Body Roundness Index and Waist–Hip Ratio Result in Better Cardiovascular Disease Risk Stratification: Results From a Large Chinese Cross-Sectional Study

Abstract

BackgroundThe appropriate optimal anthropometric indices and their thresholds within each BMI category for predicting those at a high risk of cardiovascular disease risk factors (CVDRFs) among the Chinese are still under dispute.ObjectivesWe aimed to identify the best indicators of CVDRFs and the optimal threshold within each BMI category among the Chinese.MethodsBetween 2012 and 2020, a total of 500,090 participants were surveyed in Hunan, China. Six anthropometric indices including waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), waist–hip ratio (WHR), hip circumference (HC), and waist–height ratio (WHtR) were evaluated in the present study. Considered CVDRFs included dyslipidaemia, hypertension, diabetes mellitus (DM), and chronic kidney disease (CKD). The associations of anthropometrics with CVDRFs within each BMI category were evaluated through logistic regression models. The area under the receiver operating characteristic curve (AUROC) was used to assess the predictive abilities.ResultsFor the presence of at least one CVDRFs, the WHR had the highest AUROC in overweight [0.641 (95%CI:0.638, 0.644)] and obese [0.616 (95%CI:0.609, 0.623)] men. BRI had the highest AUROC in underweight [0.649 (95%CI:0.629, 0.670)] and normal weight [0.686 (95%CI:0.683, 0.690)] men. However, the BRI had the highest discrimination ability among women in all the BMI categories, with AUROC ranging from 0.641 to 0.727. In most cases, the discriminatory ability of WHtR was similar to BRI and was easier to calculate; therefore, thresholds of BRI, WHR, and WHtR for CVDRFs identification were all calculated. In men, BRI thresholds of 1.8, 3.0, 3.9, and 5.0, WHtR thresholds of 0.41, 0.48, 0.53, and 0.58, and WHR thresholds of 0.81, 0.88, 0.92, and 0.95 were identified as optimal thresholds across underweight, normal weight, overweight, and obese populations, respectively. The corresponding BRI values in women were 1.9, 2.9, 4.0, and 5.2, respectively, and WHtR were 0.41, 0.48, 0.54, and 0.59, while the WHR values were 0.77, 0.83, 0.88, and 0.90. The recommended BRI, WHtR, or WHR cut-offs could not statistically differentiate high-risk CKD or hypercholesterolemia populations.ConclusionsWe found that BRI and WHR were superior to other indices for predicting CVD risk factors, except CKD or hypercholesterolemia, among the Chinese.

Association of anthropometric indices with the development of multimorbidity in middle-aged and older adults: A retrospective cohort study

“…Many previous studies have indicated that WHT.5R and BRI are more strongly associated with the risk of cardiovascular disease and metabolic syndrome than BMI, WC, or WHtR [18,20,21], but it is unclear whether there is an association between WHT.5R and BRI and the risk of multimorbidity. Our results demonstrate that WHT.5R and BRI are independently and positively associated with the risk of multimorbidity, and both are more strongly associated with multimorbidity than BMI and WHtR but weaker than WC, suggesting that WHT.5R and BRI are better than BMI and WHtR in screening for multimorbidity.…”

“…In addition, a new geometric index that combines height, waist circumference (WC), and hip circumference (HC) has been proposed and used, specifically, the body roundness index (BRI) [19]. Some studies have revealed that BRI is significantly associated with the occurrence of metabolic syndrome, insulin resistance, and CVD [20,21]. Although the above measures have been widely used in various studies, most of the previous studies were based on a cross-sectional design and tended to focus on the association between a single indicator of obesity and multimorbidity and the relationship between different obesity indicators and their dynamic changes and multimorbidity has not been systematically estimated.…”

The Role of Oxidative Stress Enhanced by Adiposity in Cardiometabolic Diseases

“…The WHR reference values are gender specific. For males, physiologically WHR is >0.90 and for females >0.85 [ 74 ].…”

“…The pathogenesis of MetS is influenced by genetic and lifestyle factors [ 85 ]. In patients with MetS, lifestyle modifications, and in some cases, pharmacological treatment, are required for improving patient outcome [ 3 , 74 ]. A lack of effective intervention in patients with MetS may lead to developing other CMDs, such as CVD, disability, and premature death [ 84 ].…”

Digital Anthropometry for Body Circumference Measurements: European Phenotypic Variations throughout the Decades

“…This index serves as a proxy for total and visceral body fat [ 29 ]. It shows good discriminatory power for metabolic syndrome in adults of both sexes from diverse populations [ 30 ] and is superior to other anthropometric measures for determining the presence of cardiovascular disease risk factors [ 31 ]. Moreover, BRI also provides a method to visually compare individual body types and identify the body type location relative to a healthy reference range: briefly, it can be applied as a visual tool for health status evaluations [ 29 ].…”