Non-linear relationship between the body roundness index and metabolic syndrome: data from National Health and Nutrition Examination Survey (NHANES) 1999–2018
Open accessAbstract
Obesity is an important characteristic manifestation of metabolic syndrome (MetS), and body roundness index (BRI) is one of the anthropometric indicators associated with obesity. However, studies on the relationship between BRI and MetS risk are limited. We aimed to explore the relationship between baseline BRI and MetS in the USA population. Our study used data from the National Health and Nutrition Examination Survey from 1999 to 2018, ultimately enrolling and analysing 47 303 participants. Data-driven tertiles were used to categorise BRI levels, and multivariate logistic regression models were fitted to investigate the association of BRI with MetS in adults. In addition, receiver operating characteristic curve analysis was used to assess the ability of BRI to predict MetS. The distribution of BRI was different across ethnic groups with a gradual decrease in the proportion of non-Hispanic Whites and other races. In addition, BRI was significantly associated with traditional cardiovascular risk factors. Univariate regression analysis indicated BRI to be a moderate risk factor for MetS, and multivariate logistic regression analysis found that BRI remained an independent risk factor for MetS. After adjusting for confounding variables, a non-linear relationship was found between BRI levels and the prevalence of MetS. More importantly, BRI predicted MetS with the largest AUC among anthropometric measures. In summary, elevated baseline BRI levels are independently associated with the development of MetS, and baseline BRI may assist in identifying patients at risk for MetS, leading to early and optimal treatment to improve their outcomes.
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BRI has been recognized as a reliable indicator for assessing NAFLD-associated conditions such as T2DM, insulin resistance, and metabolic syndrome.
“It has been recognized as a reliable indicator for assessing NAFLD-associated conditions such as T2DM, insulin resistance, and metabolic syndrome [45, 46].”
From Effectiveness of body roundness index for the prediction of nonalcoholic fatty liver disease: a systematic review and meta-analysis (2025) · cites this paper as [46]
The Conclusions (page unavailable) identify BRI as a better predictor of metabolic syndrome than other traditional anthropometric indices. The paper describes insulin resistance as a characteristic of metabolic syndrome and notes a relationship between metabolic syndrome and type 2 diabetes, but it does not establish BRI as an indicator for assessing either condition separately or in a NAFLD population. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThis finding aligns with existing evidence and reinforces the potential of BRI as a robust predictor for identifying individuals at high risk of MetS.
“This finding not only aligns with existing evidence but also reinforces the potential of BRI as a robust predictor for identifying individuals at high risk of MetS [29, 30].”
From Machine learning with the body roundness index and associated indicators: a new approach to predicting metabolic syndrome (2025) · cites this paper as [30]
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- Authors
- Li, Z., Fan, C., Huang, J., Chen, Z., Yu, X., & Qian, J.
- Affiliations
- Chongqing Medical and Pharmaceutical College (CN)
- Tongji University (CN)
- Corresponding author
- Qian, Jun
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2024-02-15
- Volume
- 131
- Issue
- 11
- Pages
- 1852-1859
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- OpenAlex
- W4391842637
- Cited by
- 50
- References
- 30
- Citations by year
- 2026: 8 · 2025: 32 · 2024: 10
- FWCI
- 16.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal Of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Tongji University
- Centre Scientifique et Technique du Bâtiment
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- body roundness index, metabolic syndrome, obesity, anthropometric indicators, nonlinear relationship, cardiovascular risk factors, ethnic differences, risk prediction, NHANES
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Nutrition Surveys, Obesity, Risk Factors, United States, Body Mass Index, Prevalence, Metabolic Syndrome
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