Body Roundness Index Trajectories and Incident Left Ventricular Hypertrophy: Results of a Community-Based Study in Korea

Left ventricular hypertrophy (LVH) constitutes Stage B heart failure and marks elevated risk for atrial fibrillation, stroke, and death. Unlike body mass index, body roundness index (BRI), derived from waist circumference and height, more accurately reflects visceral adiposity. Because existing BRI-LVH evidence is usually cross-sectional, we investigated whether the BRI trajectory can predict incident LVH.

Of a total of 2,578 subjects who underwent echocardiographic examinations, we studied 1,764 participants who were free of LVH on echocardiography at baseline (2007-2008, wave 4). BRI trajectory was determined from BRI values measured at four biennial examinations (2001-2008). The outcome was incident LVH on echocardiography during the follow-up (2009-2016, wave 5-8).

The mean age was 53.2±6.3 years, and 828 (46.9%) were women. Latent class mixed models identified 3 sex-specific BRI trajectory classes: stable-low (Class 1), stable-moderate (Class 2), and variable-high BRI (Class 3). Among men, 225 (24.0%), 615 (65.7%), and 96 (10.3%) were classified into these classes, respectively; among women, 319 (38.5%), 356 (43.0%), and 153 (18.5%). Incident LVH, defined as LVH on echocardiography at any of the 4 follow-up examinations conducted during 2009-2016 (wave 5-8), developed in 249 of 936 men (26.6%) and 196 of 828 women (23.7%), and incidence increased across trajectory classes in both sexes (in men, 5.8%, 30.6%, and 50.0%; in women, 7.5%, 32.3%, and 37.3%; both P < 0.001). In the fully adjusted model, compared with Class 1, OR of incident LVH were increased for Class 2 (men; 4.75 [95% CI, 2.33-9.66]; women, 4.53 [2.67-7.68]; both P < 0.001) and for Class 3 (men, 9.28 [3.91-22.02]; women, 4.60 [2.50-8.48]; both P < 0.001).

In a community-based Korean cohort, sex-specific BRI trajectories characterized by stable-moderate (Class 2) or variable-high (Class 3) BRI trajectory groups were associated with a substantially increased risk of incident LVH in both men and women.