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Cited by 86Diabetes, Cardiovascular Risks, and LipoproteinsBody Composition Measurement TechniquesObesity, Physical Activity, Diet

Feasibility of body roundness index for identifying a clustering of cardiometabolic abnormalities compared to BMI, waist circumference and other anthropometric indices: the China Health and Nutrition Survey, 2008 to 2009

Open access
Tian, Simiao, Zhang, Xiuzhi, Xu, Yang, Dong, Huimin·2016·Medicine
DOI 10.1097/md.0000000000004642PMC PMC5400331
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Abstract

The body mass index (BMI) and waist circumference (WC) are commonly used anthropometric measures for predicting cardiovascular diseases risk factors, but it is uncertain which specific measure might be the most appropriate predictor of a cluster of cardiometabolic abnormalities (CMA) in Chinese adults. A body shape index (ABSI) and body roundness index (BRI) have been recently developed as alternative anthropometric indices that may better reflect health status. The main aims of this study were to investigate the predictive capacity of ABSI and BRI in identifying various CMA compared to BMI, WC, waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR), and to determine whether there exists a best single predictor of all CMA.We used data from the 2009 wave of the China Health and Nutrition Survey, and the final analysis included 8126 adults aged 18 to 85 years with available fasting blood samples and anthropometric measurements. Receiver-operating characteristic (ROC) analyses were conducted to assess the best anthropometric indices to predict the risk of hypertension, diabetes, dyslipidemia, hyperuricemia, and metabolic syndrome (MetS). Logistic regression models were fit to evaluate the OR of each CMA according to anthropometric indices.In women, the ROC analysis showed that BRI and WHtR had the best predictive capability in identifying all of CMA (area under the curves [AUCs] ranged from 0.658 to 0.721). In men, BRI and WHtR were better predictor of hypertension, diabetes, and at least 1 CMA (AUC: 0.668, 0.708, and 0.698, respectively), whereas BMI and WC were more sensitive predictor of dyslipidemia, hyperuricemia, and MetS. Furthermore, the ABSI showed the lowest AUCs for each CMA. According to the multivariate logistic regression analysis, BRI and WHtR were superior in discriminating hyperuricemia and at least 1 CMA while BMI performed better in predicting hypertension, diabetes, and MetS in women. In men, WC and BRI were the 2 best predictor of all CMA except MetS, and the ABSI was the worst.Our results showed the novel index BRI could be used as a single suitable anthropometric measure in simultaneously identifying a cluster of CMA compared to BMI and WHtR, especially in Chinese women, whereas the ABSI showed the weakest discriminative power.

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  • BRI is less influenced by muscle mass, making it a more reliable indicator of fat-related health risks in individuals with higher muscle mass.

    “Furthermore, the BRI is less influenced by muscle mass, making it a more reliable indicator of fat-related health risks in individuals with higher muscle mass19.”

    From The nonlinear association between body roundness index and infertility in married women (2025) · cites this paper as [19]

    The Introduction (page unavailable) says BMI cannot distinguish muscle from fat and that abdominal measures address this limitation. The Discussion (page unavailable) says BRI uses waist and height to estimate body fat and is useful for identifying cardiometabolic abnormalities. The paper does not establish that BRI is less influenced by muscle mass or more reliable specifically in people with higher muscle mass. (LLM, conf=0.79)

    Experimental — accuracy not yet measured

  • Many studies have shown that BRI is associated with metabolic syndrome, is an independent risk factor, and has a high AUC value in predicting metabolic syndrome, even across different ethnic groups.

    “Many studies have shown its association with MetS, being an independent risk factor with a high AUC value in predicting MetS, even across different ethnic groups [15, 16].”

    From Machine learning with the body roundness index and associated indicators: a new approach to predicting metabolic syndrome (2025) · cites this paper as [16]

    The Results (page unavailable) report an association between BRI and metabolic syndrome and evaluate its predictive AUC in a Chinese sample. The paper does not establish prediction across different ethnic groups or BRI as an independent risk factor for future metabolic syndrome; its Discussion notes that prospective studies are needed and that only a few earlier studies had examined BRI’s predictive abilities. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Several studies have shown that BRI demonstrates superior screening performance compared with traditional indices such as BMI, waist circumference, and waist-to-height ratio, particularly for metabolic diseases including metabolic syndrome.

    “Several studies have shown that BRI demonstrates superior screening performance compared with traditional indices such as BMI, waist circumference, and waist-to-height ratio, particularly for metabolic diseases, including metabolic syndrome [12,13].”

    From The discriminatory ability of the body roundness index and body mass index for metabolic diseases in Korean adults: a comparative study (2025) · cites this paper as [12]

    The Conclusions say BRI was a superior predictor to BMI, waist circumference, and waist-to-height ratio for a cluster of cardiometabolic abnormalities including metabolic syndrome, especially in Chinese women. But the Discussion (Body roundness index) says BRI and waist-to-height ratio had coincident predictive ability, and the Introduction reports a prior study in which BRI was not superior to BMI or waist circumference. This source therefore supports the narrower finding from its own study, not the unqualified claim that several studies found BRI superior across these comparisons. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Tian et al. found that BRI demonstrated superior discriminatory ability compared with BMI for all metabolic conditions in female and for hypertension and diabetes in male.

    “Tian et al. [12], using data from the 2008-2009 China Health and Nutrition Survey, analyzed AUROC values for several metabolic diseases and found that BRI demonstrated superior discriminatory ability compared with BMI for all metabolic conditions (hypertension, diabetes, metabolic syndrome, and dyslipidemia) in female, and for hypertension and diabetes in male.”

    From The discriminatory ability of the body roundness index and body mass index for metabolic diseases in Korean adults: a comparative study (2025) · cites this paper as [12]

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Authors
Tian, S., Zhang, X., Xu, Y., & Dong, H.
Affiliations
  • Dalian University (CN)
  • Affiliated Zhongshan Hospital of Dalian University (CN)
Corresponding author
Tian, Simiao
ORCID
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-08
Volume
95
Issue
34
Pages
e4642
ISSN
0025-7974 (ISSN-L)
DOI
10.1097/md.0000000000004642
PMC
PMC5400331
OpenAlex
W2514658303
Cited by
85
References
64
Citations by year
2026: 8 · 2025: 18 · 2024: 7 · 2023: 13 · 2022: 10 · 2021: 10 · 2020: 4 · 2019: 5 · 2018: 9 · 2017: 1
FWCI
5.03
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Medicine (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
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, body shape index, anthropometric indices, cardiometabolic abnormalities, metabolic syndrome, waist-to-height ratio, waist circumference, body mass index, hypertension, diabetes mellitus, dyslipidemia, hyperuricemia, cardiovascular risk prediction, Chinese adults, sex differences, China Health and Nutrition Survey, receiver operating characteristic, discriminatory power, abdominal obesity, waist-to-hip ratio
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Anthropometry, Body Composition, Cardiovascular Diseases, China, Feasibility Studies, Female, Humans, Male, Middle Aged, Nutrition Surveys, Obesity, Predictive Value of Tests, ROC Curve, Biomarkers, Body Mass Index, Area Under Curve, Waist Circumference, Young Adult

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