Temporal trends, associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle-aged and older Chinese adults: from the China Health and Retirement Longitudinal Study 2011–2018
BackgroundObesity 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...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1515067/full |
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| author | Ying-Yuan Gan Yun-Dan Luo Lu Zhai Rong-Rui Huo Xia Dai Qian Liao |
| author_facet | Ying-Yuan Gan Yun-Dan Luo Lu Zhai Rong-Rui Huo Xia Dai Qian Liao |
| author_sort | Ying-Yuan Gan |
| collection | DOAJ |
| description | BackgroundObesity 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.MethodsThis 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.ResultsA 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.ConclusionsBRI 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. |
| format | Article |
| id | doaj-art-8ef73e3c219f486aabacf2424fe61ce2 |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Nutrition |
| spelling | doaj-art-8ef73e3c219f486aabacf2424fe61ce22025-01-24T16:35:42ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-01-011210.3389/fnut.2025.15150671515067Temporal trends, associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle-aged and older Chinese adults: from the China Health and Retirement Longitudinal Study 2011–2018Ying-Yuan Gan0Yun-Dan Luo1Lu Zhai2Rong-Rui Huo3Xia Dai4Qian Liao5Department of Scientific Research, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaDepartment of General Practice, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaDepartment of Smart Health Elderly Care Services and Management, Guangxi Health Science College, School of Nursing, Nanning, ChinaDepartment of Experimental Research, Guangxi Medical University Cancer Hospital, Nanning, ChinaDepartment of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, ChinaBackgroundObesity 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.MethodsThis 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.ResultsA 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.ConclusionsBRI 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.https://www.frontiersin.org/articles/10.3389/fnut.2025.1515067/fullobesitycardiovascular diseaseChinacohort studybody roundness index |
| spellingShingle | Ying-Yuan Gan Yun-Dan Luo Lu Zhai Rong-Rui Huo Xia Dai Qian Liao Temporal trends, associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle-aged and older Chinese adults: from the China Health and Retirement Longitudinal Study 2011–2018 Frontiers in Nutrition obesity cardiovascular disease China cohort study body roundness index |
| title | Temporal trends, associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle-aged and older Chinese adults: from the China Health and Retirement Longitudinal Study 2011–2018 |
| title_full | Temporal trends, associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle-aged and older Chinese adults: from the China Health and Retirement Longitudinal Study 2011–2018 |
| title_fullStr | Temporal trends, associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle-aged and older Chinese adults: from the China Health and Retirement Longitudinal Study 2011–2018 |
| title_full_unstemmed | Temporal trends, associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle-aged and older Chinese adults: from the China Health and Retirement Longitudinal Study 2011–2018 |
| title_short | Temporal trends, associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle-aged and older Chinese adults: from the China Health and Retirement Longitudinal Study 2011–2018 |
| title_sort | temporal trends associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle aged and older chinese adults from the china health and retirement longitudinal study 2011 2018 |
| topic | obesity cardiovascular disease China cohort study body roundness index |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1515067/full |
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