Gan Ying-Yuan, Luo Yun-Dan, Zhai Lu, Huo Rong-Rui, Dai Xia, Liao Qian
Department of Scientific Research, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Department of General Practice, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Front Nutr. 2025 Jan 24;12:1515067. doi: 10.3389/fnut.2025.1515067. eCollection 2025.
Obesity is a major global health issue, driving high morbidity and mortality rates. The body roundness index (BRI), which includes waist circumference, offers a more accurate measure of visceral and total body fat. However, despite evidence of BRI's effectiveness in predicting obesity-related diseases, national-level data, especially from non-Western populations like China, remain limited.
This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a large, nationally representative cohort of Chinese adults, to examine the temporal trends of BRI, identify associated risk factors, and investigate the longitudinal associations between BRI and cardiovascular disease (CVD) outcomes. BRI was calculated using height and waist circumference measurements. Temporal trends and risk factors were analyzed cross-sectionally, while longitudinal associations were examined using Cox proportional hazards models adjusted for confounders. Mediation analyses were conducted to assess the role of intermediate factors such as hypertension and diabetes in the relationship between BRI and CVD.
A total of 12,902 participants were included for risk factor analysis, 10,525 for longitudinal analysis, and 7,310 for cumulative analysis. BRI continued to rise slowly across survey cycles but was higher in women, older adults, and urban residents. Multivariable analysis identified age, alcohol consumption, elevated blood pressure, and diabetes as positive predictors of BRI, while male sex, rural residence, and smoking were negatively associated. Higher baseline BRI was significantly associated with increased CVD risk (HR: 1.44, 95% CI: 1.22-1.69), stroke (HR: 1.49, 95% CI: 1.12-1.98), and heart disease (HR: 1.47, 95% CI: 1.22-1.77). Cumulative BRI similarly predicted increased risks of CVD, stroke, and heart disease. Mediation analysis showed that hypertension accounted for 20.69% of the association between BRI and CVD risk.
BRI is a robust predictor of CVD risk. Targeting hypertension and other metabolic conditions could mitigate the elevated CVD risk associated with high BRI in Chinese adults. These findings underscore the importance of incorporating BRI into public health strategies to better manage obesity-related health risks in China.
肥胖是一个重大的全球健康问题，导致高发病率和死亡率。身体圆润度指数（BRI）包括腰围，能更准确地衡量内脏脂肪和全身脂肪。然而，尽管有证据表明BRI在预测肥胖相关疾病方面有效，但国家级数据，尤其是来自中国等非西方人群的数据仍然有限。
本研究利用中国健康与养老追踪调查（CHARLS）的数据，这是一个具有全国代表性的中国成年人大型队列，以研究BRI的时间趋势，确定相关风险因素，并调查BRI与心血管疾病（CVD）结局之间的纵向关联。BRI通过身高和腰围测量值计算得出。时间趋势和风险因素采用横断面分析，而纵向关联则使用经混杂因素调整的Cox比例风险模型进行检验。进行中介分析以评估高血压和糖尿病等中间因素在BRI与CVD关系中的作用。
共有12902名参与者纳入风险因素分析，10525名纳入纵向分析，7310名纳入累积分析。BRI在各调查周期中持续缓慢上升，但在女性、老年人和城市居民中更高。多变量分析确定年龄、饮酒、血压升高和糖尿病为BRI的正向预测因素，而男性、农村居民和吸烟与之呈负相关。较高的基线BRI与CVD风险增加（HR：1.44，95%CI：1.22 - 1.69）、中风（HR：1.49，95%CI：1.12 - 1.98）和心脏病（HR：1.47，95%CI：1.22 - 1.77）显著相关。累积BRI同样预测了CVD、中风和心脏病风险的增加。中介分析表明，高血压占BRI与CVD风险关联的20.69%。
BRI是CVD风险的有力预测指标。针对高血压和其他代谢状况可减轻中国成年人中与高BRI相关的CVD风险升高。这些发现强调了将BRI纳入公共卫生策略以更好地管理中国肥胖相关健康风险的重要性。
