Zhang Chong, Hao Cuijun, Liang Weiru, Hu Kun, Guo Tingting, Chen Yi, Ning Meng, Liu Yingwu
The Third Central Clinical College of Tianjin Medical University, Tianjin, 300170, China.
Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, 300170, China.
Diabetol Metab Syndr. 2025 Mar 4;17(1):75. doi: 10.1186/s13098-025-01649-0.
Abdominal obesity, assessed via the body roundness index (BRI), is a critical determinant of health outcomes. This study explores the association between abdominal obesity and frailty progression across different stages of Cardiovascular-Kidney-Metabolic (CKM) syndrome in a nationwide longitudinal cohort.
Data were derived from the China Health and Retirement Longitudinal Study, including individuals aged ≥ 45 years. Participants were categorized into early and advanced CKM syndrome stages. The BRI was used to measure abdominal obesity, and frailty was assessed using the frailty index.
Higher BRI in individuals within early CKM syndrome stages was associated with an increased risk of frailty progression compared to those with advanced stages (adjusted hazard ratio [aHR] 1.30, 95% confidence interval [CI] 1.17-1.45 vs. aHR 1.16, 95% CI 0.96-1.40). High cumulative BRI with advanced CKM stages progression and persistent advanced CKM stages over time also predicted a greater risk of frailty. Furthermore, BRI outperformed body mass index (BMI) in predicting frailty progression after combined with conventional model (area under the curve [AUC] 0.708, 95% CI 0.694-0.722 vs. AUC 0.704, 95% CI 0.690-0.718; P = 0.033).
Abdominal obesity, indicated by BRI, is a strong predictor of frailty progression, particularly in early CKM stages. High cumulative BRI, along with advanced CKM progression and persistent advanced CKM stages, further increases frailty risk. Notably, BRI outperforms BMI in enhancing conventional frailty prediction models. These findings underscore the importance of monitoring abdominal obesity in early CKM stages to mitigate future frailty risk.
通过身体圆润度指数（BRI）评估的腹部肥胖是健康结果的关键决定因素。本研究在全国范围内的纵向队列中探讨了腹部肥胖与心血管 - 肾脏 - 代谢（CKM）综合征不同阶段虚弱进展之间的关联。
数据来源于中国健康与养老追踪调查，包括年龄≥45岁的个体。参与者被分为CKM综合征的早期和晚期阶段。使用BRI测量腹部肥胖，并使用虚弱指数评估虚弱状况。
与晚期CKM综合征阶段的个体相比，早期CKM综合征阶段个体的较高BRI与虚弱进展风险增加相关（调整后风险比[aHR] 1.30，95%置信区间[CI] 1.17 - 1.45，而aHR 1.16，95% CI 0.96 - 1.40）。随着CKM晚期阶段的进展以及随着时间推移持续处于CKM晚期阶段，高累积BRI也预示着更高的虚弱风险。此外，在与传统模型结合后，BRI在预测虚弱进展方面优于体重指数（BMI）（曲线下面积[AUC] 0.708，95% CI 0.694 - 0.722，而AUC 0.704，95% CI 0.690 - 0.718；P = 0.033）。
由BRI表明的腹部肥胖是虚弱进展的有力预测指标，尤其是在CKM早期阶段。高累积BRI，连同CKM的进展以及持续处于CKM晚期阶段，会进一步增加虚弱风险。值得注意的是，BRI在增强传统虚弱预测模型方面优于BMI。这些发现强调了在CKM早期阶段监测腹部肥胖以减轻未来虚弱风险的重要性。
