Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018

BackgroundCardiometabolic syndrome (CMS), marked by abdominal obesity and metabolic dysregulation, is associated with a heightened risk of cardiovascular disease (CVD). Compared to the traditional anthropometric predictors represented by body mass index (BMI) and waist circumference (WC), body round...

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Main Authors: Xiaohua He, Jingling Zhu, Wenfei Liang, Xiuling Yang, Weimin Ning, Zhan Zhao, Jingyi Chen, Qiuxing He
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1524352/full
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author Xiaohua He
Jingling Zhu
Wenfei Liang
Xiuling Yang
Weimin Ning
Zhan Zhao
Jingyi Chen
Qiuxing He
author_facet Xiaohua He
Jingling Zhu
Wenfei Liang
Xiuling Yang
Weimin Ning
Zhan Zhao
Jingyi Chen
Qiuxing He
author_sort Xiaohua He
collection DOAJ
description BackgroundCardiometabolic syndrome (CMS), marked by abdominal obesity and metabolic dysregulation, is associated with a heightened risk of cardiovascular disease (CVD). Compared to the traditional anthropometric predictors represented by body mass index (BMI) and waist circumference (WC), body roundness index (BRI) appears to provide a more accurate reflection of the abdominal fat distribution associated with metabolic diseases. Therefore, this study intends to investigate the association of BRI with the risk of CVD and its components including congestive heart failure (CHF), coronary heart disease (CHD), angina, heart attack, and stroke in patients with CMS. At the same time, we hypothesized that BRI would identify CVD better than BMI or WC.MethodsData from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). Logistic regression models were mainly utilized to evaluate the relationship between BRI and CVD in patients with CMS, including smooth curve analysis, threshold effects analysis, subgroup analysis and multiple imputation. In addition, receiver operating characteristic (ROC) curves were used to assess the ability of BRI to predict CVD.ResultsThe logistic regression model showed a positive association between the BRI and CVD. The highest quartile of BRI (Q4) showing the strongest association with CVD. The smoothed curve revealed a linear relationship between BRI and CVD, but a U-shaped association between the BRI and CHF. For CVD, stratified analyses did not show significant difference between strata. For CHF, BMI interacted with the association, with BRI being associated with decreased risk of CHF in a subgroup of normal weight subjects and increased risk of CHF in a subgroup of obese subjects. The multiple imputation further confirmed the robustness of these results. Additionally, the ROC curve indicated that BRI, BMI and WC had predictive power for CVD and CHF (AUC > 0.05). BRI has similar predictive power to WC but better than BMI.ConclusionsAn elevated BRI is associated with a heightened risk of CVD in patients with CMS. BRI has similar ability to predict CVD and CHF as WC, but superior to BMI.
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spelling doaj-art-e470d77267c249fc930433ada9f6c7dd2025-02-03T05:11:57ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-02-011610.3389/fendo.2025.15243521524352Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018Xiaohua HeJingling ZhuWenfei LiangXiuling YangWeimin NingZhan ZhaoJingyi ChenQiuxing HeBackgroundCardiometabolic syndrome (CMS), marked by abdominal obesity and metabolic dysregulation, is associated with a heightened risk of cardiovascular disease (CVD). Compared to the traditional anthropometric predictors represented by body mass index (BMI) and waist circumference (WC), body roundness index (BRI) appears to provide a more accurate reflection of the abdominal fat distribution associated with metabolic diseases. Therefore, this study intends to investigate the association of BRI with the risk of CVD and its components including congestive heart failure (CHF), coronary heart disease (CHD), angina, heart attack, and stroke in patients with CMS. At the same time, we hypothesized that BRI would identify CVD better than BMI or WC.MethodsData from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). Logistic regression models were mainly utilized to evaluate the relationship between BRI and CVD in patients with CMS, including smooth curve analysis, threshold effects analysis, subgroup analysis and multiple imputation. In addition, receiver operating characteristic (ROC) curves were used to assess the ability of BRI to predict CVD.ResultsThe logistic regression model showed a positive association between the BRI and CVD. The highest quartile of BRI (Q4) showing the strongest association with CVD. The smoothed curve revealed a linear relationship between BRI and CVD, but a U-shaped association between the BRI and CHF. For CVD, stratified analyses did not show significant difference between strata. For CHF, BMI interacted with the association, with BRI being associated with decreased risk of CHF in a subgroup of normal weight subjects and increased risk of CHF in a subgroup of obese subjects. The multiple imputation further confirmed the robustness of these results. Additionally, the ROC curve indicated that BRI, BMI and WC had predictive power for CVD and CHF (AUC > 0.05). BRI has similar predictive power to WC but better than BMI.ConclusionsAn elevated BRI is associated with a heightened risk of CVD in patients with CMS. BRI has similar ability to predict CVD and CHF as WC, but superior to BMI.https://www.frontiersin.org/articles/10.3389/fendo.2025.1524352/fullcardiometabolic syndromecardiovascular diseasebody roundness indexNHANESobesity
spellingShingle Xiaohua He
Jingling Zhu
Wenfei Liang
Xiuling Yang
Weimin Ning
Zhan Zhao
Jingyi Chen
Qiuxing He
Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018
Frontiers in Endocrinology
cardiometabolic syndrome
cardiovascular disease
body roundness index
NHANES
obesity
title Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018
title_full Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018
title_fullStr Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018
title_full_unstemmed Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018
title_short Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018
title_sort association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome a cross sectional study based on nhanes 2009 2018
topic cardiometabolic syndrome
cardiovascular disease
body roundness index
NHANES
obesity
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1524352/full
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