Zhang Jiaying, Yu Xiaofeng
Department of Nephrology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, Sichuan, China.
Department of Cardiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, Sichuan, China.
Front Med (Lausanne). 2024 Dec 18;11:1495935. doi: 10.3389/fmed.2024.1495935. eCollection 2024.
We aimed to systematically assess whether the level of body roundness index (BRI) is associated with the risk of developing chronic kidney disease (CKD) in US adults.
The studied data was extracted from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. A total of 29,062 participants aged ≥20 years with complete information about BRI and CKD were included in this study. Logistic regression analysis, multivariate linear regression analysis, restricted cubic spline (RCS) plots curve, stratified analysis and receiver operating characteristic (ROC) curve were performed to investigate the association between BRI and CKD.
A total of 29,062 patients were included, involving 4,623 individuals with CKD and 24,439 individuals without CKD. A higher BRI level was substantially related to an increased prevalence of CKD in US adults. After adjusting for confounding variables, the BRI in the fourth quartile was correlated to a higher CKD prevalence (OR: 1.36; 95% CI: 1.10-1.70) compared to the lowest quartile. After adjusting for confounding variables, the BRI in the fourth quartile was correlated to a higher CKD prevalence (OR: 1.36; 95% CI: 1.10-1.70) compared to the lowest quartile. However, in the subgroup analysis stratified by race and body mass index (BMI), no significant associations between BRI and CKD were observed among Mexican participants (OR: 1.10; 95% CI: 0.98-1.23) and those with underweight or normal weight (OR: 0.95; 95% CI: 0.81-1.05). Moreover, a non-linear relationship was found between BRI and the prevalence of CKD. In ROC analysis, BRI demonstrated higher discriminating for CKD (area under the curve: 0.6247; 95% CI: 0.6161-0.6333; optimal cutoff value: 5.161) compared with other indices.
In summary, BRI was independently associated with a higher prevalence of CKD in overweight and obese US adults, excluding Mexican. This may be an important therapeutic target and predictor of CKD. Physicians should advise patients with high BRI scores, especially overweight and obese patients, to embrace healthy lifestyle changes, such as maintaining a balanced diet and engaging in regular physical activity. These changes can help them control their body weight and reduce abdominal fat, ultimately lowering the risk of CKD.
我们旨在系统评估身体圆润度指数(BRI)水平是否与美国成年人患慢性肾脏病(CKD)的风险相关。
研究数据取自1999年至2018年的美国国家健康与营养检查调查(NHANES)。本研究纳入了29062名年龄≥20岁且拥有关于BRI和CKD完整信息的参与者。进行了逻辑回归分析、多元线性回归分析、限制性立方样条(RCS)曲线、分层分析和受试者工作特征(ROC)曲线分析,以研究BRI与CKD之间的关联。
共纳入29062例患者,其中4623例患有CKD,24439例未患CKD。较高的BRI水平与美国成年人中CKD患病率的增加显著相关。在调整混杂变量后,与最低四分位数相比,第四四分位数的BRI与更高的CKD患病率相关(比值比:1.36;95%置信区间:1.10 - 1.70)。然而,在按种族和体重指数(BMI)分层的亚组分析中,在墨西哥参与者(比值比:1.10;95%置信区间:0.98 - 1.23)以及体重过轻或正常体重的参与者(比值比:0.95;95%置信区间:0.81 - 1.05)中,未观察到BRI与CKD之间存在显著关联。此外,发现BRI与CKD患病率之间存在非线性关系。在ROC分析中,与其他指标相比,BRI对CKD的鉴别能力更高(曲线下面积:0.6247;95%置信区间:0.6161 - 0.6333;最佳截断值:5.161)。
总之,在美国超重和肥胖成年人(不包括墨西哥人)中,BRI与较高的CKD患病率独立相关。这可能是CKD的一个重要治疗靶点和预测指标。医生应建议BRI评分高的患者,尤其是超重和肥胖患者,采取健康的生活方式改变,如保持均衡饮食和定期进行体育活动。这些改变有助于他们控制体重并减少腹部脂肪,最终降低患CKD的风险。