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Published on: September 27, 2024
Circadian Syndrome Mediates the Association Between Body Roundness Index and Incident Stroke Risk in Middle-Aged and
Gaiying Ma1, Hongwei Liu2, Haiyan Wu3
1Department of Neurology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital of Shanxi Medical University), Taiyuan, Shanxi Province, China.
Insights
Higher Body Resistin Index (BRI) is linked to increased stroke risk, with circadian syndrome (CircS) partially mediating this effect. Maintaining circadian health may aid in stroke prevention.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- The Body Resistin Index (BRI) is a novel measure for chronic disease risk.
- The association between BRI and stroke risk, particularly under varying circadian syndrome (CircS) conditions, remains unclear.
Purpose of the Study:
- To investigate the relationship between BRI and stroke risk.
- To explore the mediating role of CircS in the BRI-stroke association.
- To compare the stroke prediction performance of BRI with conventional metabolic indices.
Main Methods:
- Utilized data from 7535 participants in the China Health and Retirement Longitudinal Study (CHARLS).
- Defined CircS by at least four concurrent metabolic disturbances related to circadian rhythm disruption.
- Employed Cox models, restricted cubic splines, Kaplan-Meier curves, mediation, subgroup, and sensitivity analyses.
- Used ROC analysis to compare BRI's predictive performance against other metabolic indices.
Main Results:
- Higher BRI was significantly associated with increased stroke risk (HR=2.50).
- The association between BRI and stroke risk was not significant in CircS patients but remained significant in non-CircS individuals.
- CircS mediated 21.0% of the association between BRI and stroke risk.
- BRI demonstrated moderate stroke prediction capability (AUC=0.656), outperforming other anthropometric indices.
Conclusions:
- Increased BRI is associated with a higher risk of stroke.
- CircS partially mediates the relationship between BRI and stroke risk.
- Circadian health plays a potential role in stroke prevention strategies.
Background:
Despite BRI being a novel measure for chronic disease risk, the relationship between BRI and stroke risk under varying circadian syndrome (CircS) conditions is still unclear.
Methods:
The analysis utilized data from 7535 participants involved in the China Health and Retirement Longitudinal Study (CHARLS). CircS was defined by at least four concurrent metabolic disturbances due to circadian rhythm disruption. To ensure robustness, the BRI-stroke association was assessed using Cox models, restricted cubic splines, Kaplan-Meier curves, and mediation analyses, along with subgroup and sensitivity analyses. The receiver operating characteristic (ROC) analysis was used to compare the stroke risk prediction performance of BRI with conventional metabolic indices.
Results:
Following full adjustment, higher log (BRI) values were significantly associated with an increased risk of stroke (HR = 2.50, 95% CI: 1.81-3.44, p < 0.001), with Q4 showing a greater risk than Q1 (HR = 2.23, 95% CI: 1.63-3.04, p < 0.001). In CircS patients, no significant association was observed (log (BRI) HR = 1.23, 95% CI: 0.55-2.76; Q4 vs. Q1 HR = 0.61, 95% CI: 0.21-1.77; all p > 0.05). However, the association remained significant in non-CircS individuals (log (BRI) HR = 2.36, 95% CI: 1.61-3.47; Q4 vs. Q1 HR = 2.08, 95% CI: 1.46-2.98; all p < 0.001). Subgroup and sensitivity analyses bolstered the robustness of our findings. CircS mediated 21.0% of the association between BRI and stroke risk (95% CI: 18%-91%, p < 0.001). With an area under the curve (AUC) of 0.656, BRI demonstrated moderate predictive capability for stroke, outperforming other anthropometric indices.
Conclusions:
An increased BRI is associated with a higher stroke risk, partially mediated by CircS, highlighting the potential role of circadian health in stroke prevention.
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