Zhao Ziyi, Ji Hongxiang, Liu Wenyu, Wang Zhengdan, Ren Shengquan, Liu Chunlei, Wu Caifeng, Wang Jian, Ding Xiaoheng
Department of Hand and Foot, Microsurgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Medicine (Baltimore). 2025 Aug 29;104(35):e43750. doi: 10.1097/MD.0000000000043750.
A growing body of evidence has established a close association between obesity and bone metabolism. The body roundness index (BRI), a novel anthropometric parameter, has demonstrated superior predictive capability for estimating both visceral fat percentage and total body fat percentage when compared with traditional measures such as Body Mass Index (BMI) and waist circumference. However, there is a paucity of research exploring the relationship between BRI and bone mineral density (BMD). Therefore, this investigation was designed to assess the association between BRI and lumbar spine BMD among adults in the United States. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) cycles spanning 2011 to 2018, including participants aged 20 years and older. To evaluate the linear association between BRI and lumbar BMD, weighted multivariable regression models were applied. Additionally, weighted smooth curve fitting along with a 2-piecewise linear regression approach was utilized to detect potential nonlinear relationships. Stratified subgroup analyses were carried out based on age, sex, race/ethnicity, and BMI categories. The final analysis included a total of 10,996 adult participants. In the fully adjusted regression model, BRI exhibited a significant inverse association with lumbar BMD (β = -0.048; 95% CI: -0.059 to -0.037). This negative correlation persisted across most subgroups (all interaction P-value > .05), with the exception of BMI-defined strata. A nonlinear association between BRI and lumbar BMD was identified, with an inflection point observed at a BRI value of 7.63. Comparable nonlinear patterns were detected in subpopulations stratified by age (<40 years and ≥ 40 years), gender (male), and race/ethnicity (non-Hispanic White and other race). This study highlights a significant inverse and nonlinear relationship between the BRI and lumbar spine BMD in U.S. adults. These findings may offer novel insights for the development of targeted strategies in osteoporosis prevention and intervention.
越来越多的证据表明肥胖与骨代谢之间存在密切关联。身体圆润度指数（BRI）是一种新的人体测量参数，与传统测量指标如体重指数（BMI）和腰围相比，在估计内脏脂肪百分比和全身脂肪百分比方面具有更强的预测能力。然而，探索BRI与骨密度（BMD）之间关系的研究较少。因此，本研究旨在评估美国成年人中BRI与腰椎BMD之间的关联。数据来自2011年至2018年的国家健康与营养检查调查（NHANES）周期，包括20岁及以上的参与者。为了评估BRI与腰椎BMD之间的线性关联，应用了加权多变量回归模型。此外，采用加权平滑曲线拟合和两段式线性回归方法来检测潜在的非线性关系。根据年龄、性别、种族/民族和BMI类别进行分层亚组分析。最终分析共纳入10996名成年参与者。在完全调整的回归模型中，BRI与腰椎BMD呈显著负相关（β = -0.048；95%CI：-0.059至-0.037）。这种负相关在大多数亚组中持续存在（所有交互P值>.05），BMI定义的分层除外。确定了BRI与腰椎BMD之间的非线性关联，在BRI值为7.63时观察到一个拐点。在按年龄（<40岁和≥40岁）、性别（男性）和种族/民族（非西班牙裔白人及其他种族）分层的亚人群中也检测到了类似的非线性模式。本研究强调了美国成年人中BRI与腰椎BMD之间存在显著的负向和非线性关系。这些发现可能为骨质疏松症预防和干预的针对性策略的制定提供新的见解。
