Zhao Xuanli, Jing Fangyuan, Ren Yanan, Zhu Jing, Jing Xinzhe, Lv Meiqun, Huang Ke, Guo Jing, Li Jiayu, Sun Xiaohui, Mao Yingying, Ye Ding
Department of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Public Health, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China.
BMJ Open Diabetes Res Care. 2025 Sep 15;13(5):e005339. doi: 10.1136/bmjdrc-2025-005339.
Type 2 diabetes (T2D) is closely associated with excess adiposity, particularly visceral fat. The body roundness index (BRI), calculated from height and waist circumference, provides a refined estimate of visceral adiposity. This study aimed to investigate the associations of baseline BRI and longitudinal changes in BRI with the risk of incident T2D.
We used UK Biobank data, a cohort involving adults aged 37-73 years. Both baseline and last follow-up BRI values were classified according to the tertiles of baseline BRI, and long-term BRI changes were categorized by baseline and follow-up grades. The annual average rate of change (AARC) of BRI was also calculated. Cox regression models were employed to evaluate HRs and 95% CIs, while restricted cubic splines explored non-linear relationships.
Among 485 509 participants, 32 956 developed T2D during the follow-up period. Elevated baseline BRI was correlated with a greater risk of T2D, with adjusted HRs of 2.39 (95% CI: 2.28 to 2.51) and 6.23 (95% CI: 5.96 to 6.50) for the second and third tertiles of BRI, respectively. In the longitudinal analysis of 65 684 participants (1153 T2D cases), low baseline BRI with grade increase was linked to higher risk of T2D (HR: 1.49, 95% CI: 1.05 to 2.13). Among participants with middle baseline BRI, grade decrease and increase showed HRs of 0.65 (95% CI: 0.45 to 0.93) and 1.66 (95% CI: 1.32 to 2.10) versus stable middle. Grade decrease with high baseline BRI was associated with lower T2D risk (HR: 0.50, 95% CI: 0.40 to 0.62) compared with stable high. Non-linear associations between AARC of BRI and T2D risk were identified (p <0.05).
This study shows that both baseline BRI and long-term BRI changes are linked to T2D risk, emphasizing the significance of monitoring BRI trends for T2D prevention and control.
2型糖尿病(T2D)与肥胖尤其是内脏脂肪过多密切相关。根据身高和腰围计算得出的身体圆润度指数(BRI)能更精确地评估内脏肥胖程度。本研究旨在探讨基线BRI及BRI的纵向变化与T2D发病风险之间的关联。
我们使用了英国生物银行的数据,该队列研究涉及年龄在37至73岁的成年人。基线和末次随访时的BRI值均根据基线BRI的三分位数进行分类,长期BRI变化则根据基线和随访等级进行分类。同时还计算了BRI的年平均变化率(AARC)。采用Cox回归模型评估风险比(HR)和95%置信区间(CI),并使用受限立方样条来探究非线性关系。
在485509名参与者中,有32956人在随访期间患上了T2D。基线BRI升高与T2D风险增加相关,BRI第二和第三三分位数的调整后HR分别为2.39(95%CI:2.28至2.51)和6.23(95%CI:5.96至6.50)。在对65684名参与者(1153例T2D病例)进行的纵向分析中,基线BRI低且等级升高与T2D风险较高相关(HR:1.49,95%CI:1.05至2.13)。在基线BRI中等的参与者中,等级降低和升高的HR分别为0.65(95%CI:0.45至0.93)和1.66(95%CI:1.32至2.10),而中等稳定水平的HR为1。与高稳定水平相比,基线BRI高且等级降低与较低的T2D风险相关(HR:0.50,95%CI:0.40至0.62)。研究发现BRI的AARC与T2D风险之间存在非线性关联(p<0.05)。
本研究表明,基线BRI和BRI的长期变化均与T2D风险相关,强调了监测BRI趋势对T2D预防和控制的重要性。