美国20岁及以上成年人中身体质量指数（BRI）、颈围指数（CI）和腰围身高比（WHtR）与握力的非线性关联及阈值效应：一项横断面研究
Non-linear associations and threshold effects of BRI, CI, and WHtR with grip strength in U. S. adults aged ≥20 years: a cross-sectional study.
作者信息
Yang Sijia, Liao Kun, Zhou Lu, Zhang Shengbo, Wu Jianchao
机构信息
Department of Thyroid Diagnosis and Treatment Center, Zhuhai People's Hospital (The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University), Zhuhai, China.
Department of Breast Surgery Ward, Zhuhai People's Hospital (The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University), Zhuhai, China.
出版信息
Front Nutr. 2025 Jun 18;12:1597065. doi: 10.3389/fnut.2025.1597065. eCollection 2025.
BACKGROUND
Muscle strength is strongly associated with various physiological functions and health risks, with grip strength serving as a key indicator for its assessment. Currently, the relationship between novel obesity indices [Body Roundness Index (BRI), Conicity Index (CI), and waist-to-height ratio (WHtR)] and grip strength remains unclear. The current study aimed to investigate the non-linear/threshold relationships between BRI, CI, WHtR, and grip strength.
METHODS
A cross-sectional study design was adopted to analyze the data of 9,356 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2014. Researchers measured grip strength and calculated BRI, CI, and WHtR, while controlling for age, sex, ethnicity, and other covariates. Statistical analyses included linear regression, smooth curve fitting, and threshold effect models to evaluate non-linear/threshold relationships. The significance level was set at a < 0.05, and 95% confidence intervals (CIs) were reported.
RESULTS
BRI, CI, and WHtR exhibited significant non-linear associations with grip strength. For BRI, values below 3.55 exhibited a strong positive effect on grip strength ( = 3.60, 95% CIs: 2.81-4.39), with weakened but persistent positive effects above this threshold ( = 0.24, 95% CI: 0.10-0.39). WHtR demonstrated a similar pattern, with a threshold set at 0.51: = 62.46 (48.36-76.55) below and = 6.47 (2.85-10.08) above. CI showed an inverted U-shaped relationship, shifting from positive ( = 15.87, 7.85-23.90) to negative ( = -9.98, -14.98 to -4.98, < 0.01) at a threshold of 1.27.
CONCLUSION
In U. S. adults, BRI, CI, and WHtR exhibited non-linear and threshold-dependent associations with grip strength, suggesting that these indices can help refine the assessment of muscle strength. The findings indicate that integrating these indices could enhance the accuracy of risk stratification for muscle dysfunction, particularly in individuals with central obesity. Longitudinal studies are needed to further validate the causal relationships underlying these associations.
背景
肌肉力量与多种生理功能和健康风险密切相关，握力是评估肌肉力量的关键指标。目前，新型肥胖指数[体圆度指数（BRI）、锥度指数（CI）和腰高比（WHtR）]与握力之间的关系尚不清楚。本研究旨在探讨BRI、CI、WHtR与握力之间的非线性/阈值关系。
方法
采用横断面研究设计，分析2011年至2014年美国国家健康与营养检查调查（NHANES）中9356名参与者的数据。研究人员测量了握力，并计算了BRI、CI和WHtR，同时控制了年龄、性别、种族和其他协变量。统计分析包括线性回归、平滑曲线拟合和阈值效应模型，以评估非线性/阈值关系。显著性水平设定为α<0.05，并报告95%置信区间（CI）。
结果
BRI、CI和WHtR与握力呈现出显著的非线性关联。对于BRI，低于3.55的值对握力有很强的正向影响（β=3.60，95%CI：2.81-4.39），高于此阈值时正向影响减弱但仍持续存在（β=0.24，95%CI：0.10-0.39）。WHtR呈现出类似的模式，阈值设定为0.51：低于该阈值时β=62.46（48.36-76.55），高于该阈值时β=6.47（2.85-10.08）。CI呈现出倒U形关系，在阈值为1.27时从正向（β=15.87，7.85-23.90）转变为负向（β=-9.98，-14.98至-4.98，P<0.01）。
结论
在美国成年人中，BRI、CI和WHtR与握力呈现出非线性和阈值依赖性关联，表明这些指数有助于完善肌肉力量的评估。研究结果表明，整合这些指数可以提高肌肉功能障碍风险分层的准确性，尤其是在中心性肥胖个体中。需要进行纵向研究以进一步验证这些关联背后的因果关系。
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