Investigation of the Relationship Between Laryngopharyngeal Reflux and the Body Roundness Index

The aim of this study was to evaluate the relationship between laryngopharyngeal reflux (LPR) and a new anthropometric indicator, the body roundness index (BRI).

In this retrospective case-control study, adults with LPR (n = 89; reflux symptom index [RSI] > 13 and RFS>7) and controls (n = 94; RSI ≤ 13 and reflux finding score [RFS] ≤ 7) underwent anthropometry (body mass index [BMI]; BRI; body fat percentage [BF%]; visceral adipose tissue, [VAT]), patient-reported scales (Turkish voice handicap index-10, Turkish Eating Assessment Tool-10), and acoustic analysis (fundamental frequency, jitter%, shimmer%, harmonic-noise ratio, cepstral peak prominence smoothed [CPPS], acoustic voice quality index-3.0). Group differences were assessed with Mann-Whitney U. Multiple testing was controlled with Benjamini-Hochberg false discovery rate (FDR). Effect sizes were summarized by Hodges-Lehmann median difference and rank-biserial correlation (r_rb).

The groups were similar in terms of age, gender, and BMI (P > 0.05). BRI showed no association with LPR (median 6.10 vs 5.20; P = 0.130; q = 0.239; r_rb = 0.13). VAT (percentage and total mass) likewise did not differ (all q ≥ 0.32). In contrast, BF% was higher in LPR overall (Δ = +2.55%; P = 0.006; q = 0.064; r_rb = 0.24), driven by men (P = 0.002; q = 0.004; r_rb = 0.40), while women showed no clear difference. Nominal acoustic differences (higher jitter%, lower CPPS) did not survive FDR correction and had small effect sizes (|r_rb|≤0.18).

BRI did not discriminate LPR, and VAT estimates were likewise uninformative. In contrast, directly measured BF%, particularly in men, showed a modest association with LPR status, suggesting that simple, direct adiposity assessment may be more clinically meaningful than shape indices when evaluating patients with suspected LPR. Prospective studies should test gender-specific thresholds and incorporate objective reflux monitoring to clarify causality.