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Published on: September 27, 2024
Body Roundness Index Associated With Cardiometabolic Multimorbidity and Mortality: A Multistate Model
Xi Cai1, Yicheng Liao2, Xuemei Yang3
1Department of Rheumatology and Immunology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, Hebei, China.
Insights
Body roundness index (BRI) is a key indicator for cardiometabolic disease (CMD) and multimorbidity (CMM) risk. Higher BRI levels predict increased risk of developing CMM and mortality, especially in women, highlighting the need for targeted prevention.
Area of Science:
- Cardiology
- Metabolic Health
- Public Health
Background:
- Cardiometabolic diseases (CMD) represent a significant global health burden.
- Understanding novel biomarkers for CMD and cardiometabolic multimorbidity (CMM) is crucial for early intervention.
- Body roundness index (BRI) has emerged as a potential indicator of central obesity and metabolic risk.
Purpose of the Study:
- To investigate the associations between body roundness index (BRI) and the risk of developing cardiometabolic disease (CMD), cardiometabolic multimorbidity (CMM), and all-cause mortality.
- To evaluate the impact of BRI across different stages of CMM progression.
- To explore sex-specific and disease-specific differences in BRI associations.
Main Methods:
- A prospective cohort study involving 87,902 participants from the Kailuan cohort.
- Participants were categorized into BRI quartiles.
- Cox proportional hazards models and multistate models were used to assess risks and transitions across CMM stages.
Main Results:
- Over a median follow-up of 13.68 years, elevated BRI was associated with increased risks of first cardiometabolic disease (FCMD), CMM, and all-cause mortality.
- Multistate analysis showed higher BRI quartiles were linked to increased risk of transitioning from healthy to FCMD and from FCMD to CMM.
- BRI's impact on mortality varied across CMM stages, with a protective effect observed in the CMM stage for the highest BRI quartile. Associations were stronger in females.
Conclusions:
- Dynamic monitoring of BRI serves as a valuable biomarker for early identification of CMM risk and prognostic assessment.
- Disease- and sex-specific prevention strategies are necessary, considering the varying impact of BRI.
- BRI monitoring can aid in personalized risk stratification for cardiometabolic disorders.
Objective:
This study aimed to investigate the associations of body roundness index (BRI) with cardiometabolic disease (CMD), cardiometabolic multimorbidity (CMM), and all-cause mortality, while evaluating its impact across different stages of CMM progression.
Methods:
In this prospective cohort study, 87,902 participants from the Kailuan cohort were categorized into BRI quartiles. Cox models estimated hazard ratios (HRs) and 95% CIs for the first occurrence of cardiometabolic disease (FCMD), CMM, and mortality. Multistate models assessed BRI's role across CMM progression.
Results:
Over a median follow-up of 13.68 years, 21,636 participants developed FCMD, 2114 developed CMM, and 14,782 died. Elevated BRI increased risks of FCMD, CMM, and mortality in Cox models. Multistate analysis revealed differential BRI effects across CMM progression: participants in the highest versus lowest BRI quartile showed HRs of 2.08 (1.99-2.17) for healthy-to-FCMD transition, 1.61 (1.38-1.88) for FCMD-to-CMM transition, and 1.09 (1.03-1.16), 0.99 (0.89-1.10), and 0.73 (0.54-0.99) for mortality from the healthy state, FCMD, and CMM, respectively. BRI's impact varied by disease type (diabetes mellitus, myocardial infarction, stroke) and sex, with stronger associations in females.
Conclusions:
Our findings emphasize dynamic BRI monitoring as a biomarker for early CMM risk identification and prognostic assessment, necessitating disease- and sex-specific prevention strategies.
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