is a commonly used parameters to measure obesity, but it cannot well reflect the distribution of body fat, which has limitations in clinical practice. Novel adiposity parameters have emerged as substitution to BMI to assess obesity. This study aimed to comprehensively investigate the association between hyperuricemia and novel adiposity parameters.

Methods

We included data from the National Health and Nutrition Examination Survey from 1999-2006. Weighted logistic regression was employed to evaluate the relations between hyperuricemia and novel adiposity parameters, including body roundness index (BRI), weight-adjusted waist index (WWI), a body shape index (ABSI), and conicity index (CoI). To assess the most diagnostic factor for hyperuricemia, the receiver operating characteristic (ROC) curve analysis was employed. The area under the curve (AUC) was used to assess the diagnostic power of each parameter.

Results

The study included 24,763 participants, 3,528 of whom were diagnosed with hyperuricemia. Compared with the first quartile (Q1), the fourth quartile's (Q4) BRI, WWI, ABSI and CoI were linked to an increased risk of hyperuricemia (OR: 9.34, 95% CI: 7.73-11.28; OR: 4.67, 95% CI: 3.97-5.49; OR: 2.61, 95% CI: 2.26-3.02; OR: 7.34, 95% CI: 6.12-8.81, respectively). This relationship persisted after adjusting for confounding factors. Among the four novel obesity parameters, BRI had the largest AUC and was a good diagnostic index of hyperuricemia (AUC = 0.697 for male and AUC = 0.751 for female).

Conclusion

In the general population, larger obesity parameters are linked to a higher risk of hyperuricemia. BRI has high diagnostic value and can be used as a new index for the evaluation of hyperuricemia. This study provides a new basis for the prevention and monitoring of hyperuricemia.

Elevated body roundness index increases the risk of cardiovascular disease in Chinese patients with circadian syndrome

Objective

The body roundness index (BRI) and circadian syndrome (CircS) are considered new risk factors for cardiovascular disease (CVD), yet it remains uncertain whether elevated BRI is associated with CVD incidence in CircS patients. In this study, we investigated the association between BRI and CVD occurrence among CircS participants.

Methods

We conducted a retrospective cohort study involving 8,888 participants aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS 2011-2020 wave). CircS was evaluated with a combination of the International Diabetes Federation (IDF) MetS, along with short sleep duration and depression. The threshold for CircS was established at ≥4. In the first phase, the receiver operating characteristic (ROC) curves were used to evaluate the accuracy of diagnosing CircS according to baseline BRI. During the 9-year follow-up, the associations between BRI and CVD incidence in CircS patients were explored by employing logistic regression, restricted cubic spline (RCS) analysis, and subgroup analysis.

Results

BRI demonstrated an independent association with CircS, and multivariable-adjusted restricted cubic spline analyses suggested "J-shaped" associations between BRI and risk of CircS. BRI demonstrated better diagnostic performance in diagnosing CircS compared to general obesity indices such as ABSI (AUC: 0.617), BMI (AUC: 0.746), and WC (AUC: 0.722), with an AUC of 0.760. After a 9-year follow-up, BRI was found to be independently associated with the occurrence of CVD in CircS patients, and the associations between incident CVD and the second, third, and fourth BRI quartiles were 1.30 (95% CI: 0.99~1.69), 1.32 (95% CI: 1.01~1.72), and 1.59 (95% CI: 1.21~2.08), respectively, relative to the first BRI quartile. Then, we assessed the relationship between other obesity indices and the CVD occurrence, and likewise observed a significant effect in the fourth quartile.

Conclusion

BRI was independently associated with CircS, outperforming obesity indices such as BMI and WC in identifying individuals with CircS. During the 9-year follow-up, elevated BRI levels was significantly associated with CVD incidence among CircS patients, especially in men. Thus, early identification of high-risk populations with CircS and elevated BRI levels may help promote healthy aging among middle-aged and elderly individuals.

Association of the body roundness index with chronic diarrhea and chronic constipation: findings based on the National Health and Nutrition Examination Survey 2005-2010 data

AIM

The study aimed to explore potential links between long-term digestive issues (specifically diarrhea and constipation) and body roundness index (BRI) in a representative U.S. population sample.

METHODS

This study adopted a design that is cross sectional, drawing on data from the NHANES, gathered from 2005 to 2010 with health information from a total of 11,235 individuals. Persistent bowel movement patterns were categorized based on the BSFS-Bristol Stool Form Scale, while stool types 1 and 2 were designated as indicators of long-term constipation and types 6 and 7 were identified as markers of persistent diarrhea. To assess the relationship between digestive health and the BRI, this study employed weighted logistic regression analysis. To capture and visualize the nuanced interplay between BRI and gastrointestinal patterns, we utilized advanced nonlinear regression methods, specifically restricted cubic spline (RCS) analyses. Additionally, the research compared the efficacy of various physical measurements-including BRI, WC, BMI (body roundness index, waist circumference, and body mass index, respectively)-to determine their respective diagnostic power for chronic diarrhea and constipation through comparative analysis of receiver operating characteristic (ROC) curves.

RESULTS

After comprehensive adjustment in the final statistical model (Model 3), the BRI demonstrated the statistically significant associations with diarrhea and persistent constipation. RCS analysis further uncovered statistically significant nonlinear positive associations of BRI and with diarrhea (P = 0.005) and constipation (P = 0.037). Further stratified analyses revealed that the relationship between BRI and persistent diarrhea was particularly evident among individuals with diabetes. In contrast, the association between BRI and constipation was stronger in individuals under 60 years of age. ROC analysis indicated that BRI outperformed conventional anthropometric measures (AUC, area under the curve: 0.601). Specifically, BMI resulted in an AUC of 0.569, while WC produced an AUC of 0.572. However, the AUC value of BRI (0.537) was less effective than BMI (0.551) and WC (0.570) in diagnosing constipation.

CONCLUSIONS

BRI is strongly associated with changes in the individual's bowel habits, particularly in diagnosing chronic diarrhea. This study highlighted the potential significance of maintaining moderate BRI levels to improve bowel health and prevent diarrhea.

The nonlinear association between body roundness index and infertility in married women

Infertility is increasingly linked to obesity, especially visceral fat accumulation. The Body Roundness Index (BRI) provides a precise quantification of body and visceral fat but its implications for infertility risks and diagnostic value are yet to be fully determined. This study analyzed data from 1,305 married women aged 20-45 years, drawn from the National Health and Nutrition Examination Survey (NHANES). Logistic regression was utilized to examine the relationship between BRI and infertility, incorporating univariate and multivariate regression analyses, smooth curve fittings, and subgroup analyses. Additionally, Receiver Operating Characteristic (ROC) analysis assessed the predictive capability of BRI for infertility. An increase in one unit of BRI correlated with a 13% higher prevalence of infertility after adjusting for covariates (OR = 1.13; 95% CI: 1.05, 1.21). Women with higher BRI exhibited greater infertility odds compared to the reference group (OR: 2.20, 95% CI: 1.42, 3.42). Smooth curve fitting analysis revealed a positive, nonlinear relationship, with an inflection point observed at a BRI value of 7.95. Subgroup analyses upheld the robustness of this association across varied demographic segments. ROC curves indicated significant diagnostic potential of BRI in younger women, whereas its predictive relevance diminished in those over 35, akin to other obesity markers. This study is the first to rigorously affirm a strong link between increased BRI and the higher prevalence of infertility among married women aged 20-45. To optimize fertility, maintaining a healthy weight and waist circumference is recommended. The integration of BRI into clinical practice could assist in early intervention for women at risk of infertility. However, further research is required to identify effective predictive markers for infertility in women aged 36-45.

Associations between various anthropometric indices and hypertension and hyperlipidaemia: a cross-sectional study in China

BACKGROUND

This study aims to explore the association and determine the distinguished potential of anthropometric adiposity indices in screening for hypertension and hyperlipidaemia in the Chinese population.

METHODS

A recent nationwide cross-sectional study, called the Thyroid Disorders, Iodine State, and Diabetes Epidemiological Survey (TIDE 2015-2017), provided the newest data on the relationships between anthropometric adiposity indices and hypertension and hyperlipidaemia and included 65,231 subjects. The area under the curve (AUC) was used to assess the feasibility of using these indices to distinguish hypertension and hyperlipidaemia. After age stratification, a restricted cubic spline (RCS) fitted for generalized linear regression was used to visualize the relationships of the body mass index (BMI), waist circumference (WC), the waist-to-height ratio (WHtR), the body roundness index (BRI), and the "a body shape index" (ABSI) with hypertension and hyperlipidaemia.

RESULTS

The results showed that there were significant differences in the BMI, WC, the WHtR, the BRI, and the ABSI among the different age groups (P < 0.0001). After adjusting for sex, age, education, income, smoking status, urban or rural residence, and ethnicity in model, The WHtR and BRI had greater discriminatory power in identifying hypertension (AUC = 0.665, 95% confidence interval (CI) 0.660-0.671 for both), hypercholesterolaemia (AUC = 0.629, 95% CI 0.624-0.634 for both), and high low-density lipoprotein cholesterol (LDL-C; AUC = 0.659, 95% CI 0.653-0.664 for both) status in the overall population. When distinguishing hypertriglyceridaemia among the general population, the BMI (AUC = 0.711, 95% CI 0.706-0.716) and WC (AUC = 0.715, 95% CI 0.710-0.720) had greater discriminatory ability than the other anthropometric indices did. The BMI (AUC = 0.631, 95% CI 0.625-0.637) had the highest power for low high-density lipoprotein cholesterol (HDL-C) status in the general population.

CONCLUSIONS

Several anthropometric indices show significant correlation with hypertension and hyperlipidaemia. The WHtR and BRI were better in distinguishing hypertension, hypercholesterolaemia and high LDL-C status, while the BMI was better in hypertriglyceridaemia and low HDL-C status. The use of combined indices, such as the BMI, WC, the WHtR and the BRI, can be included in an individual's medical history and can be used as tools for cardiovascular health screening, which may yield superior results for public health.

The association between low carbohydrate dietary score (LCDS) and cardiovascular risk factors: results from the Shiraz Heart Study (SHS)

BACKGROUND

Cardiovascular disease (CVD) is a major cause of death and recent studies have highlighted the potential role of dietary carbohydrate indices in cardiovascular health. Given the controversial results in this field, the aim of this study was to investigate the association between low carbohydrate dietary score (LCDS) and CVD risk factors in a population of Iranian adults.

METHODS

This cross-sectional study was conducted within the framework of the Shiraz Heart Study (SHS) including 1982 adults. The validated 168 items food frequency questionnaire (FFQ) was used to assess participants' dietary intakes. To investigate the association between LCDS and cardiometabolic risk factors, logistic regression, was conducted.

RESULTS

During 5 years of follow-up, a total of 1982 adults, with a mean age of 53.07 ± 8.38 years, were included to the analysis. The adjusted model based on known confounding factors (age, sex, smoking, physical activity, energy intake and body mass index) revealed a significant decrease in a body shape index (ABSI) (OR = 0.70, 95% CI= (0.50 to 0.98), P = 0.038) comparing highest LCDS tertile vs. the reference. In contrast, risk of hypertension (HTN), body mass index (BMI), waist-hip ratio (WHR), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), atherogenic index of plasma (AIP), and fasting blood sugar (FBS) were not significantly associated with LCDS.

CONCLUSION

Current findings suggest that adherence to a low carbohydrate diet reduces ABSI, a main indicator of central obesity.

Body roundness index and the risk of hypertension: a prospective cohort study in Southwest China

BACKGROUND

Body roundness index (BRI) is an anthropometric measure related to obesity, combining waist circumference (WC) and height to more accurately reflect body fat. This study aims to investigate the relationship between BRI and the risk of hypertension using data from a prospective cohort study in Southwest China.

METHODS

Data for the study were derived from Guizhou Population Health Cohort Study (GPHCS), established in 2010. A total of 9,280 participants (aged 18 to 95 years, mean 41.53 ± 14.15 years) from 48 townships across 12 districts/counties were surveyed at baseline through multistage stratified random cluster sampling. Cox proportional risk models were employed to analyze the association between BRI and the risk of hypertension, estimating hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for confounding factors. The relationship between BRI and the onset time of hypertension was analyzed using the time failure acceleration model.

RESULTS

Over a median follow-up period of 6.64 years, 1,157 participants were diagnosed with hypertension. After adjusting for confounding variables, each unit increase in BRI was associated with a 17% increase in hypertension risk (HR = 1.17, 95% CI: 1.11, 1.24, P for trend < 0.001). Compared to participants in the first quartile (Q1) of BRI, the risk of hypertension for those in the third quartile (Q3) and fourth quartile (Q4) was 1.31 (95% CI: 1.10, 1.56) and 1.53 (95% CI: 1.28, 1.84), respectively. Each unit increase in BRI advanced the onset of hypertension by 0.26 years (95% CI: 0.16, 0.35).

CONCLUSION

This study indicates that BRI has a positive association with hypertension and can accelerate the onset of hypertension in the Chinese population. It is suggested that reducing BRI by controlling abdominal fat may be one of the effective measure to prevent hypertension.

Association between body shape index and coronary heart disease in individuals over 20 years old with obese

BACKGROUND

While body mass index (BMI) defines obesity as a well-established risk factor for cardiovascular disease, the paradoxical theory of BMI suggests that obesity may indeed have a favorable impact on the prognosis of cardiovascular disease. Therefore, this study aims to assess the correlation between body shape index (ABSI), which is a novel measure of obesity, and coronary heart disease (CHD) among obese individuals in the United States.

METHODS

The data from the National Health and Nutrition Examination Survey (NHANES) were evaluated by us for 5046 patients. We assessed the exposure variable ABSI, which includes waist circumference (WC), height, and BMI. The outcome variable was CHD.

RESULTS

The cross-sectional study included a total of 5046 obese adults aged over 20 years, with an average age (standard deviation: SD) of 49.86 (16.24) years and a male proportion of 44.57%.The odds ratio (OR) values for CHD in Model 1, Model 2, 3 were found to be 2.45 (95%CI: 2.12, 2.83), 1.53 (95%CI:1.30, 1.81) and 1.31 (95%CI:1.09, 1.56) per SD increase in ABSI, respectively. In the fully adjusted model, we designated participants in the T1 group as the reference group. Our findings indicate a significant increase in the prevalence of CHD (OR:1.82, 95%CI: 1.07-3.10) only within the T3 group. Although there is an increased prevalence of CHD (OR:1.32, 95%CI: 0.77-2.29) in the T2 group, no statistically significant difference was observed.

CONCLUSIONS

The increase in ABSI is strongly associated with the rise in CHD prevalence among obese individuals in the United States.

Comparison of novel and traditional anthropometric indices in Eastern-China adults: which is the best indicator of the metabolically obese normal weight phenotype?

BACKGROUND

People with the metabolically obese normal weight (MONW) phenotype have been confirmed to significantly increase the risk of unfavorable health consequences. This study aimed to investigate the relationships between traditional and novel anthropometric indices with the MONW phenotype and compare the predictive ability of different anthropometric indices in identifying individuals with the MONW phenotype.

METHODS

This cross-sectional study involved a total of 26,332 participants aged 18 years or older with a normal weight from Nanjing, China. Sociodemographic information, biochemical measurements, and anthropometric indices were collected. The novel body fat anthropometric indices included body shape index (ABSI), body roundness index (BRI), abdominal volume index (AVI), weight-adjusted-waist index (WWI), body adiposity index (BAI), conicity index (CI), waist-hip-height ratio (WHHR), as well as traditional indices such as waist circumference (WC), hip circumference (HC), body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR).The prevalence ratio (PR) from modified poisson regression and area under the receiver-operating characteristic curve (AUC) were conducted to compare the association and predictive capacity of different obesity indicators for the MONW phenotype. All analyses were stratified by sex.

RESULTS

Modified poisson regression analyses revealed that weight, WC, HC, BMI, WHR, WHtR, ABSI, BRI, AVI, WWI, BAI, CI, and WHHR were independently associated with higher risk of the MONW phenotype, regardless of whether they were treated as a continuous or categorical variable (P < 0.05). Notably, BRI demonstrated the strongest association in both men (highest quartile VS lowest quartile; PR = 3.14, 95%CI, 2.49, 3.96; P < 0.001) and women (PR = 4.63, 95%CI, 3.81, 5.62; P < 0.001). Receiver operating characteristic analysis indicated that AUC for the different anthropometric indices ranged from 0.50 to 0.80. BRI and WHtR had the largest AUC in both males (both AUC = 0.733; 95% CI, 0.717, 0.750) and females (both AUC = 0.773; 95% CI, 0.761, 0.786). The optimal cut-off points for BRI, determined by maximizing the Youden's index, were 3.102 (sensitivity: 63.2%, specificity: 36.2%) in males and 3.136 (sensitivity: 68.9%, specificity: 44.2%) in females. Moreover, BRI and WHtR exhibited the highest diagnostic accuracy in younger age groups, specifically those aged 18-34 in both sexes.

CONCLUSIONS

BRI emerged as the optimal predictor and independent determinant of the MONW phenotype, regardless of gender. This association was particularly pronounced in young individuals.

The association between dietary inflammatory index with some cardio-metabolic risk indices among the patients with type 2 diabetes from Hoveyzeh cohort study: a cross-sectional study

BACKGROUND

The dietary inflammatory index (DII) serves as a tool to assess the inflammatory impact of an individual's diet. This study aimed to investigate the association between DII and some cardio-metabolic risk indices among patients with T2DM.

METHODS

Data from the Hoveyzeh Cohort Study, encompassing 2045 adults with T2DM, were analyzed. DII scores were calculated based on food frequency questionnaires. Anthropometric measurements and biochemical tests were performed to assess cardio-metabolic risk factors.

RESULTS

Higher DII scores were positively associated with elevated triglyceride levels, triglyceride-glucose (TyG) index, lipid accumulation product (LAP), anthropometric indices including a body shape index (ABSI), body roundness index (BRI), body mass index (BMI), hip, waist circumferences (WC), and waist-to-height ratio (all Ptrend < 0.05). Notably, no significant association was observed between DII and fasting blood sugar (FBS) levels (Ptrend > 0.05). Additionally, dietary intake analysis revealed a negative correlation between DII scores and intake of fiber, fruits, vegetables, legumes, fish, seafood, dairy products, magnesium, and vitamins A, C, D, and E (all Ptrend < 0.05). Conversely, higher DII scores were associated with increased consumption of red meat, processed meat, refined cereals, potatoes, and soft drinks (all Ptrend < 0.05).

CONCLUSION

This study underscores the critical link between dietary inflammation, assessed by the DII score, and a multitude of cardio-metabolic risk factors in patients with T2DM. Notably, while the study did not find a significant association between DII and fasting blood sugar levels, it identified robust associations with novel anthropometric and biochemical indices indicative of cardio-metabolic risk. These findings highlight the potential of dietary interventions as a cornerstone strategy for managing T2DM and mitigating its associated complications.

Non-linear relationship between the body roundness index and metabolic syndrome: data from National Health and Nutrition Examination Survey (NHANES) 1999-2018

Obesity is an important characteristic manifestation of metabolic syndrome (MetS), and body roundness index (BRI) is one of the anthropometric indicators associated with obesity. However, studies on the relationship between BRI and MetS risk are limited. We aimed to explore the relationship between baseline BRI and MetS in the USA population. Our study used data from the National Health and Nutrition Examination Survey from 1999 to 2018, ultimately enrolling and analysing 47 303 participants. Data-driven tertiles were used to categorise BRI levels, and multivariate logistic regression models were fitted to investigate the association of BRI with MetS in adults. In addition, receiver operating characteristic curve analysis was used to assess the ability of BRI to predict MetS. The distribution of BRI was different across ethnic groups with a gradual decrease in the proportion of non-Hispanic Whites and other races. In addition, BRI was significantly associated with traditional cardiovascular risk factors. Univariate regression analysis indicated BRI to be a moderate risk factor for MetS, and multivariate logistic regression analysis found that BRI remained an independent risk factor for MetS. After adjusting for confounding variables, a non-linear relationship was found between BRI levels and the prevalence of MetS. More importantly, BRI predicted MetS with the largest AUC among anthropometric measures. In summary, elevated baseline BRI levels are independently associated with the development of MetS, and baseline BRI may assist in identifying patients at risk for MetS, leading to early and optimal treatment to improve their outcomes.

Association between body roundness index and overactive bladder: results from the NHANES 2005-2018

BACKGROUND AND AIM

An increasing amount of research has indicated obesity greatly affects individuals with overactive bladder (OAB). However, traditional anthropometric methods present challenges in accurately assessing the likelihood of OAB. Hence, this study's objective was to identify the correlation between the body roundness index (BRI) and OAB.

METHODS

The research included 12,401 individuals who participated in the National Health and Nutrition Examination Survey spanning 2005-2018. The correlation between BRI and OAB was explored by using weighted multiple logistic regression and weighted restricted cubic spline (RCS). Subgroup analyses showed the associations based on different population types. The study also analyzed the predictive capability of various anthropometric indices, including BRI, body mass index, waist circumference, and weight, in assessing the likelihood of OAB through Receiver-operating characteristic (ROC) curves.

RESULTS

An independent positive correlation between OAB and BRI was identified after adjusting for potential confounders in weighted multivariate logistic models[odds ratio (OR) = 1.15, 95% confidence interval (CI), 1.12-1.17]. Weighted RCS analysis found a positive dose-response correlation between OAB and BRI. The effect size of BRI on OAB remained stable across all prespecified subgroups (all P for interactions > 0.05). In ROC analysis, BRI showed better discriminatory ability for OAB compared with other anthropometric measures for both genders (all P < 0.01). The best BRI cutoff for predicting OAB was lower for men (5.151) than for women (5.383), suggesting that men were more susceptible to changes in BRI than women.

CONCLUSIONS

This study demonstrated that a raised BRI is correlated with a higher likelihood of OAB. Due to the effectiveness and non-invasiveness of BRI in predicting OAB, it is expected to become the preferred method for early detection and management strategies.

Association between body roundness index (BRI) and gallstones: results of the 2017-2020 national health and nutrition examination survey (NHANES)

BACKGROUND

Gallstones are associated with obesity, and the BRI is a new obesity index that more accurately reflects body fat and visceral fat levels. The relationship between BRI and gallstone risk is currently unknown, and we aimed to explore the relationship between BRI and gallstone prevalence.

METHODS

A cross-sectional study was conducted utilizing data from the 2017-2020 NHANES involving a total of 5297 participants. To assess the association between BRI and gallstones, we used logistic regression analysis, subgroup analysis, and interaction terms. In addition, we performed restricted cubic spline (RCS) analysis and threshold effects analysis to characterize nonlinear relationships. We assessed the ability of BRI and Body mass index (BMI) to identify gallstones using receiver operating curve (ROC) analysis and area under the curve (AUC), and compared them using the Delong test.

RESULTS

Of the 5297 participants aged 20 years and older included in the study, 575 had gallstones. In fully adjusted models, a positive association between BRI and gallstone prevalence was observed (OR = 1.16, 95% CI: 1.12-1.20, P < 0.0001). Individuals in the highest quartile of BRI had a 204% increased risk of gallstones compared with those in the lowest quartile (OR = 3.04, 95% CI: 2.19-4.22, P < 0.0001). The correlation between BRI and gallstones persisted in subgroup analyses. RCS analyses showed a nonlinear relationship between BRI and gallstones. The inflection point was further found to be 3.96, and the correlation between BRI and gallstones was found both before and after the inflection point. ROC analysis showed that BRI (AUC = 0.667) was a stronger predictor of gallstones than BMI (AUC = 0.634).

CONCLUSIONS

Elevated BRI is associated with an increased risk of gallstones in the U.S. population, and BRI is a stronger predictor of gallstones than BMI. Maintaining an appropriate BRI is recommended to reduce the incidence of gallstones.

The association between frailty and body composition among the elderly: Birjand Longitudinal Aging Study (BLAS)

Background

This study aims to assess the possible relationship between frailty and anthropometric indices in older adults using data from the first phase of the Birjand Longitudinal Aging Study (BLAS).

Methods

In this cross-sectional study, we assessed the association between frailty (Frailty index (FI) and Fried frailty phenotype) and body composition indices in 1364 participants aged ≥ 60 years (September 2018 to April 2019). Analysis was conducted using one-way ANOVA and ordinal logistic regression.

Results

Participants were categorized as frail (n = 164), non-frail (n = 415), and pre-frail (n = 785) based on FI. A significant positive association was observed between the frailty and body mass index (BMI) (OR: 1.04, 95% CI:1.01- 1.07), waist circumference (WC) (OR: 1.02, 95% CI: 1.01- 1.03), waist-to-hip ratio (WHR) (OR: 2.36, 95% CI 1.05- 5.27) and waist-to-height ratio (WHtR) (OR: 1.27, 95%CI: 1.09- 1.47). Body shape index, body roundness index, and body adiposity index showed no significant association with frailty. Moreover, a BMI greater than 29 kg/m2 increased the odds of frailty and prefrailty by 79% (OR = 1.79, 95%CI = 1.30- 2.46, P < 0.001).

Conclusion

Results of this study showed that the risk of frailty increases as BMI and abdominal obesity indices increase. Therefore, BMI and abdominal obesity indices (WC, WHR, and WHtR) could serve as suitable tools for evaluating frailty in the elderly. However, additional studies are needed to evaluate the utility of the newly developed anthropometric indices in older adults.

Association between body roundness index and prevalence of kidney stone in the U.S: a study based on the NHANES database

OBJECTIVE

This study aimed to evaluate the potential association between the body roundness index (BRI) and kidney stone prevalence in adults in the United States.

METHODS

A cohort of participants from the National Health and Nutrition Examination Survey (NHANES) database spanning 2007-2018 were gathered for analysis. Logistic regression analyses, subgroup assessments, and calculations were employed to examine the potential link between BRI and kidney stone prevalence.

RESULTS

The study included 30,990 participants aged > 20 years, of which 2,891 declared a kidney stone history. After modulating all relevant confounding factors, each unit increase in the BRI was linked to a 65% increase in kidney stone prevalence (OR = 1.65, 95% CI: 1.47, 1.85). Sensitivity analyses conducted by categorizing the BRI into three groups revealed a 59% increase in kidney stone prevalence in the highest tertile BRI group compared to the lowest one (OR = 1.59, 95% CI: 1.42, 1.79). Furthermore, dose-response curves depicted a positive near-linear correlation between the BRI and the risk of kidney stone prevalence.

CONCLUSION

These findings suggest a clinically noteworthy positive correlation between higher BRI values and kidney stone prevalence among the studied US adult population. However, it is essential to acknowledge that the observed relationship does not establish a causal link.

Association between six different types of anthropometric indices and arterial stiffness measured by brachial-ankle pulse wave velocity in hypertensive Chinese adults

Background

The associations of body fat parameters with arterial stiffness measured by brachial-ankle pulse wave velocity in hypertensive patients were scarce.

Methods

This cross-sectional study analyzed 4322 hypertensive adults. The correlations between the anthropometric indexes (body mass index [BMI], waist circumference, waist-tohip ratio [WHR], waist-to-height ratio [WHtR], a body shape index [ABSI], body round index [BRI]) and ba-PWV values were analyzed using multivariable linear regression model.

Results

In both sex categories, linear regression models showed that BMI levels were inversely related to baPWV (adjusted-β per SD increase in male: -0.51, 95% CI -0.66 to -0.36, P < 0.001; female: -0.50, 95% CI -0.63 to -0.37, P < 0.001). Waist circumference positively correlated with baPWV only in male hypertensive individuals. BaPWV positively correlated to WHR or WHtR levels (adjusted-β per SD increase: 0.32, 95% CI 0.21 to 0.43, P < 0.001; 0.64, 95% CI 0.47 to 0.82, P < 0.001; respectively), ABSI (adjusted-β per SD increase for ABSI × 100: 0.27, 95% CI 0.18 to 0.36, P < 0.001) and BRI (adjusted-β per SD increase: 0.64, 95% CI 0.46 to 0.81, P < 0.001) levels. The relationship between anthropometric indices and arterial stiffness based on baPWV values were also consistent. ABSI had the highest predictive power of arterial stiffness (area under the curve, 0.594; P < 0.001).

Conclusion

In Chinese adults with hypertension, BMI was inversely related to baPWV, while WHR, WHtR, ABSI and BRI were positively related. Waist circumference positively correlated with baPWV only in male hypertensive individuals.

Novel anthropometric indices for predicting type 2 diabetes mellitus

BACKGROUND

This study aimed to compare anthropometric indices to predict type 2 diabetes mellitus (T2DM) among first-degree relatives of diabetic patients in the Iranian community.

METHODS

In this study, information on 3483 first-degree relatives (FDRs) of diabetic patients was extracted from the database of the Endocrinology and Metabolism Research Center of Isfahan University of Medical Sciences. Overall, 2082 FDRs were included in the analyses. A logistic regression model was used to evaluate the association between anthropometric indices and the odds of having diabetes. Furthermore, a receiver operating characteristic (ROC) curve was applied to estimate the optimal cutoff point based on the sensitivity and specificity of each index. In addition, the indices were compared based on the area under the curve (AUC).

RESULTS

The overall prevalence of diabetes was 15.3%. The optimal cutoff points for anthropometric measures among men were 25.09 for body mass index (BMI) (AUC = 0.573), 0.52 for waist-to-height ratio (WHtR) (AUC = 0.648), 0.91 for waist-to-hip ratio (WHR) (AUC = 0.654), 0.08 for a body shape index (ABSI) (AUC = 0.599), 3.92 for body roundness index (BRI) (AUC = 0.648), 27.27 for body adiposity index (BAI) (AUC = 0.590), and 8 for visceral adiposity index (VAI) (AUC = 0.596). The optimal cutoff points for anthropometric indices were 28.75 for BMI (AUC = 0.610), 0.55 for the WHtR (AUC = 0.685), 0.80 for the WHR (AUC = 0.687), 0.07 for the ABSI (AUC = 0.669), 4.34 for the BRI (AUC = 0.685), 39.95 for the BAI (AUC = 0.583), and 6.15 for the VAI (AUC = 0.658). The WHR, WHTR, and BRI were revealed to have fair AUC values and were relatively greater than the other indices for both men and women. Furthermore, in women, the ABSI and VAI also had fair AUCs. However, BMI and the BAI had the lowest AUC values among the indices in both sexes.

CONCLUSION

The WHtR, BRI, VAI, and WHR outperformed other anthropometric indices in predicting T2DM in first-degree relatives (FDRs) of diabetic patients. However, further investigations in different populations may need to be implemented to justify their widespread adoption in clinical practice.

Abdominal obesity as assessed by anthropometric measures associates with urinary incontinence in females: findings from the National Health and Nutrition Examination Survey 2005-2018

BACKGROUND

Urinary incontinence (UI) is significantly link to abdominal obesity. This study aimed to assess the association between anthropometric indices of abdominal obesity, including body roundness index (BRI), conicity index (CI), and waist-to-height ratio (WHtR), and UI risk in adult females.

METHODS

We analyzed data from 10, 317 adult females in the National Health and Nutrition Examination Survey (NHANES) database (2005-2018). Weighted multivariable-adjusted regression analysis was conducted to determine the odds ratio (OR) and 95% confidence intervals (CI) for the association between BRI, CI, WHtR, and UI. Stratified analyses revealed the association based on the population type. Receiver operating characteristic curve (ROC) analyses were used to assess the predictive value of UI.

RESULTS

All indices of abdominal obesity investigated were positively and independently associated with the prevalence and severity of three types of UI. After adjusting for all relevant confounding variables, a significantly positive association between BRI and the prevalence of UI were observed (OR quartile 4 vs. quartile 1: urge UI (UUI): 1.93, 95% CI 1.61-2.30; stress UI (SUI): 2.29, 95% CI 1.94-2.70; mixed UI (MUI): 2.26, 95% CI 1.82-2.82; all P < 0.0001, P for trend < 0.0001, respectively), as well as WHtR and CI, which particularly prominent for female in premenopausal. Moreover, a one-unit increment of BRI was significantly associated with an increased severity index of UUI (β: 0.06, 95% CI 0.04-0.09, P < 0.0001), SUI (β: 0.10, 95% CI 0.07-0.13, P < 0.0001) and MUI (β: 0.07, 95% CI 0.04-0.10, P < 0.0001), which this trend was also observed in each subtype of UI for WHtR and CI. Furthermore, the ROC analysis demonstrated a higher diagnostic efficacy of BRI and WHtR compared with BMI in discriminating UI with an AUC of 0.600 for SUI, 0.617 for UUI, and 0.622 for MUI (all P < 0.05).

CONCLUSIONS

An increased BRI, CI, and WHtR are significantly associated with higher prevalence and severity of UI in females.

Comparison of seven anthropometric indexes to predict hypertension plus hyperuricemia among U.S. adults

Purpose

This study aims to compare the association of hypertension plus hyperuricemia (HTN-HUA) with seven anthropometric indexes. These include the atherogenic index of plasma (AIP), lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride-glucose index (TyG), body roundness index (BRI), a body shape index (ABSI), and the cardiometabolic index (CMI).

Methods

Data was procured from the National Health and Nutrition Examination Survey (NHANES), which recruited a representative population aged 18 years and above to calculate these seven indexes. Logistic regression analysis was employed to delineate their correlation and to compute the odds ratios (OR). Concurrently, receiver operating characteristic (ROC) curves were utilized to evaluate the predictive power of the seven indexes.

Results

A total of 23,478 subjects were included in the study. Among these, 6,537 (27.84%) were patients with HUA alone, 2,015 (8.58%) had HTN alone, and 2,836 (12.08%) had HTN-HUA. The multivariate logistic regression analysis showed that the AIP, LAP, VAI, TyG, BRI, ABSI, and CMI were all significantly associated with concurrent HTN-HUA. The OR for the highest quartile of the seven indexes for HTN-HUA were as follows: AIP was 4.45 (95% CI 3.82-5.18), LAP was 9.52 (95% CI 7.82-11.59), VAI was 4.53 (95% CI 38.9-5.28), TyG was 4.91 (95% CI 4.15-5.80), BRI was 9.08 (95% CI 7.45-11.07), ABSI was 1.71 (95% CI 1.45 -2.02), and CMI was 6.57 (95% CI 5.56-7.76). Notably, LAP and BRI demonstrated significant discriminatory abilities for HTN-HUA, with area under the curve (AUC) values of 0.72 (95% CI 0.71 - 0.73) and 0.73 (95% CI 0.72 - 0.74) respectively.

Conclusion

The AIP, LAP, VAI, TyG, BRI, ABSI, and CMI all show significant correlation with HTN-HUA. Notably, both LAP and BRI demonstrate the capability to differentiate cases of HTN-HUA. Among these, BRI is underscored for its effective, non-invasive nature in predicting HTN-HUA, making it a superior choice for early detection and management strategies.

Association between body roundness index and risk of ultrasound-defined non-alcoholic fatty liver disease

Objectives

While several indicators have been studied, the association of body roundness index (BRI) with non-alcoholic fatty liver disease (NAFLD) remains unclear. We aimed to explore the association between BRI and ultrasound-defined NAFLD.

Methods

The sample dataset was extracted from the National Health and Nutrition Examination Survey (NHANES) during the period of 2017-2018. The diagnosis of NAFLD was determined based on the controlled attenuated parameter (CAP≥248 dB/m) score of liver ultrasound transient elastography (LUTE). Participants with excessive alcohol use and viral hepatitis were excluded. To delve deeper into the relationship, Multivariable logistic regression with adjustment for confounding variables and smoothing curve analysis was used to investigate the association and nonlinear relationships between BRI and NAFLD.

Results

Among 4210 individuals aged 20 years or older included in the study, 28.2 % had NAFLD. Compared to the first tertile, BRI notably increased the risk of NAFLD 3.53-fold [95 % confidence interval (CI) = 2.73-4.57] in the second tertile and 7.00-fold (95%CI = 5.29-9.27) in the third tertile after adjusting for multiple covariates (P for trend <0.001). Furthermore, when BRI was treated as a continuous variable, one unit of increment in BRI was associated with 41 % higher odds of NAFLD [adjusted odds ratio (aOR) = 1.41; 95%CI = 1.34-1.48; P < 0.001]. The associations of BRI with NAFLD persisted in all subgroup analyses. A smoothing curve fitting demonstrated that the relationship between BRI and NAFLD was a nonlinear connection. The risk of NAFLD increased significantly when BRI was lower than 4.82, after which the curve showed a modest ascent.

Conclusion

Higher BRI was consistently associated with an increased risk of NAFLD in US adults. BRI is a risk factor for NAFLD, and there is an imperative to give more attention to lowering the BRI.

The association between the body roundness index and the risk of colorectal cancer: a cross-sectional study

BACKGROUND

Colorectal cancer (CRC), has a link between obesity, especially visceral fat. The body roundness index (BRI) can more accurately assess body fat and visceral fat levels. It is, however, unknown whether BRI is associated with CRC risk.

METHODS

53,766 participants were enrolled from the National Health and Nutrition Examination Survey (NHANES). Analysing the corelation between BRI and CRC risk was performed using logistic regression. Stratified analyses revealed the association based on the population type. Receiver operating characteristic curve (ROC) was performed for predicting CRC risk using different anthropometric indices.

RESULTS

The risk of CRC mounting apparently with elevated BRI for participants with CRC compared to normal participants (P-trend < 0.001). The association persisted even after adjusting for all covariates (P-trend = 0.017). In stratified analyses, CRC risk increased with increasing BRI, especially among those who were inactive (OR (95% CI): Q3 3.761 (2.139, 6.610), P < 0.05, Q4 5.972 (3.347, 8.470), P < 0.01), overweight (OR (95% CI): Q3 2.573 (1.012, 7.431), P < 0.05, Q4 3.318 (1.221, 9.020), P < 0.05) or obese (OR (95% CI): Q3 3.889 (1.829, 8.266), P < 0.001, Q4 4.920 (2.349, 10.308), P < 0.001). ROC curve showed that BRI had a better ability in forecasting the risk of CRC than other anthropometric indices such as body weight etc. (all P < 0.05).

CONCLUSIONS

CRC risk and BRI have a positive and significant relationship, particularly in inactive participants with BMI ≥ 25 kg/m². It is hoped that these results will raise awareness of the importance of reducing visceral fat deposition.

Sex difference in the associations among obesity-related indices with incidence of diabetes mellitus in a large Taiwanese population follow-up study

Background

Obesity is a major risk factor for diabetes mellitus (DM), which is in turn a major risk factor for cardiovascular diseases such as coronary artery disease and stroke. As few studies have investigated sex differences in the association between obesity and incidence of DM, the aim of this longitudinal study was to explore this issue in a large group of Taiwanese participants.

Methods

A total of 24,346 participants were enrolled in this study, of whom 8,334 (mean age, 50.6 ± 11.0 years) were male and 16,012 (mean age, 50.5 ± 10.1 years) were female. The following obesity-related indices were studied: body mass index, waist-to-height ratio, waist-to-hip ratio (WHR), body roundness index, conicity index (CI), body adiposity index, abdominal volume index, lipid accumulation product (LAP), and visceral adiposity index (VAI).

Results

The analysis showed significant associations between all of these indices with incidence of DM (all p < 0.001). In the male participants, the strongest predictors for incidence of DM were LAP (AUC = 0.692), WHtR (AUC = 0.684), and WHR (AUC = 0.683). In the female participants, the strongest predictors were LAP (AUC = 0.744), WHtR (AUC = 0.710) and VAI (AUC = 0.710), followed by BRI (AUC = 0.708).

Conclusion

Strong associations were found between the studied obesity-related indices and incidence of DM, and sex differences were found. Hence, to better control DM, reducing body weight may be beneficial in addition to lifestyle modifications, diet control, and pharmacological interventions.

Association between a body shape index and abdominal aortic calcification in general population: A cross-sectional study

Background

The association between a body shape index (ABSI) and abdominal aortic calcification (AAC) is still unclear, so we tried to prove the association between ABSI and AAC in the general population in this cross-sectional study.

Materials and methods

After excluding participants with missing data on height, weight, waist circumference (WC), and AAC, we finally selected 3,140 participants aged 40-80 years from the 2013-2014 National Health and Nutrition Examination Survey. Using multivariate logistic regression and receiver operating characteristic (ROC) curves to test the association between ABSI and AAC.

Results

Participants (median age: 58.0 years; 48.3% men) were divided into two groups by the optimal cutoff point of ABSI: higher ABSI (> 0.84) and lower ABSI (≤ 0.84). Participants with higher ABSI showed significantly higher proportion of AAC than those with lower ABSI (39.8 vs. 23.7%, P < 0.001). Participants with higher ABSI had an increased risk of developing AAC in crude model (ABSI as a continuous variable: OR = 2.485, 95% CI: 2.099-2.942, P < 0.001; as a categorical variable: OR = 2.132, 95% CI: 1.826-2.489, P < 0.001), and ABSI was still independently associated with AAC in all adjusted models (all P < 0.05). Further subgroup analyses showed that higher ABSI was consistently associated with AAC in subgroups with sex (male or female), age (≤ 65 or > 65 years), smoking history (yes or no), hypertension (yes or no), diabetes (yes or no), sleep disorder (yes or no), body mass index (BMI) (< 23 or ≥ 23 kg/m²), systolic blood pressure (< 140 or ≥ 140 mmHg), diastolic blood pressure (< 90 or ≥ 90 mmHg), fasting plasma glucose (< 126 or ≥ 126 mg/dL), and low-density lipoprotein cholesterol (≤ 130 or > 130 mg/dL) (P for interaction > 0.05). While in other subgroups, the association was no longer synchronized. The ROC showed that the area under the curve of ABSI was significantly higher than height, weight, BMI, WC, and waist-to-height ratio (WHtR).

Conclusion

Higher ABSI was closely associated with higher risk of AAC, and discriminant ability of ABSI for AAC was significantly higher than height, weight, BMI, WC, and WHtR.

Associations of Body-Roundness Index and Sarcopenia with Cardiovascular Disease among Middle-Aged and Older Adults: Findings from CHARLS

OBJECTIVES

Sarcopenia and obesity may contribute to chronic disease. However, little is known about the association between sarcopenia, body roundness index (BRI), and cardiovascular disease (CVD). The aim of this study was to investigate the association of sarcopenia and BRI with CVD in middle-aged and older Chinese population.

DESIGN

Cohort study with an 8-year follow-up.

SETTING AND PARTICIPANTS

Data were derived from 4 waves of the China Health and Retirement Longitudinal Study, and 6152 participants aged 45 or above were included in the study.

METHODS

Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. CVD was defined as the presence of physician-diagnosed heart disease, diabetes and/or stroke. The associations of BRI and sarcopenia with CVD risk were explored using Cox proportional hazards regression models.

RESULTS

The mean age of the participants was 58.3 (8.9) years, and 2936 (47.7%) were males. During the 8 years follow-up, 2385 cases (38.8%) with incident CVD were identified. Longitudinal results demonstrated that compared to neither sarcopenia or high BRI, both sarcopenia and high BRI (HR: 1.49, 95%CI: 1.08, 2.07) were associated with higher risk of CVD. In the subgroup analysis, individuals with both sarcopenia and high BRI were more likely to have new onset stroke (HR: 1.93, 95%CI: 1.12, 3.32) and increased risk of multimorbidity (HR: 2.15, 95% CI: 1.14, 4.04).

CONCLUSIONS

Coexistence of sarcopenia and high BRI was associated with higher risk of CVD. Early identification and intervention for sarcopenia and BRI not only allows the implementation of therapeutic strategies, but also provides an opportunity to mitigate the risk of developing CVD.

Data mining approaches for type 2 diabetes mellitus prediction using anthropometric measurements

BACKGROUND

The aim of this study was to evaluate the anthropometric measurements most associated with type 2 diabetes mellitus (T2DM) using machine learning approaches.

METHODS

A prospective study was designed for a total population of 9354 (43% men and 57% women) aged 35-65. Anthropometric measurements include weight, height, demispan, Hip Circumference (HC), Mid-arm Circumference (MAC), Waist Circumference (WC), Body Roundness Index (BRI), Body Adiposity Index (BAI), A Body Shape Index (ABSI), Body Mass Index (BMI), Waist-to-height Ratio (WHtR), and Waist-to-hip Ratio (WHR) were completed for all participants. The association was assessed using logistic regression (LR) and decision tree (DT) analysis. Receiver operating characteristic (ROC) curve was performed to evaluate the DT's accuracy, sensitivity, and specificity using R software.

RESULTS

Traditionally, 1461 women and 875 men with T2DM (T2DM group). According to the LR, in males, WC and BIA (p-value < 0.001) and in females, demispan and WC (p-value < 0.001) had the highest correlation with T2DM development risk. The DT indicated that WC has the most crucial effect on T2DM development risk, followed by HC, and BAI.

CONCLUSIONS

Our results showed that in both men and women, WC was the most important anthropometric factor to predict T2DM.

Relationship between body roundness index and the risk of heart failure in Chinese adults: the Kailuan cohort study

AIMS

Body roundness index (BRI) is an obesity-related anthropometric index that combines waist circumference and height to better reflect body fat. This study aims to prospectively explore the relationship between BRI and the risk of heart failure (HF) based on a community-based cohort.

METHODS AND RESULTS

A total of 140 362 individuals without tumour and HF at baseline were included from the Kailuan cohort study. Their demographic information, anthropometric parameters, and biochemical indexes were collected or measured. The participants were followed up until 31 December 2016 or death or diagnosed with HF, whichever came first. Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident HF. Restricted cubic spline analysis was applied to further evaluate the possible non-linear dose-response relationship between BRI and the risk of HF. After a median follow-up period of 9.84 years, we identified 1990 HF events. The participants were grouped into four groups according to the quartiles of BRI (Q1: ≤2.93, Q2: 2.93-3.59, Q3: 3.59-4.38, and Q4: ≥4.38). After adjustment for potential confounders, compared with the group of participants in the lowest quartile of BRI, the adjusted HRs (95%CI) were 1.03 (95%CI: 0.87-1.22), 1.27 (95%CI: 1.07-1.49), and 1.50 (95%CI: 1.26-1.78) for subjects in the Q2, Q3, and Q4 groups, respectively. With each standard deviation (here is 1.10) of BRI increasing, the risk of HF increased by 18% (HR: 1.18, 95%CI: 1.12-1.24). Subgroup analysis indicated that the association between BRI and HF was more prominent in younger people (HR: 2.94, 95%CI: 1.80-4.80) than older (HR: 1.89, 95%CI: 1.57-2.27) (P for interaction < 0.001). A significant linear dose-response relationship between BRI and HF was also observed (P for non-linearity = 0.730).

CONCLUSIONS

Our study suggests that higher BRI is associated with an increased risk of HF. If these findings can be replicated in other populations, future studies need to examine whether lowering the BRI may lower the risk of incident HF.

The association of interleukin-6, interleukin-27, and body roundness index with gestational diabetes mellitus

We aimed to investigate the relationship between GDM and IL-27, IL-6, and body roundness index (BRI), a new anthropometric measurement more sensitive than BMI in identifying obesity and predicting cardiometabolic outcomes. We enrolled 80 patients, 40 pregnant women with GDM and 40 healthy pregnant women at midgestation. The women's anthropometric measurements were recorded and serum markers and IL-6, IL-27 were analysed. At the time of delivery maternal, neonatal results were recorded. Women with GDM had significantly higher pregestational, midgestational and prepartum BMI and midgestational BRI; HOMA-IR; HbA1c; and IL-6 values and lower HDL values (p < .05). There was no statistically significant difference in IL-27 values between the groups (p = .939). In multivariate logistic regression analysis, HbA1c, IL-6 (>4.886 pg/mL), and BRI (>6.708) were found as independent risk factors associated with GDM (p < .05). Mean BRI was significantly associated with obesity (p < .001) and BRI higher than 6.708 was found to have 67.5% sensitivity and 80% specificity in the prediction of GDM. Women with GDM had elevated IL-6 levels, but no relationship was detected between IL-27 and GDM. BRI is a new anthropometric index that strongly correlated with BMI and seems to be a reliable alternative to BMI for the evaluation of obesity in GDM patients.IMPACT STATEMENTWhat's already known on this subject? Gestational diabetes mellitus (GDM) is the most common systemic disease in pregnancy. The risk of GDM was 3 times higher in obese pregnant women compared to normal weighted patients. IL-6 is an adipose-derived cytokine that was found to be associated with GDM. The body roundness index (BRI) is a new sensitive anthropometric index for detecting obesity and its secondary cardiometabolic results.What do the results of this study add? Our results showed that BRI was strongly correlated with obesity in GDM patients. HbA1c, IL-6 and BRI were found as independent risk factors associated with GDM. IL 27, a cytokine associated with inflammatory diseases, was not associated with GDM.What are the implications of these findings for clinical practice and/or further research? BRI could be a reliable alternative to BMI for the evaluation of obesity in pregnant women and predicting cardiometabolic outcomes.

Evaluation of anthropometric indices as a predictor of diabetes in Dong and Miao ethnicities in China: A cross-sectional analysis of China Multi-Ethnic Cohort Study

BACKGROUND

Although it is known that obesity is inseparable from diabetes, many anthropometric indices are used for determining obesity. At the same time, research on the predictive indices of diabetes in Chinese minority populations is lacking. Therefore, this study determines the relationship between different anthropometric indices and diabetes, and identifies the best index and best cut-off values for predicting diabetes.

METHOD

In total, 11,035 Dong and Miao ethnic participants (age: 30-79 years) from the China Multi-Ethnic Cohort study were included. The logistic regression model was used to examine the relationship between the different anthropometric indices and diabetes risk. The receiver operating characteristic curve and the area under the curve (AUC) were used to identify the best predictor of diabetes.

RESULTS

In multivariate adjusted logistic regression models, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and visceral adiposity index (VAI) were positively correlated with diabetes risk. Among Chinese Dong men and women and Miao men, WHR had the largest AUC (0.654/0.719/0.651). Among Miao women, VAI had the largest AUC(0.701). The best cut-off values of WHR for Dong men and women and Miao men were 0.94, 0.92, and 0.91, respectively. The best cut-off value of VAI for Miao women was 2.20.

CONCLUSION

Obesity indicators better predict diabetes in women than men. WHR may be the best predictor of diabetes risk in both sex of Dong ethnicity and Miao men, and VAI may be the best predictor of diabetes risk in Miao women.

Body Roundness Index and Waist–Hip Ratio Result in Better Cardiovascular Disease Risk Stratification: Results From a Large Chinese Cross-Sectional Study

Background

The appropriate optimal anthropometric indices and their thresholds within each BMI category for predicting those at a high risk of cardiovascular disease risk factors (CVDRFs) among the Chinese are still under dispute.

Objectives

We aimed to identify the best indicators of CVDRFs and the optimal threshold within each BMI category among the Chinese.

Methods

Between 2012 and 2020, a total of 500,090 participants were surveyed in Hunan, China. Six anthropometric indices including waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), waist–hip ratio (WHR), hip circumference (HC), and waist–height ratio (WHtR) were evaluated in the present study. Considered CVDRFs included dyslipidaemia, hypertension, diabetes mellitus (DM), and chronic kidney disease (CKD). The associations of anthropometrics with CVDRFs within each BMI category were evaluated through logistic regression models. The area under the receiver operating characteristic curve (AUROC) was used to assess the predictive abilities.

Results

For the presence of at least one CVDRFs, the WHR had the highest AUROC in overweight [0.641 (95%CI:0.638, 0.644)] and obese [0.616 (95%CI:0.609, 0.623)] men. BRI had the highest AUROC in underweight [0.649 (95%CI:0.629, 0.670)] and normal weight [0.686 (95%CI:0.683, 0.690)] men. However, the BRI had the highest discrimination ability among women in all the BMI categories, with AUROC ranging from 0.641 to 0.727. In most cases, the discriminatory ability of WHtR was similar to BRI and was easier to calculate; therefore, thresholds of BRI, WHR, and WHtR for CVDRFs identification were all calculated. In men, BRI thresholds of 1.8, 3.0, 3.9, and 5.0, WHtR thresholds of 0.41, 0.48, 0.53, and 0.58, and WHR thresholds of 0.81, 0.88, 0.92, and 0.95 were identified as optimal thresholds across underweight, normal weight, overweight, and obese populations, respectively. The corresponding BRI values in women were 1.9, 2.9, 4.0, and 5.2, respectively, and WHtR were 0.41, 0.48, 0.54, and 0.59, while the WHR values were 0.77, 0.83, 0.88, and 0.90. The recommended BRI, WHtR, or WHR cut-offs could not statistically differentiate high-risk CKD or hypercholesterolemia populations.

Conclusions

We found that BRI and WHR were superior to other indices for predicting CVD risk factors, except CKD or hypercholesterolemia, among the Chinese.

Non-linear relationship between the body roundness index and incident type 2 diabetes in Japan: a secondary retrospective analysis

Background

Body roundness index (BRI) is one of the obesity-related anthropometric indices. However, studies on the relationship between BRI and diabetes risk is limited. The purpose of this study was to explore the relationship between baseline BRI and incident type 2 diabetes mellitus (T2DM) in the Japanese population.

Methods

A retrospective longitudinal study of 15,310 participants in a physical examination program at Murakami Memorial Hospital in Japan from 2004 to 2015. The association between BRI levels and incident T2DM was analyzed by Cox proportional-hazards regression, smooth curve fitting, subgroup analyses, and a set of sensitivity analyses. Receiver operating characteristic curve analysis was used to assess the ability of BRI to predict diabetes.

Result

Baseline BRI levels were elevated in participants who developed T2DM. Baseline BRI levels were positively associated with incident T2DM after adjusting confounding variables (HR = 1.570, 95% CI 1.360–1.811). Additionally, we did a set of sensitivity analyses to ensure the robustness of the results. There was also a non-linear relationship between BRI and incident diabetes in both genders, and the inflection point of BRI was 4.137 in females and 3.146 in males. We found a strong positive correlation between BRI and the incidence of diabetes on the right of the inflection point (Male: HR = 1.827, 95% CI 1.449–2.303; Female: HR = 4.189, 95% CI 1.862–9.421). What’s more, among the anthropometric indices, BRI showed the optimal capability to predict T2DM (Male: AUC = 0.706, 95% CI 0.674–0.738; Female: AUC = 0.735, 95% CI 0.676–0.795).

Conclusion

An elevated BRI level in baseline was independently associated with incident T2DM. Baseline BRI improves the identification of patients at risk of T2DM and may enable early and optimized therapy to improve their outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12967-022-03321-x.

Weight-to-height ratio and body roundness index are superior indicators to assess cardio-metabolic risks in Chinese children and adolescents: compared with body mass index and a body shape index

OBJECTIVE

To assess the relationship between five anthropometric indicators, which includes body mass index (BMI), weight-to-height ratio (WHtR), a body shape index (ABSI), ABSI-adolescents, and body roundness index (BRI) in Chinese children and adolescents, and select which could better predict cardio-metabolic risk factors (CMRFs).

METHODS

Cross-sectional study with 1,587 participants aged 3 to 17 years. Five anthropometric indicators were calculated according to weight, height and waist circumference (WC). Anthropometric measurements and laboratory indicators were used to diagnose CMRFs, which included hypertension, dyslipidemia, impaired fasting glucose and abdominal obesity. Partial correlation analysis was used to evaluate the relationship among anthropometric indicators, area under the receiver operating characteristic curve (AUCs) were used to compare the predict ability of each anthropometric indicators, the cut-off value, sensitivity, specificity and Youden Index of each indicator were calculated.

RESULTS

In 3-6 years old children, ABSI-adolescent positively correlated with WC (r=0.727, P<0.001), BMI (r=0.218, P<0.001) and WHtR (r=0.752, P<0.001), and in 7-17 years old participants, the correlation coefficients increased to 0.842, 0.563 and 0.850 (P<0.001), respectively. BRI were strong correlated with BMI, WHtR and ABSI-adolescents in both age group (P<0.001). In 3-6 years group, the ROC analysis showed that BMI and ABSI were significantly better in identifying hypertension in both genders, WHtR and BRI were significantly better in identifying abdominal obesity in girls, but all of them were failed in identifying dyslipidemia and hyperglycemia. In 7-17 years group, WHtR and BRI were significantly better in identifying hypertension, dyslipidemia, abdominal obesity in both genders, BMI and ABSI performed better in identifying hyperglycemia in girls.

CONCLUSIONS

In Chinese children aged 3-6 years, there is no indicator performed best in all the CMRFs, in 7-17 years old teenagers, WHtR and BRI can be recommended to identify hypertension, dyslipidemia, abdominal obesity and clustered CMRFs in both genders. However, ABSI showed weak discriminative power.

Relationship of a new anthropometric index with left ventricular hypertrophy in hypertensive patients among the Han Chinese

Background

This study aimed to assess the relationship of a new anthropometric index with left ventricular hypertrophy (LVH) in hypertensive patients among the Han Chinese.

Methods

The study is a community-based cross-sectional study that included 4639 patients with hypertension and integrated clinical and echocardiographic data. Left ventricular (LV) mass was measured by transthoracic echocardiography. LVH was diagnosed by using the criteria of left ventricular mass indexed (LVMI) over 49.2 g/m^2.7 for men and 46.7 g/m^2.7 for women. Quartiles of a body shape index (ABSI), body roundness index (BRI), waist circumference (WC), and body mass index (BMI) were used regarding LVH prevalence. The logistic regression model was used to determine the odds ratio (OR) and 95% confidence intervals (CI) of the new anthropometric index and LVH. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive ability of the obesity indices for LVH risk.

Results

The prevalence of LVH increased across quartiles for ABSI, BRI, BMI, and WC. Comparing the lowest with the highest quartile, adjusted OR (95% CI) for LVH were significantly different for BRI 3.86 (3.12–4.77), BMI 3.54 (2.90–4.31), and WC 2.29 (1.88–2.78). No association was observed for ABSI. According to ROC analysis, the area under the curve (AUC) of BRI was (AUC: 0.653, 95% CI 0.637–0.669), BMI (AUC: 0.628, 95% CI 0.612–0.644), WC (AUC: 0.576, 95% CI 0.559–0.593), ABSI (AUC: 0.499, 95% CI 0.482–0.516).

Conclusions

This study shows that LVH prevalence increased per quartile across the Han Chinese population with hypertension for ABSI, BRI, BMI, and WC. There is a significant association between BRI and LVH in hypertensive people, while ABSI was not. BRI showed potential for use as an alternative obesity measure in the assessment of LVH.

Four-year changes in central fatness, risk of diabetes, and metabolic control in older adults: a cohort study with mediation analysis

BACKGROUND/AIMS

Older adults are vulnerable to central obesity, while the association of changes in central fatness with risk of diabetes and metabolic control has not been investigated among this particular population. This study was aimed to address these issues.

METHODS

A total of 1,815 adults aged ≥ 60 years without diabetes at baseline were followed for 4 years. Incident diabetes was ascertained based on plasma glucose, hemoglobin A1c, medical history, and/or the use of anti-diabetic drugs. Central fatness was assessed by waist circumference (WC), waist-height ratio (WHtR), and body roundness index (BRI). Logistic regression analyses were used to assess the association of changes in central fatness with risk of diabetes, along with dose-response and mediation analyses.

RESULTS

During the 4-year follow-up, 177 participants developed diabetes. The risk of diabetes was increased by 42%, 41%, and 40% per 1 standard deviation increases in WC, WHtR, and BRI, respectively, in multivariable-adjusted models (all p < 0.01). Moreover, these relationships were all linearly-shaped (all pnonlinearity ≥ 0.11). Increases in WC, WHtR, and BRI correlated with increases in hemoglobin A1c, triglycerides-and-glucose index, triglycerides, white blood cell, and C-reactive protein (all p ≤ 0.04). Yet only changes in hemoglobin A1c and triglycerides-and-glucose index were identified as the possible mediators for risk of diabetes, with their mediating effect being about 35% and 21%, respectively.

CONCLUSION

Increases in central fatness were related to elevated risk of diabetes, and this association might be partly explained by the worsening of glycemic control and insulin resistance in older adults.

Evaluation of the Association between Obesity Markers and Type 2 Diabetes: A Cohort Study Based on a Physical Examination Population

PURPOSE

To evaluate the predictive effect of different obesity markers on the risk of developing type 2 diabetes in a population of healthy individuals who underwent physical examination and to provide a reference for the early detection of individuals at risk of diabetes.

METHODS

This retrospective cohort study included 15206 healthy subjects who underwent a physical examination (8307 men and 6899 women). Information on the study population was obtained from the Dryad Digital Repository. Cox proportional risk models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of different obesity markers, including the lipid accumulation index (LAP), body mass index (BMI), waist-to-height ratio (WHtR), visceral adiposity index (VAI), and body roundness index (BRI) on the development of type 2 diabetes. The effectiveness of each obesity marker in predicting the risk of developing type 2 diabetes was analyzed using the receiver operating characteristic curve (ROC curve) and the area under the curve (AUC).

RESULTS

After a mean follow-up of 5.4 years, there were 372 new cases of type 2 diabetes. After correcting for confounding factors such as age, sex, smoking, alcohol consumption, exercise, and blood pressure, Cox proportional risk model analysis showed that elevations in BMI, LAP, WHtR, VAI, and BRI increased the risk of developing type 2 diabetes. The ROC curve results showed that LAP was the best predictor of the risk of developing diabetes, with an AUC (95% CI) of 0.759 (0.752-0.766), an optimal cutoff value of 16.04, a sensitivity of 0.72, and a specificity of 0.69.

CONCLUSION

An increase in the BMI, LAP, WHtR, VAI, and BRI can increase the risk of developing type 2 diabetes, with LAP being the best predictor of this risk.

Body Roundness Index Is a Superior Obesity Index in Predicting Diabetes Risk Among Hypertensive Patients: A Prospective Cohort Study in China

Objective: Individuals with both hypertension and diabetes have been confirmed to significantly increase the risk of cardiovascular disease morbidity and mortality compared with those with only hypertension or diabetes. This study aimed to evaluate the potential of different anthropometric indices for predicting diabetes risk among hypertensive patients. Methods: The study group consisted of 6,990 hypertensive adults without diabetes who were recruited in China. Demographic and clinical assessment, physical examinations, laboratory tests, and anthropometric measurements, including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and novel indices (ABSI, AVI, BAI, BRI, CI, WWI, and WHHR), were performed at baseline and during the (median) 3-year follow-up. Cox regression analyses were conducted to estimate effects from these indices for the onset of diabetes. Receiver operator characteristic (ROC) analyses were conducted to assess the predictive capacities of the anthropometric indices and determine the optimal cut-points. Results: A total of 816 (11.7%) developed diabetes during our prospective study. Multivariate Cox regression analyses revealed weight, WC, WHR, WHtR, BAI, BRI, and WWI as the independent risk factor for diabetes among hypertensive patients, regardless of whether it was treated as a continuous or categorical variable (P < 0.05). Further Cox analyses combining BMI and different central obesity indices showed that elevated WC, WHR, WHtR, AVI, BRI, CI, regardless of the general obesity status, were found to be each independently associated with increased diabetes risk (P < 0.05). Dynamic increases of BRI < 5.24 to BRI ≥ 5.24 were associated with increased risk (HR = 1.29; 95% CI, 1.02, 1.64), and its reversal was associated with reduced risk (HR = 1.56; 95% CI, 1.23, 1.98) compared with the others (HR = 1.95; 95% CI, 1.63, 2.32). ROC analysis indicated that the areas under the ROC curves (AUC) of the anthropometric indices ranged from 0.531 to 0.63, with BRI (cut-off value = 4.62) and WHtR having the largest area. Conclusions: Based on this novel study, BRI was the most superior predictor and independent determinant for diabetes onset among the hypertensive population. Hypertensive patients with BRI > 4.62, regardless of general obesity status, were at high risk of diabetes. Thus, the prompt screening and diagnosis of diabetes should be carried out among these patients for timely integrated intervention.

Visceral adiposity index outperforms conventional anthropometric assessments as predictor of diabetes mellitus in elderly Chinese: a population-based study

Background

This study assessed the performance of visceral adiposity index and body shape index in predicting diabetes mellitus (DM) risk and compared their predictive ability to that of body mass index and waist circumference.

Methods

Among 8249 consecutive subjects who attended the Nationwide Health Check Up System for Senior Citizens (≥ 65 years) between 2008 and 2018, we examined the associations of several adiposity indices with DM risk and explored gender differences.

Results

Among all adiposity indicators, Chinese visceral adiposity index (CVAI) demonstrated the highest discriminatory ability for diabetes mellitus with area under receiver operating characteristic curves (AUC) of 0.65, 0.68, and 0.66 for men, women, and all participants, respectively, and optimal cut-offs set as 126.09 in men and 117.77 in women. Compared with body shape index (ABSI), both CVAI and VAI were strongly associated with baseline DM (adjusted OR: 4.85, 95% CI: 4.05–5.82 and 4.22, 95% CI: 3.53–5.05 for 4th vs 1st quartile groups by CVAI and VAI, P < 0.001), which was more pronounced in older adult women (P_interaction < 0.05). Over a median of 5.25 years (IQR: 3.07–6.44 years) follow-up, Cox regression models showed higher predictive ability of CVAI and VAI compared to ABSI. Further, both CVAI and VAI independently predicted new-onset DM (adjusted HR: 1.29, 95% CI: 1.22–1.37 and 1.16, 95% CI: 1.11–1.21 by CVAI and VAI) and composite endpoint of new DM and death among those without baseline DM.

Conclusions

Our population-based data demonstrated that Chinese visceral adiposity index may serve as a superior clinical indicator of diabetes when compared with conventional anthropometric indices among older adult Chinese, especially in women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12986-021-00608-6.

Are the body shape index, the body roundness index and waist-to-hip ratio better than BMI to predict recurrent pregnancy loss?

PURPOSE

Etiology could not be determined in approximately 50% of recurrent pregnancy loss cases, and it was named unexpected recurrent pregnancy loss(URPL). A body shape index(ABSI), body roundness index(BRI), and waist-to-hip ratio(WtHR) are new indexes that are superior to BMI in showing body fat distribution. We aimed to investigate the potency of ABSI, BRI, and WtHR in URPL, their superiority to BMI, and their suitability for clinical use.

METHODS

One hundred and thirty-eight patients between the ages of 20-40 who applied to our hospital for URPL between January 2016 and December 31, 2020 were included in our study. Weight, height, waist circumference, and hip circumference were measured, and indexes were calculated. Differences between the URPL and control groups were calculated using the IBM SPSS program.

RESULTS

There was a significant difference between the two groups for BRI, ABSI, and WtHR values, while there was no significant difference in BMI. BRI(4.4 ± 1.7vs3.9 ± 1.5), ABSI(0.08 ± 0.005 vs 0.078 ± 0.004), and WtHR(0.84 ± 0.06vs0.82 ± 0.05) values were higher in the URPL group. ROC analysis showed us that BRI, ABSI, and WtHR have a diagnostic value for URPL(P < .05). When indexes were above the cutoff values, RPL risk increased 3.59 times in ABSI, 2.26 times in BRI, and 2.9 times in WtHR(P < .05).

CONCLUSIONS

The relationship between obesity and URPL can be explained more clearly by using effective indexes that show body fat distribution rather than BMI. Ethics committee approval was obtained from Erzincan Binali Yildirim University in 14.01.2021. Clinical Research Ethics Committee no: 01/01.

Are body roundness index and a body shape index in the first trimester related to foetal macrosomia?

This study investigated the effectiveness of maternal Body Roundness Index (BRI), Body Shape Index (ASBI), and Visceral Adiposity Index (VAI) in predicting foetal macrosomia and small for gestational age (SFGA) babies in obese and non-obese pregnant women. This prospective trial included 168 pregnant women (99 obese and 69 non-obese). A logistic regression model was used to identify the independent risk factors of foetal macrosomia and SFGA. BRI, waist/hip ratio, HbA1c and HOMA-IR were found to be significantly associated with increased macrosomia risk in obese women (OR = 1.469, % CI: 1.126-1.917, p = .005; OR = 4.289, % CI: 0.178-1.030, p = .012, OR = 6.277, %Cl: 1.233-31.948, p = .027, and OR = 1.393, %Cl: 1.060-1.832, p = .017). The present study indicates that first-trimester BRI and waist/hip ratio may be powerful determinants in predicting foetal macrosomia in obese pregnant women.Impact statementWhat is already known on this subject? Obesity is a major risk factor for maternal and foetal morbidity and mortality. The rate of obesity continues to increase rapidly around the world. The accuracy of ultrasound in estimated foetal weight is reduced in obese pregnant women. The Body Roundness Index (BRI) is a new anthropometric index that shows body fat distribution.What do the results of this study add? Our results show that the BRI was an independent risk factor associated with foetal macrosomia in obese pregnant women.What are the implications of these findings for future clinical practice and/or further research? BRI measurements should be taken before pregnancy to help predict shoulder dystocia, GDM, FGR and foetal macrosomia in obese women.

Clinical Usefulness of Anthropometric Indices to Predict the Presence of Prediabetes. Data from the ILERVAS Cohort

Prediabetes is closely related to excess body weight and adipose distribution. For this reason, we aimed to assess and compare the diagnostic usefulness of ten anthropometric adiposity indices to predict prediabetes. Cross-sectional study with 8188 overweight subjects free of type 2 diabetes from the ILERVAS project (NCT03228459). Prediabetes was diagnosed by levels of glycated hemoglobin (HbA1c). Total body adiposity indices [BMI, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and Deurenberg's formula] and abdominal adiposity (waist and neck circumferences, conicity index, waist to height ratio, Bonora's equation, A body shape index, and body roundness index) were calculated. The area under the receiver-operating characteristic (ROC) curve, the best cutoff and the prevalence of prediabetes around this value were calculated for every anthropometric index. All anthropometric indices other than the A body adiposity were higher in men and women with prediabetes compared with controls (p < 0.001 for all). In addition, a slightly positive correlation was found between indices and HbA1c in both sexes (r ≤ 0.182 and p ≤ 0.026 for all). None of the measures achieved acceptable levels of discrimination in ROC analysis (area under the ROC ≤ 0.63 for all). Assessing BMI, the prevalence of prediabetes among men increased from 20.4% to 36.2% around the cutoff of 28.2 kg/m², with similar data among women (from 29.3 to 44.8% with a cutoff of 28.6 kg/m²). No lonely obesity index appears to be the perfect biomarker to use in clinical practice to detect individuals with prediabetes.

Body roundness index is a superior indicator to associate with the cardio-metabolic risk: evidence from a cross-sectional study with 17,000 Eastern-China adults

Background

To investigate the ability of body shape index (ABSI), body roundness index (BRI), waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body adiposity index (BAI) for predicting non-adipose cardio-metabolic risk.

Methods

A total of 17,360 Chinese subjects aged 18–95 years old who escaped cardiovascular disease (CVD) or diabetes were recruited in the cross-sectional study. Anthropometric and biochemical parameters were assessed. Receiver operating characteristic curve (ROC) and multinomial logistic regression were conducted to examine the association of anthropometric indicators with cardio-metabolic risk factors.

Results

The mean age of subjects were 53.7(13.1) years, 41.6 % were males. The areas under the curve (AUC) demonstrated that WC, BMI, WHR, WHtR and BRI were able to predict high cardio-metabolic risk (AUC > 0.70). Meanwhile, multinomial logistic regression showed BRI was significantly associated with high cardio-metabolic risk (OR 3.27, 95% CI 3.01–3.55). The optimal cut-off values of BRI for high cardio-metabolic risk were (< 60 y: 3.49 vs. ≥60 y: 3.46) in males and (< 60 y: 3.47 vs. ≥60 y: 3.60) in females.

Conclusions

WC, BMI WHR, and WHtR were potential obesity indicators in discriminating high cardio-metabolic risk, while BAI or ABSI was not. Moreover, BRI revealed superior predictive capacity and significant association with accumulated cardio-metabolic risk factors.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12872-021-01905-x.

Relationship between Body Roundness Index and Risk of Type 2 Diabetes in Japanese Men and Women: A Reanalysis of a Cohort Study

PURPOSE

The purpose of this study was to investigate the association between body roundness index (BRI) and type 2 diabetes (T2DM) in each sex, explore the dose-response relationship between them, and evaluate the predictive value of BRI for T2DM.

MATERIALS AND METHODS

A retrospective cohort study was performed on 15,464 Japanese patients at the Murakami Memorial Hospital. Data on anthropometric indices and biochemical parameters were obtained. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) of incident T2DM associated with BRI. Dose-response relationships were evaluated using a smoothing function analysis and the threshold effect. Receiver operating characteristic curves were used to evaluate and compare the predictive values of BRI, body mass index (BMI), and waist circumference (WC) for T2DM.

RESULTS

During a median 5.4-year follow-up period, 373 subjects were diagnosed with T2DM. After adjusting for age, alcohol intake, smoking status, fatty liver, systolic blood pressure, fasting plasma glucose, glycated hemoglobin, high-density lipoprotein cholesterol, triglycerides, and total cholesterol, the relationship between BRI and T2DM was linear in women (HR (95% CI) for BRI Z score = 1.48 (1.26,1.74)) and curvilinear in men (HR (95% CI) on the left and right of the inflection point = 0.70 (0.44, 1.10) and 1.46 (1.27, 1.67), respectively). Compared with BMI (area under the curve (AUC) = 0.684; p < 0.001) and WC (AUC = 0.700; p=0.007), BRI was the strongest predictor of T2DM in men (AUC = 0.715). Similarly, the AUC of BRI was larger than that of BMI (AUC = 0.757; p=0.966) and WC (AUC = 0.733; p=0.015) in women.

CONCLUSIONS

BRI was positively linearly associated with an elevated risk of incident T2DM in women. In men, the relationship between BRI and T2DM was J-shaped. BRI is an effective indicator of predicting T2DM. Its discriminatory power was higher than that of BMI and WC in both sexes.

Predicting value of five anthropometric measures in metabolic syndrome among Jiangsu Province, China

BACKGROUND

Metabolic syndrome (MetS), a condition of metabolic disorders, is now causing large disease burden around the world. This study aimed to update the prevalence of MetS in Jiangsu Province of China and evaluate the predicting value of five anthropometric measures including waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), a body shape index (ABSI) and body roundness index (BRI) in MetS.

METHODS

8040 participants from 12 survey sites were enrolled into this cross-sectional study by multi-stage stratified cluster random sampling method from 2014 nutrition and diet investigation project in Jiangsu Province. The transformation of sex-specific z-score made the comparison meaningful when conducting the logistic analysis between anthropometric indices and MetS. The abilities of anthropometric indices to predict MetS were evaluated by the receiver operating characteristic curve (ROC). Delong test was applied to compare area under different ROC curves.

RESULTS

The prevalence of MetS in Jiangsu Province was 35.2% and the standardized prevalence was 34.8%. WC, BMI, WHtR, ABSI and BRI z-scores were positively related to MetS and its components. WC, WHtR and BRI z-score had stronger associations with MetS than BMI and ABSI in both male and female population. WC, WHtR and BRI had larger area under ROC curve than BMI and ABSI in male and female. WC in men had the largest area under the ROC curve, significantly higher than the other four measures of BMI, WHtR, ABSI and BRI (Z value = 9.08, 2.88, 16.73, 2.75 respectively). Among women, WC, WHtR and BRI had larger area under the ROC curve than BMI and ABSI, but the area under the WC, WHtR and BRI curve were not significantly different after the pairwise comparison by the Delong test. The optimal cut-off values of WC, WHtR and BRI for predicting MetS was 85.25 cm, 0.52 and 3.61 in male, 80.05 cm, 0.51 and 3.83 in female.

CONCLUSION

MetS has become one of the major chronic diseases in Jiangsu Province. WC was better than other four indices in predicting MetS among male population in Jiangsu. WC, WHtR and BRI had superior abilities than BMI/ABSI in predicting MetS among female population.

Effectiveness of body roundness index in predicting metabolic syndrome: A systematic review and meta-analysis

Body roundness index (BRI) is a new anthropometric index developed to predict both body fat and the percentage of visceral adipose tissue. Our aim was to investigate whether BRI is superior to traditional anthropometric indices in predicting metabolic syndrome (MetS). This systematic review and meta-analysis was conducted using Pubmed, Scopus and Web of Sciences databases. The estimated pooled areas under curve (AUCs) for BRI predicting MetS was higher than body mass index (BMI), waist-to-hip ratio (WHR), body shape index (ABSI) and body adiposity index (BAI), similar to waist circumference (WC) and lower than waist-to-height ratio (WHtR). However, the difference between BRI and BMI, WC and WHtR predicting MetS was statistically non-significant. Similar results were found with the summary receiver operating characteristic curve (AUC-SROC). In addition, the non-Chinese population had pooled AUCs greater than the Chinese population for all indices. Pooled ORs showed that BRI is associated with an increased MetS risk. In conclusion, BRI had good discriminatory power for MetS in adults of both sexes from diverse populations (AUC > 0.7; AUC-SROC>0.7). However, WC and WHtR offer the best performance when screening for MetS, and non-significant differences were found with BRI. In contrast, BRI was superior to BMI, WHR, ABSI and BAI in predicting MetS.

Entrenamiento intermitente de alta intensidad versus continuo en mujeres con hipertensión

Objetivo: comparar los efectos de la implementación de un programa de ejercicio continuo de mediana intensidad vs. un programa de ejercicio interválico de alta intensidad sobre los parámetros antropométricos y de condición física en mujeres hipertensas.Materiales y método: estudio experimental con pre y post prueba, realizado en 62 mujeres hipertensas divididas en 3 grupos: el primer grupo realizó ejercicio interválico de alta intensidad, el segundo hizo ejercicio continuo de mediana intensidad y el tercero es el grupo control. La intervención se realizó durante 12 semanas con una frecuencia semanal de 3 repeticiones. En todas las mujeres hipertensas se evaluó su condición física y características antropométricas.Resultados: posterior a la intervención, se encontraron diferencias estadísticamente significativas entre el grupo HiiT (high intensity interval training) y el grupo control en cuanto a las variables porcentaje de grasa (p = 0,014), densidad corporal (p = 0,014) e índice de conicidad [IC] (p = 0,003). Adicionalmente, se identificaron diferencias entre los dos grupos de ejercicio y el grupo control en las variables distancia recorrida (p = 0,04), flexibilidad en miembro superior derecho (p = 0,00) y fuerza en miembros inferiores (p = 0,01).Conclusiones: el estudio demostró que el ejercicio es una herramienta efectiva para mejorar la aptitud física de mujeres hipertensas. Sin embargo, no se encontraron diferencias en la efectividad entre el entrenamiento interválico de alta intensidad y el entrenamiento continuo.

Which Metabolic Index is Appropriate for Predicting Non-alcoholic Steatohepatitis?

BACKGROUND There are controversial ideas about the application of metabolic indices for the prediction of nonalcoholic steatohepatitis (NASH). In this study, we evaluated some novel metabolic indices for the screening of NASH. METHODS This prospective case-control study was performed in a gastroenterology outpatient clinic. Consecutively selected patients with persistently elevated aminotransferase levels and evidence of fatty liver in ultrasonography were enrolled. Those with other etiologies of aminotransferase elevation were excluded. The remaining was presumed to have NASH. The control group consisted of age and sex-matched subjects with normal liver function tests and liver ultrasound examinations. RESULTS Finally, 94 patients with steatohepatitis and 106 controls were included in the project. The mean liver fat content (LFC), aspartate aminotransferase, and alanine aminotransferase levels were significantly lower in the control group than in the NASH group. LFC was independently associated with the presence of NASH in logistic regression analysis. LFC had a good area under the curve for the prediction of NASH in ROC (receiver operating characteristic curve) analysis. CONCLUSION LFC seems to be a reliable metabolic index for the detection of patients with NASH.