A Body Shape Index and Body Roundness Index in Relation to Anxiety, Depression, and Psychological Distress in Adults

A Body Shape Index (ABSI) as a risk factor for all-cause mortality among US adults with type 2 diabetes: evidence from the NHANES 1999-2018

Background and objective

A Body Shape Index (ABSI) serves as a potential indicator of fat distribution, offering a more reliable association with all-cause mortality compared to overall adiposity. The present cohort study aims to explore the relationship between ABSI and all-cause mortality in US adults with Type 2 Diabetes (T2D).

Methods

For this cohort study, we extracted information on 5,461 US adults with T2D from the National Health and Nutrition Examination Survey (NHANES) and the NHANES Linked Mortality File. Trends in ABSI from 1999 to 2018 were calculated and analyzed using partial Mann-Kendall tests. To assess the relationship between ABSI and all-cause mortality, as well as the robustness of the association results, we employed weighted restricted cubic splines (RCS), weighted Cox proportional hazards models, sensitivity analyses, and stratified analyses. Additionally, we conducted time-dependent receiver operating characteristic (ROC) curve analysis to evaluate ABSI's predictive capability for all-cause mortality over 3, 5, and 10 years.

Results

Among US adults with Type 2 Diabetes (T2D), the mean ABSI gradually increased from 0.08333 to 0.08444 between 1999 and 2018. Following a median follow-up period of 90 months, 1,355 deaths (24.8% of the participants) occurred due to all causes. A left J-shaped association was observed between ABSI and all-cause mortality, with a 39% increased risk among US adults with T2D who had an ABSI below 0.08105 after full adjustment.

Conclusion

Our research has demonstrated a significant association between an elevated ABSI and the risk of all-cause mortality among US adults with T2D. These findings support the potential use of ABSI as a noninvasive tool to estimate mortality risk among US adults with T2D.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-025-01570-3.

Prognostic effect of body roundness index on all-cause mortality among US older adults

The Body Rounds Index (BRI) is an anthropometric indicator specifically developed to evaluate an individual's obesity level, particularly emphasizing central or abdominal obesity. This study aimed to explore the relationship between BRI and all-cause mortality in older U.S. adults. The research sample comprised individuals aged 65 and older from the National Health and Nutrition Examination Survey (NHANES), eligible for mortality analyses between 1999 and 2018. We utilized Cox regression analyses, restricted cubic spline (RCS), threshold effects analysis, Kaplan-Meier curves, and subgroup analyses were conducted to assess how the BRI correlates with all-cause mortality among older adults in the U.S. To further ensure the robustness of our findings, we conducted sensitivity analyses. Among 5371 U.S. older adults (age ≥ 65), with an average age of 72.45 (standard deviation [SD]:5.65) years, 2884 (60%) were women. During the follow-up period, there were 2781 deaths from all causes among the 5371 participants. After adjusting for all covariates, a U-shaped association was identified between BRI and the all cause mortality. Compared to a BRI of less than 4.457, a BRI between 4.457 and 5.538 was associated with a 19% reduction in the likelihood of mortality from any cause (HR = 0.81, 95% CI = 0.69-0.95). A BRI between 5.538 and 6.888 was linked to a 8% reduction in mortality risk (HR = 0.92, 95% CI = 0.79-1.07), while a BRI exceeding 6.888 showed a 1% increase in this risk (HR = 1.01, 95% CI = 0.87-1.17). RCS analysis indicated a U-shaped relationship between BRI and all-cause mortality. The turning point was located at 4.546, with correlations observed both before and after this point. This NHANES-based study highlights the U-shaped relationship between BRI and all-cause mortality among U.S. older adults, suggesting that the BRI has predictive value for mortality outcomes. The findings offer compelling support for utilizing BRI as a non-invasive mortality risk screening tool.

Association of objective body shape and perceived body image with depressive symptoms in men and women

AIMS

Mental health issues related to negative body image are growing concerns. We explored the association between objectively and subjectively measured body shape and depressive symptoms.

METHOD

A nationwide sample of 26,204 Korean adults was analyzed. Objective body shape was measured using the A Body Shape Index (ABSI), where a higher score indicates greater central obesity. ABSI scores were categorized into three groups: low, medium, and high. Perceived body image was classified into five categories: (i) very thin, (ii) slightly thin, (iii) normal, (iv) slightly fat, and (v) very fat. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Logistic regressions were employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

An increase in ABSI score was positively associated with depressive symptoms in men (OR = 1.27; 95% CI = 1.09-1.49) but not in women. Among men, those who perceived their body shape as very thin or very fat had 2.62-fold (95% CI = 1.70-4.05) and 2.34-fold (95% CI = 1.57-3.47) higher odds of having depressive symptoms, respectively, compared with those who perceived their body shape as normal. Among women, those who perceived their body shape as very thin or very fat had 2.73-fold (95% CI = 1.92-3.86) and 2.48-fold (95% CI = 1.97-3.14) increased odds of having depressive symptoms, respectively. The association between perceived body image and depressive symptoms manifested differently depending on ABSI group and gender.

CONCLUSION

Negative body image was associated with depressive symptoms, and this relation was differently observed across genders and different categories of actual body shape.

The relationship between body roundness index (BRI) and suicidal ideation: evidence from NHANES 2013-2018

IMPORTANCE

Emerging research suggests a complex interplay between physical health metrics and mental health outcomes, including suicidal ideation. The body roundness index (BRI), a novel measure of body size, may offer insights into this relationship. This study seeks to investigate the intricate connection between BRI and suicidal ideation in a sample that reflects the entire U.S. population-working to validate the potential of BRI as a predictor of suicidal ideation.

METHODS

Data from the NHANES spanning 2013 to 2018 was used in this cross-sectional study to analyze a sample of 14,058 participants. BRI was calculated based on height and waist circumference measurements. Suicidal ideation was assessed using the Mental Health-Depression Screener Questionnaire ninth question. To investigate potential non-linear relationships between BRI and suicidal ideation, we employed generalized additive models and smooth curve fitting, and used ROC curves to compare the predictive ability of BMI and BRI for suicidal ideation. Subgroup analyses and interaction tests were utilized to study the moderating effects of categorical covariates.

RESULTS

Multiple logistic regression analysis revealed a significant positive correlation between increased BRI and heightened suicidal ideation, with a nonlinear pattern persisting even after adjustment for covariates. This nonlinear relationship was reinforced by a sharp increase in the prevalence of suicidal ideation when the BRI exceeded 6.7. Based on ROC curve analysis, BRI demonstrates a slightly stronger predictive ability for suicide ideation compared to BMI. Subgroup analyses confirmed the relative robustness of this association across populations, including age, education and PRI, etc. However, the interaction between the two was influenced by gender, coronary artery disease and angina pectoris.

CONCLUSION

In conclusion, our cross-sectional study reveals a significant positive correlation between increased BRI and heightened suicidal ideation, with a sharp increase in prevalence when BRI exceeds 6.7. It is recommended that appropriate BRI be maintained to minimize suicidal ideation.

The association between body roundness index and sarcopenia in older adults: a population-based study

Background

Sarcopenia, defined by the gradual decline in skeletal muscle mass and functionality, is a common disorder in the aging population and is linked to an elevated risk of falls and osteoporotic fractures. The contemporary diagnosis of sarcopenia depends on intricate and expensive techniques, such as computed tomography (CT) scans or dual-energy X-ray absorptiometry (DXA), which hinder the timely prevention of sarcopenia.

Objective

This study seeks to explore the association between the Body Roundness Index (BRI) and sarcopenia in the older adult cohort, utilizing data from the National Health and Nutrition Examination Survey (NHANES) in the United States.

Methods

Our study adopted a cross-sectional design, encompassing 9,411 older individuals, of which 1,147 were diagnosed with sarcopenia. After weighting, the number of individuals with sarcopenia was 23,985,011. The study employed multivariate logistic regression analysis to evaluate the association between BRI and sarcopenia, incorporating stepwise adjustments for potential confounders.

Results

The outcomes of the multivariate logistic regression analysis revealed that, in contrast to individuals without sarcopenia, those with sarcopenia exhibited significantly higher mean BRI values and a greater prevalence of comorbid conditions, including hypertension and diabetes. A significant positive correlation was observed between BRI and the likelihood of developing sarcopenia. Specifically, after controlling for all covariates, each one-unit increase in BRI was linked to a 64% elevation in the risk of sarcopenia (OR = 1.64, 95% CI = 1.58-1.71). Furthermore, the receiver operating characteristic (ROC) curve analysis indicated that BRI is a robust predictor for diagnosing sarcopenia, with an AUC of 0.744.

Conclusion

These findings suggest that, within the U.S. older adult population, an elevated BRI is associated with a heightened risk of sarcopenia. BRI can function as a practical and cost-effective anthropometric index for more precise prediction of sarcopenia risk in older adults.

Associations of moderate-to-vigorous physical activity and body roundness index with psychological symptoms in adolescents in mainland China: a national multicenter cross-sectional survey

BACKGROUND

Decreased physical activity and overnutrition among adolescents have become important public health problems shared by countries around the world. In addition, the prevalence of psychological symptoms among adolescents continues to increase, which negatively affects schooling and future quality of life. However, no studies have been found in the past on the association of moderate-to-vigorous physical activity(MVPA) and body roundness index(BRI) with psychological symptoms in Chinese adolescents. This study may provide theoretical support for the prevention and intervention of psychological symptoms among adolescents in mainland China.

METHODS

From September to November 2023, MVPA, BRI, and psychological symptoms were assessed in 43,031 adolescents aged 12-17 years from different regions of mainland China. The chi-square test, t-test, logistic regression analysis, and ordered logistic regression were used to analyze the associations that existed between MVPA and BRI with psychological symptoms.

RESULTS

The prevalence of psychological symptoms among adolescents in mainland China was 20.3%. The proportions of adolescents with MVPA of < 30 min/day, 30-60 min/day, and > 60 min/day were 46.0%, 40.0%, and 14.0%, respectively. The adolescent BRI value was (2.02 ± 0.95); boys (2.12 ± 1.03) had a higher BRI value than girls (1.92 ± 0.86), and the difference was statistically significant (t = 22.111, P < 0.001). After adjusting for relevant covariates, ordered logistic regression analysis showed that, overall, adolescents in the group with MVPA > 60 min/day and BRI quartiles Q1 as the reference group, adolescents in the group with MVPA of 30-60 min/day and BRI quartiles Q2 (OR = 0.65, 95% CI:0.51 ∼ 0.82) had a lower risk of developing psychological symptoms (P < 0.001); adolescents in the MVPA < 30 min/day group and BRI quartiles Q4 group (OR = 1.62, 95% CI: 1.30-2.02) had a higher risk of psychological symptoms (P < 0.001).

CONCLUSIONS

There is an association between MVPA and BRI and psychological symptoms among adolescents in mainland China. A decrease in MVPA and an increase in BRI were associated with an increase in the prevalence of psychological symptoms. In the future, we should effectively improve the MVPA level and maintain a reasonable BRI value in adolescents in mainland China to better promote adolescents' mental health development.

CLINICAL TRIAL NUMBER

Not applicable.

Associations of body roundness index and sugar-sweetened beverage consumption with psychological symptoms in adolescents: a multicenter cross-sectional survey based on Chinese adolescents aged 12-18 years old

Background

Adolescent psychosocial symptoms continue to rise, negatively affecting academic performance and future achievement, and have become an important public health issue of common concern worldwide. However, few studies have been conducted on the association between body roundness index (BRI) and sugar-sweetened beverage (SSB) consumption and psychological symptoms in Chinese adolescents. The present study may provide implications for the intervention and prevention of psychological symptoms in Chinese adolescents.

Methods

In this study, 47,520 adolescents aged 12-18 years from six geographic regions of China were assessed cross-sectionally for BRI, SSB consumption, and psychological symptoms in 2023. Independent samples t-tests, chi-square tests, logistic regression analyses, and ordered logistic regression analyses were used to compare and analyze the associations that existed between BRI and SSB consumption and psychological symptoms among Chinese adolescents.

Results

The BRI of Chinese adolescents aged 12-18 years was (2.03 ± 0.94). The proportions of adolescents with SSB consumption ≤1 times/week, 2-3 times/week, and ≥ 4 times/week were 33.2, 52.0, and 14.7%, respectively, and the differences were statistically significant in comparison (X 2 value of 597.860, p < 0.001). The prevalence of psychological symptoms among Chinese adolescents was 19.2%. The prevalence rates of emotional problems, behavioral problems, and social adjustment difficulties were 26.1, 25.2, and 16.1%, respectively. After adjusting for relevant covariates, ordered logistic regression analysis showed that with BRI quartiles Q1 and SSB consumption ≤1 times/week as the reference group, the adolescents in the group with BRI quartiles of Q4 and SSB consumption ≥4 times/week (OR = 2.01, 95% CI: 1.77-2.30) had the highest risk of developing psychological symptoms (p < 0.001).

Conclusion

There is an association between BRI and SSB consumption with psychological symptoms in Chinese adolescents. Chinese adolescents with higher BRI and SSB consumption were at higher risk of developing psychological symptoms. In the future, the increase in BRI and SSB consumption should be effectively controlled to prevent or reduce the occurrence of psychological symptoms.

Association between body roundness index and suicidal ideation in U.S. adults: A cross-sectional study

Purpose

The relationship between the body roundness index (BRI) and suicidal ideation has not been previously examined. This study aimed to investigate this association through a cross-sectional analysis.

Method

The data used in this study was extracted from the National Health and Nutrition Examination Survey ranging from 2011 to 2012 to 2017-2018. The BRI was calculated from body measurement data, while a questionnaire was used to assess suicidal ideation. Weighted multivariable logistic regression analysis, weighted stratified analysis, and smooth curve fitting were conducted to assess the relationship between the BRI and suicidal ideation. Results: A total of 12,878 participants were included in the study with 441 of them reported experiencing suicidal thoughts. After adjusted for all covariates, a one-unit increase in BRI was associated with a 5 % greater likelihood of having suicidal thoughts [1.05 (1.00, 1.10)]. Additionally, BRI was categorized into quartiles, and individuals in the highest quartile were 1.52 times as likely to experience suicidal thoughts compared to those in the lowest quartile [1.52 (1.03, 2.25)]. There were no interaction effects between BRI and suicidal ideation for any subgroups stratified by demographics.

Conclusion

The present study indicated that a greater BRI was significantly associated with higher levels of suicidal ideation. The findings underscore the importance of considering BRI as a potential indicator for identifying individuals at elevated risk of suicidal ideation. The study also emphasizes the need for a shift towards a weight-inclusive approach in public health, which can help reduce societal pressures and mitigate the psychological impact of weight stigma.

The association between a body shape index and depressive symptoms: a cross-sectional study using NHANES data (2011-2018)

Objective

This study aimed to explore the relationship between A Body Shape Index (ABSI) and depressive symptoms, and to evaluate the moderating effects of sociodemographic, lifestyle, and health factors.

Methods

We analyzed data from 19,659 participants in the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). ABSI was calculated from waist circumference, height, and BMI. Multiple linear regression models were employed to investigate the association between ABSI and depressive symptoms, with subgroup analyses to examine potential associations within specific populations.

Results

Higher ABSI was significantly associated with increased depressive symptoms, after adjusting for covariates including age, sex, race, marital status, poverty-income ratio, smoking, alcohol consumption, physical activity, diabetes, and hypertension. Individuals in the highest ABSI quartile (Q4) had significantly more depressive symptoms compared to those in the lowest quartile (Q1) (β = 0.22, 95% CI = 0.02-0.41, p = 0.0323). Subgroup analyses revealed that marital status and hypertension significantly moderated the association between ABSI and depressive symptoms.

Conclusion

This study provides the first comprehensive analysis of the link between ABSI and depressive symptoms, suggesting that higher ABSI is associated with greater depressive symptoms. These findings highlight the potential importance of waist circumference and abdominal fat distribution in assessing depression risk. Future research should explore the causal mechanisms underlying this association and investigate the biological pathways involved, to inform more effective strategies for depression prevention and intervention.

Association of noise exposure with lipid metabolism among Chinese adults: mediation role of obesity indices

PURPOSE

Noise exposure in the workplace has been linked to a number of health consequences. Our objectives were to explore the relationship between occupational noise and lipid metabolism and evaluate the possible mediating effect of obesity indices in those relationships with a cross-sectional study design.

METHODS

Cumulative noise exposure (CNE) was used to measure the level of noise exposure. Logistic regression models or generalized linear models were employed to evaluate the association of occupational noise and obesity with lipid metabolism markers. Cross-lagged analysis was conducted to explore temporal associations of obesity with lipid metabolism.

RESULTS

A total of 854 participants were included, with each one-unit increase in CNE, the values of total cholesterol/high-density lipoprotein cholesterol and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol increased by 0.013 (95% confidence interval: 0.006, 0.020) and 0.009 (0.004, 0.014), as well as the prevalence of dyslipidemia increased by 1.030 (1.013, 1.048). Occupational noise and lipid metabolism markers were all positively associated with body mass index (BMI), waist circumference (WC), a Body Shape Index (ABSI) and a Body Shape Index and Body Roundness Index (BRI) (all P < 0.05). Moreover, BMI, WC, ABSI and BRI could mediate the associations of occupational noise with lipid metabolism; the proportions ranged from 21.51 to 24.45%, 23.84 to 30.14%, 4.86 to 5.94% and 25.59 to 28.23%, respectively (all P < 0.05).

CONCLUSIONS

Our study demonstrates a positive association between occupational noise and abnormal lipid metabolism, and obesity may partly mediate the association. Our findings reinforce the need to take practical steps to reduce or even eliminate the health risks associated with occupational noise.

The Relationship Between BRI and Depressive Symptoms in Chinese Older Adults: A CLHLS-Based Study

BACKGROUND

There is a lack of research examining the association between obesity and depressive symptoms in relation to mental health. This study aimed to examine the correlation between Body Roundness Index (BRI) and depressive symptoms in elderly Chinese individuals.

METHODS

The study sample consisted of 11,842 individuals aged 65 years or older from the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS) database. A multivariate logistic regression analysis was used to investigate how BRI affects the likelihood of experiencing depressive symptoms, with restricted cubic spline (RCS) curves illustrating this impact. BRI values were calculated using a predefined formula for each participant, and depressive status was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D-10).

RESULTS

The mean age of the participants was 83.1 ± 10.9 years. A non-linear relationship was identified between the BRI score and the risk of depressive symptoms. The analysis showed that for BRI scores below 5.17, there was a significant 9% increase in the risk of depressive symptoms for every 1-point decrease in BRI score. Conversely, when the BRI was 5.17 or higher, a decrease in the BRI score did not lead to a significant increase in the risk of depressive symptoms.

CONCLUSION

The study demonstrated a significant association between BRI and depressive symptoms in elderly Chinese individuals. Furthermore, it was noted that older adults classified as overweight and mildly obese had a lower likelihood of experiencing depressive symptoms and demonstrated improved mental health.

Body roundness index and cognitive function in older adults: a nationwide perspective

Background

Obesity negatively impacts cognitive function. However, the correlation between the body roundness index (BRI) and cognitive performance remains inadequately explored.

Methods

This study used data from the National Health and Nutrition Examination Survey (NHANES) collected from 2011 to 2014 to examine the correlation between BRI and cognitive function in individuals aged 65 and older. Models of multiple linear regression were used to investigate the relationship between BRI and cognitive performance. Additionally, smoothed curve fittings explored potential non-linear associations. Interaction tests and subgroup analyses were also performed.

Results

One thousand eight hundred seventy participants were taken into account, revealing an important negative relationship between BRI levels and cognitive performance. In the fully adjusted model, elevated BRI was substantially correlated with lower Digit Symbol Substitution Test (DSST) scores (β = -0.34, 95% CI = -0.64 to -0.05, p = 0.023), indicating that the higher BRI values are linked to worse cognitive performance. Sex differences were observed, with males showing a stronger negative association (p for interaction = 0.040).

Conclusion

Elevated BRI is related to worse cognitive function in the elderly population.

The association between abdominal obesity and depressive symptoms among Chinese adults: Evidence from national and regional communities

BACKGROUND

The association between body shape and depressive symptoms has been reported in adults. The present study aimed to investigate the association between body shape-specific abdominal obesity and depressive symptoms among multi-regional Asian adults.

METHODS

The 2011-2012 China Health and Retirement Longitudinal Study and 2022-2023 Hangzhou study were used as the discovery and validation datasets, respectively. Body shape was assessed by body mass index categories. Abdominal obesity was defined as a body shape index (ABSI) ≥ 75th centile. Depression was measured using 10-item Centre for Epidemiological Studies Depression Scale and Geriatric Depression Scale short 15-item version, respectively. General linear and multinomial logistic models were used to explore the association of ABSI, abdominal obesity with depressive scores and presence, respectively.

RESULTS

A total of 12,229 and 1210 participants were included in the discovery and validation datasets, respectively. A non-linear reverse L-shaped association was found between ABSI and depressive scores. Participants with abdominal obesity had higher depressive scores (β = 0.05, 95%CI = 0.01-0.09; and β = 0.13, 95%CI = 0.01-0.24; respectively). Stratified analyses showed that abdominal obesity was associated with higher depressive scores (β = 0.09, 95%CI = 0.00-0.17; and β = 0.25, 95%CI = 0.05-0.46; respectively) and presence (OR = 1.46, 95%CI = 1.02-2.10; and OR = 3.95, 95%CI = 1.58-9.84; respectively) in overweight adults. Furthermore, abdominal obesity was associated with depressive symptoms among overweight females, but not among males.

LIMITATION

Causal links weren't addressed because of the observational study design.

CONCLUSION

Abdominal obesity exhibited a positive association with depressive symptoms among Asian overweight adults, particularly in females. Prevention and early diagnosis of depressive symptoms should focus on overweight females.

Association of body roundness index with female infertility: 2013-2018 NHANES

Aim

This study aims to understand the association between body roundness index (BRI) and female infertility prevalence. Infertility is a public health concern with significant implications for individuals' well-being and rights.

Methods

All individuals who completed the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2018 were initially included in this cross-sectional study. Following the screening, 2,777 eligible participants were selected for analysis from the original pool of 10,375 participants. Trained operators conducted anthropometric measurements, including height, weight, and waist circumference. The BRI was then calculated based on established research. Data from infertility status questionnaires were gathered from the NHANES database for all participants, with self-reported infertility serving as the study outcome. Multivariable logistic regression and restricted cubic splines (RCS) were employed to investigate the relationship between BRI and infertility. Subgroup analyses were also conducted to further explore the association between BRI and infertility.

Results

Upon analyzing the baseline characteristics of all women in the study, notable distinctions were identified in the clinical and demographic features between fertile and infertile women. Our investigation revealed a positive correlation between BRI and the likelihood of infertility in both weighted and unweighted multiple logistic regression models. Additionally, BRI exhibited a significant association with infertility in both continuous and categorical forms. Utilizing RCS curves, we noted a linear escalation in the prevalence of infertility with rising BRI values. Subgroup analyses provided further clarity on these observations.

Conclusion

Our study demonstrates a statistically significant positive correlation between BRI and the prevalence of infertility across diverse populations, suggesting potential implications for infertility prevention and treatment. Future prospective cohort studies will explore this association and understand the underlying mechanisms.

The association between the dietary behavior, diet quality, and lifestyle scores with anthropometric indices and happiness levels among university students

BACKGROUND

Limited information exists linking food habits, diet quality, and lifestyle scores with anthropometric indices and happiness levels. Our aim was to examine the association between food habits, diet quality, and lifestyle scores with anthropometric indices and happiness levels in the Iranian population.

METHODS

This cross-sectional study included 200 students randomly selected from a university in Iran. Dietary intakes, physical activity (PA), and happiness levels of study participants were assessed using validated questionnaires. The anthropometric indices examined in this study included the body shape index (ABSI), body roundness index (BRI), and abdominal volume index (AVI). Multiple logistic regression models were used to examine the association between food habits, diet quality, and lifestyle scores with anthropometric indices and happiness levels.

RESULTS

The mean age and body mass index (BMI) of study participants were 23.5 years ± 4.52 and 23.8 kg/m2 ± 3.17, respectively. In the study population, no significant association was seen between ABSI, BRI, AVI and happiness with food habits, diet quality, and lifestyle scores respectively. After adjusting for potential confounders (age, energy intake, marital status, education, smoking, physical activity, gender, and BMI), the association remained not significant for ABSI and food habits, diet quality, and lifestyle scores respectively (OR: 0.56, 95% CI (0.25-1.34), P = 0.193; OR: 0.59, 95% CI (0.22-1.57), P = 0.413; OR:1.19, 95%CI (0.54-2.63), P = 0.652), BRI and food habits, diet quality, and lifestyle scores respectively (OR:1.98, 95% CI (0.41-9.49), P = 0.381; OR: 0.57, 95%CI (0.12-2.74), P = 0.512; OR: 1.19, 95% CI (0.3-4.71), P = 0.811), AVI and food habits, diet quality, and lifestyle scores (OR:1.15, 95% CI (0.53-2.48), P = 0.743, OR:1.01, 95% CI (0.47-2.18), P = 0.965; OR: 1.3, 95% CI (0.64-2.65), P = 0.465) and happiness and food habits, diet quality, and lifestyle scores respectively (OR:0.3, 95%CI (0.07-1.25), P = 0.972; OR: 0.77, 95%CI (0.18-3.19), P = 0.724, OR: 0.3, 95% CI (0.07-1.25), P = 0.083).

CONCLUSIONS

No significant association was detected between food habits, diet quality, and lifestyle scores with anthropometric indices and happiness levels. However, longitudinal studies are required to confirm these findings.

Change in self-image pressure level before and after autologous fat breast augmentation and its effect on social adaptability

BACKGROUND

There is an increasingly strong demand for appearance and physical beauty in social life, marriage, and other aspects with the development of society and the improvement of material living standards. An increasing number of people have improved their appearance and physical shape through aesthetic plastic surgery. The female breast plays a significant role in physical beauty, and droopy or atrophied breasts can frequently lead to psychological inferiority and lack of confidence in women. This, in turn, can affect their mental health and quality of life.

AIM

To analyze preoperative and postoperative self-image pressure-level changes of autologous fat breast augmentation patients and their impact on social adaptability.

METHODS

We selected 160 patients who underwent autologous fat breast augmentation at the First Affiliated Hospital of Xinxiang Medical University from January 2020 to December 2022 using random sampling method. The general information, self-image pressure level, and social adaptability of the patients were investigated using a basic information survey, body image self-assessment scale, and social adaptability scale. The self-image pressure-level changes and their effects on the social adaptability of patients before and after autologous fat breast augmentation were analyzed.

RESULTS

We collected 142 valid questionnaires. The single-factor analysis results showed no statistically significant difference in the self-image pressure level and social adaptability score of patients with different ages, marital status, and monthly income. However, there were significant differences in social adaptability among patients with different education levels and employment statuses. The correlation analysis results revealed a significant correlation between the self-image pressure level and social adaptability score before and after surgery. Multiple factors analysis results showed that the degree of concern caused by appearance in self-image pressure, the degree of possible behavioral intervention, the related distress caused by body image, and the influence of body image on social life influenced the social adaptability of autologous fat breast augmentation patients.

CONCLUSION

The self-image pressure on autologous fat breast augmentation patients is inversely proportional to their social adaptability.

Atherogenic Index of Plasma as a Mediator in the association between Body Roundness Index and Depression: insights from NHANES 2005-2018

BACKGROUND

Previous studies have shown a correlation between depression and obesity, as well as between depression and the Atherogenic Index of Plasma (AIP). However, there is limited research on the association between visceral obesity and depression, as well as the potential mediating role of AIP in this relationship.

METHODS

This study included 13,123 participants from the 2005-2018 National Health and Nutrition Examination Survey. Visceral obesity was measured with the Body Roundness Index (BRI), while depression was evaluated with the Patient Health Questionnaire-9. The AIP served as a marker for lipid disorders. To investigate the association between the BRI and depression, multivariate logistic regressions, restricted cubic spline models, subgroup analyses, and interaction tests were used. Additionally, a mediation analysis was conducted to explore the role of AIP in mediating the effect of BRI on depression.

RESULTS

There was a positive linear correlation between the BRI and depression. After controlling for all covariates, individuals in the highest BRI (Q4) group had an OR of 1.42 for depression (95% CI: 1.12-1.82) in comparison with individuals in the lowest BRI (Q1) group. Moreover, the AIP partially mediated the association between the BRI and depression, accounting for approximately 8.64% (95% CI: 2.04-16.00%) of the total effect.

CONCLUSION

The BRI was positively associated with depression, with the AIP playing a mediating role. This study provides a novel perspective on the mechanism that connects visceral obesity to depression. Managing visceral fat and monitoring AIP levels may contribute to alleviating depression.

The Association between cognitive impairment and anthropometric indices among the elderly: birjand longitudinal aging study

Background

The population of older adults has been consistently on the rise. We aimed to assess the possible relationship between cognitive decline and anthropometric indices in older adults, using data from the Birjand longitudinal aging study (BLAS).

Methods

In this cross-sectional research, the association between cognitive impairment as determined by two tests (Six Item Cognitive Impairment Test (6-CIT)) and (Mini-Mental State Examination (MMSE)) and anthropometric indices including waist circumference (WC), body mass index (BMI), waist to height ratio (WHtR), waist to hip ratio (WHR), body roundness index (BRI), and a body shape index (ABSI) were assessed among 1353 elderly ≥ 60 years old, participating in the BLAS cohort study (September 2018 to April 2019). Ordinal and binary logistic regression were used for analysis.

Results

According to the MMSE test, 58.3% of participants had cognitive impairment, while this frequency was 64.2% based on the 6-CIT test. A significant reverse association was observed between cognitive decline according to the 6-CIT test and BMI, WHR, and WC (P < 0.05). Cognitive impairment, according to MMSE, was inversely associated with WC and directly associated with WHtR and ABSI in the crude model, which disappeared after adjustment for confounders. BRI was not significantly related to any of the cognitive tests. According to BMI and WC, overweight and obesity could reduce the risk of cognitive impairment.

Conclusions

Overall, the result of this study showed that the risk of cognitive decline decreased among the elderly as BMI, WC, and WHR increased.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-024-01404-8.

Dose-response association of obesity and risk of mental health among tehranian residents: result of a cross-sectional study

BACKGROUND

Obesity and mental health issues are two of the most prevalent global public health issues for a significant portion of people. The purpose of this study was to investigate the relationship between obesity indicators and mental health in Tehran-dwelling Iranian adults.

METHODS

We conducted a cross-sectional study on healthy Iranian adults using a convenience sampling technique. The short form of the Depression Anxiety and Stress Scale (DASS-21) was used to measure the outcome, and independent variables included body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body adiposity index (BAI), and a body shape index (ABSI). The relationship between obesity and mental health was investigated using a multivariate logistic regression model. The non-linear dose-response relationships were evaluated using restricted cubic splines (RCS) with three knots. The Benjamini-Hochberg procedure was used to adjust for multiple testing.

RESULTS

In our study of 434 participants, females made up 52% of the participants, with a mean age of 38.57 years. In all, 54.6%, 53.9%, and 56.6% were classified as having anxiety, depression, and stress respectively. Logistic regression analysis showed that the odds of mental health components including anxiety, depression, or stress was not significantly different across the tertiles of the obesity indicators. We observed a significant dose-response relationship between BAI and ABSI and the risk of anxiety (PBenjamini-Hochberg 0.028 > Pdose-response 0.023) and stress (PBenjamini-Hochberg 0.028 > Pdose-response 0.003) but not depression (PBenjamini-Hochberg 0.014 < Pdose-response 0.018). The lowest risk for anxiety was observed in people with a BAI of 28% and ABSI equal to 0.079. The risk of stress seemed to increase beyond an ABSI of 0.086.

CONCLUSION

Our findings showed no direct linear association between obesity indices and anxiety. However, a dose-response relationship was observed between BAI and ABSI and the risk of anxiety and stress, indicating the need for further investigation.

Obesity and lipid indices as predictors of depressive symptoms in middle-aged and elderly Chinese: insights from a nationwide cohort study

BACKGROUND

Depressive symptoms are one of the most common psychiatric disorders, with a high lifetime prevalence rate among middle-aged and elderly Chinese. Obesity may be one of the risk factors for depressive symptoms, but there is currently no consensus on this view. Therefore, we investigate the relationship and predictive ability of 13 obesity- and lipid-related indices with depressive symptoms among middle-aged and elderly Chinese.

METHODS

The data were obtained from The China Health and Retirement Longitudinal Study (CHARLS). Our analysis includes individuals who did not have depressive symptoms at the baseline of the CHARLS Wave 2011 study and were successfully follow-up in 2013 and 2015. Finally, 3790 participants were included in the short-term (from 2011 to 2013), and 3660 participants were included in the long-term (from 2011 to 2015). The average age of participants in short-term and long-term was 58.47 years and 57.88 years. The anthropometric indicators used in this analysis included non-invasive [e.g. waist circumference (WC), body mass index (BMI), and a body mass index (ABSI)], and invasive anthropometric indicators [e.g. lipid accumulation product (LAP), triglyceride glucose index (TyG index), and its-related indices (e.g. TyG-BMI, and TyG-WC)]. Receiver operating characteristic (ROC) analysis was used to examine the predictive ability of various indicators for depressive symptoms. The association of depressive symptoms with various indicators was calculated using binary logistic regression.

RESULTS

The overall incidence of depressive symptoms was 20.79% in the short-term and 27.43% in the long-term. In males, WC [AUC = 0.452], LAP [AUC = 0.450], and TyG-WC [AUC = 0.451] were weak predictors of depressive symptoms during the short-term (P < 0.05). In females, BMI [AUC = 0.468], LAP [AUC = 0.468], and TyG index [AUC = 0.466] were weak predictors of depressive symptoms during the long-term (P < 0.05). However, ABSI cannot predict depressive symptoms in males and females during both periods (P > 0.05).

CONCLUSION

The research indicates that in the middle-aged and elderly Chinese, most obesity- and lipid-related indices have statistical significance in predicting depressive symptoms, but the accuracy of these indicators in prediction is relatively low and may not be practical predictors.

Non-linear relationship between body roundness index and albuminuria among children and adolescents aged 8-19 years: A cross-sectional study

INTRODUCTION

Obesity has been found to be correlated with numerous health issues, including an elevated risk of albuminuria in adults. However, this correlation is still controversial among children and adolescents, as several recent large-scale cross-sectional studies have observed a negative correlation between obesity and albuminuria. Our study aimed to investigate the link between the body roundness index (BRI) and albuminuria among children and adolescents, in order to further understand the correlation between obesity and albuminuria in this demographic.

METHODS

We employed information from the National Health and Nutrition Examination Survey (NHANES) 1999-2010 for cross-sectional analysis. Weighted logistic regression was employed to explore the linear relationship between BRI and albuminuria, with subgroup analyses performed for more detailed insights. Weighted linear regression analysis was employed to explore the relationship between BRI and the urine albumin-creatinine ratio (UACR). Additionally, we applied smooth curve fitting to investigate their non-linear relationship and conducted threshold effect analysis to identify any turning point.

RESULTS

In this study of 15,487 participants aged 8-19 years, multivariate logistic regression analysis revealed a significant negative correlation between BRI and albuminuria (OR = 0.616, 95%CI: 0.526-0.722). The relationship between BRI and UACR, as shown by multivariate linear regression analysis, was significantly inversely correlated (β: -5.424, 95%CI: -7.416 to -3.433). Furthermore, smooth curve fitting and threshold effect analysis showed a non-linear relationship between BRI and albuminuria, with a BRI inflection point identified at 2.906.

CONCLUSIONS

These findings of our study suggest a significant nonlinear negative association between BRI and the presence of albuminuria among children and teenagers, and maintaining an appropriate BRI may decrease the occurrence of albuminuria in this population.

Associations of body roundness index with cardiovascular and all-cause mortality: NHANES 2001-2018

Body roundness index (BRI) was associated with cardiovascular diseases. But the relationship between BRI with cardiovascular disease (CVD) mortality and all-cause mortality remains largely unknown in hypertensive patients. This prospective cohort study included patients with hypertension who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 through 2018, and aimed to evaluate the association between BRI with CVD mortality and all-cause mortality. A total of 15570 patients were included. Over a median follow-up of 8.0 years (interquartile range, 4.3-12.6 years), 3445 individuals died, including 1166 CVD deaths. Weighted restricted cubic spline regression results showed a nonlinear association between BRI and CVD mortality and all-cause mortality (both P for nonlinear trend <0.001). The weighted multivariate Cox proportional hazards regression showed the hazard ratio (HRs) for CVD mortality were 0.93 (95% CI: 0.84-1.03, P = 0.160) in the low levels of BRI (≤5.9) and 1.11 (95% CI: 1.05-1.19, P < 0.001) in the high levels of BRI (>5.9). Similar associations were observed for all-cause mortality, the HRs were 0.91 (95% CI: 0.87-0.96, P < 0.001) in the low levels of BRI (≤6.3) and 1.09 (95% CI: 1.05-1.13, P < 0.001) in the high levels of BRI (>6.3). This cohort study supported that BRI was nonlinearly associated with CVD mortality and all-cause mortality among patients with hypertension. The thresholds of 5.9 and 6.3 for CVD mortality and all-cause mortality, respectively, may represent intervention targets for lowering the risk of premature death, but this needs to be confirmed in large clinical trials.

Association between novel anthropometric indices and prevalence of kidney stones in US adults

BACKGROUND

Our aim is to evaluate the relationship between prevalence of kidney stones (KS) and novel anthropometric indices (AHIs).

METHODS

Participants who participated in the KS questionnaire was extracted from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018.A series of covariates were also obtained. The novel AHIs include a body shape index (ABSI) and body roundness index (BRI). Weighted multivariable-adjusted logistic regression was performed to investigate the association of KS with AHIs.

RESULTS

After relative covariates were adjusted, a greater risk of KS for each z score increase in ABSI (OR = 1.13, 95%CI 1.05-1.22), and the risk of KS augmented by 19% for every 1 BRI z score added (OR = 1.19, 95%CI 1.11-1.27). The results from subgroup analysis showed that among adults aged 20-39 (OR = 1.31, 95%CI 1.04-1.65), male (OR = 1.14, 95%CI 1.02-1.28), the risk of KS is higher with the increase of each ABSI z score. Raising each BRI z score in those who were male aged 20-39 and 40-59 resulted in a higher risk of KS (aged 20-39: OR = 1.34, 95%CI 1.06-1.69; aged 40-59: OR = 1.29, 95%CI 1.09-1.53). In female aged 40-59, increasing each BRI z score led to a higher risk of KS (OR = 1.23, 95%CI 1.07-1.41). A linear association of ABSI z score with the risk of KS and a non-linear relationship between BRI z score and the risk of KS were discovered.

CONCLUSION

This study found that the novel AHIs was related to the risk of kidney stones, and can be used as important indicators to evaluate the risk of KS.

Predicting depressive symptom by cardiometabolic indicators in mid-aged and older adults in China: a population-based cross-sectional study

Objective

Depressive symptom is a serious mental illness often accompanied by physical and emotional problems. The prevalence of depressive symptom in older adults has become an increasingly important public health priority. Our study used cardiometabolic indicators to predict depressive symptom in middle-aged and older adults in China.

Methods

The data came from the China Health and Retirement Longitudinal Study 2011 (CHARLS2011), which was a cross-sectional study. The analytic sample included 8,942 participants aged 45 years or above. The study evaluated the relationship between cardiometabolic indicators and depression by measuring 13 indicators, including body mass index (BMI), waist circumference, waist-height ratio (WHtR), conicity index, visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-waist circumference, TyG-WHtR). Binary logistic regression analysis was used to examine the association between thirteen cardiometabolic indicators and depressive symptom. In addition, the receiver operating characteristic (ROC) curve analysis and area under curve (AUC) were used to evaluate the predictive anthropometric index and to determine the optimum cut-off value.

Results

The study included 8,942 participants, of whom 4,146 (46.37%) and 4,796 (53.63%) were male and female. The prevalence of depressive symptom in mid-aged and older adults in China was 41.12% in males and 55.05% in females. The results revealed that BMI [AUC = 0.440, 95%CI: 0.422-0.457], waist circumference [AUC = 0.443, 95%CI: 0.425-0.460], WHtR [AUC = 0.459, 95%CI: 0.441-0.476], LAP [AUC = 0.455, 95%CI: 0.437-0.472], BRI [AUC = 0.459, 95%CI: 0.441-0.476], CVAI [AUC = 0.449, 95%CI: 0.432-0.467], TyG-BMI [AUC = 0.447, 95%CI: 0.429-0.465], and TyG-waist circumference [AUC =0.452, 95%CI: 0.434-0.470] were weak predictors of depressive symptom (p < 0.05) in males. In females, BMI [AUC = 0.470, 95%CI: 0.453-0.486], LAP [AUC = 0.484, 95%CI: 0.467-0.500], TyG-BMI [AUC = 0.470, 95%CI: 0.454-0.487], and TyG-waist circumference [AUC =0.481, 95%CI: 0.465-0.498] were weak predictors of depressive symptom (p < 0.05). On the other side, VAI, ABSI, conicity index and TyG index could not predict depressive symptom in middle-aged and older adults.

Conclusion

Most cardiometabolic indicators have important value in predicting depressive symptom. Our results can provide measures for the early identification of depressive symptom in middle-aged and older adults in China to reduce the prevalence of depressive symptom and improve health.

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 between novel anthropometric measures and the prevalence of hypertension among 45,853 adults: A cross-sectional study

AIMS

Traditional anthropometric measures, including body mass index (BMI), are insufficient for evaluating the risk of hypertension. We aimed to investigate the association between novel anthropometric indices and hypertension risk in a large population in the United States.

METHODS

Forty-five thousand eight hundred fifty-three participants from the National Health and Nutrition Examination Survey (NHANES) (1999-2018) were enrolled. Social demographic information, lifestyle factors, blood biochemical measurements and anthropometric indices, including body weight, body mass index (BMI), waist circumference, waist-to-height ratio (WtHR), conicity index (CI), a body shape index (ABSI), body roundness index (BRI) and lipid accumulation product (LAP) were collected. Multivariable logistic regression and restricted cubic spline were adopted to investigate the associations between hypertension risk and anthropometric indices. We also performed receiver operating characteristic (ROC) curve analyses to further evaluate the discriminatory powers of anthropometric measurements for screening hypertension risk. Moreover, participants were randomly assigned to the training group and the validation group in a ratio of 3 to 1. A nomogram model based on anthropometric measures was established and validated in the training group and validation group, respectively.

RESULTS

All of the anthropometric measurements investigated were positively and independently associated with the hypertension risk. Among all anthropometric indices, per-SD increment in ABSI had the highest OR (OR: 3.4; 95% CI: 2.73-4.24) after adjusting for age, sex, race/ethnicity, education, smoking, drinking, diabetes, and eGFR. Moreover, results from restricted cubic splines revealed the non-linear association between anthropometric measurements and hypertension risk. In ROC analyses, CI had superior discriminatory power for hypertension (area under the curve: 0.71; 95% CI: 0.706-0.715; optimal cutoff value: 1.3) compared with other indices. Nomogram model based on age, sex, diabetes, CI and LAP showed favorable predicting ability of hypertension risk with an AUC (95% CI) in training group of 80.2% (79.7-80.6%), and the AUC (95% CI) in validation group was 79.5% (78.3-80.1%). Meanwhile, calibration plot showed good consistency.

CONCLUSIONS

Anthropometric measurements including BMI, WtHR, CI, ABSI, BRI and LAP are closely associated with hypertension risk in the present study. For better prevention and treatment of hypertension, more attention should be paid to anthropometric indices, especially novel anthropometric indices.