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. 2025 Jul 30:12:1623766.
doi: 10.3389/fnut.2025.1623766. eCollection 2025.

Association between body roundness index and advanced cardiovascular-kidney-metabolic syndrome

Yuehui Chen  1 , Hongxiang Tu  1 , Min Liang  1 , Mo Shen  1
Affiliations

Association between body roundness index and advanced cardiovascular-kidney-metabolic syndrome

Yuehui Chen et al. Front Nutr. .

Abstract

Background: Cardiovascular-kidney-metabolic (CKM) syndrome is a disease characterized by interrelated cardiovascular, renal, and metabolic abnormalities. The body roundness index (BRI) is an innovative anthropometric index that characterizes human body shape by calculating body roundness and using eccentricity to estimate visceral and total body fat percentages. The present study aimed to clarify the relation between BRI and advanced CKM syndrome.

Methods: Data were obtained from the National Health and Nutrition Examination Survey conducted between 2005 and 2018. Tertiles based on data analysis were applied to divide the levels of BRI. Regression methods assessed the association of BRI with the risk of advanced CKM syndrome. Moreover, receiver operating characteristic analysis determined BRI's predictive performance for such a syndrome.

Results: The present study included 12,329 participants, with an advanced CKM occurrence rate of 12.20%. Regression analysis revealed a positive association between BRI and advanced CKM syndrome. After adjusting for covariates, individuals in the highest BRI tertile (T3) showed a significantly higher prevalence of advanced CKM syndrome compared to the reference group (odds ratio: 1.49; 95% confidence interval: 1.09-2.03, p < 0.001). Smoothed curve-fitting analyses showed a linear trend. Subgroup analyses yielded results consistent with the total results. Furthermore, restricted cubic spline analyses indicated that BRI was a stronger predictor of advanced CKM syndrome than other anthropometric measures.

Conclusion: An increased BRI is associated with a higher occurrence rate of advanced CKM syndrome. BRI demonstrated a stronger correlation with advanced CKM than traditional measures and warrants consideration as a preferred metric for CKM risk stratification.

Keywords: CKM; NHANES; RCS; body roundness index; obesity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study cohort selection.
Figure 2
Figure 2
Association between BRI and advanced CKM syndrome. Adjustment factors included age, gender, ethnicity, educational attainment, marital status, BMI, PIR, smoking status, drinking status, HDL-C, TC, serum creatinine, serum uric acid, glycohemoglobin, SBP, and DBP.
Figure 3
Figure 3
Subgroup analyses of the association between BRI and advanced CKM syndrome. Adjusted for age, sex, ethnicity, educational attainment, marital status, BMI, PIR, smoking status, drinking status, HDL-C, TC, serum creatinine, serum uric acid, glycohemoglobin, SBP, and DBP.
Figure 4
Figure 4
Receiver operating characteristic curves of the BRI, BMI, and WC for the risk of advanced CKM syndrome.
See this image and copyright information in PMC

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