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Cited by 84Diabetes, Cardiovascular Risks, and LipoproteinsBody Composition Measurement TechniquesObesity, Physical Activity, Diet

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

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Li, Ying, He, Yongmei, Yang, Lin, Liu, Qingqi, Li, Chao, Wang, Yaqin, Yang, Pingting, Wang, Jiangang +2 more·2022·Frontiers in Nutrition
DOI 10.3389/fnut.2022.801582PMC PMC8960742
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Abstract

Background: The 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. Objectives: We aimed to identify the best indicators of CVDRFs and the optimal threshold within each BMI category among the Chinese. Methods: Between 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. Results: For 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. Conclusions: We found that BRI and WHR were superior to other indices for predicting CVD risk factors, except CKD or hypercholesterolemia, among the Chinese.

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  • BRI is well-documented as a robust predictor of diabetes, including prediabetes, cardiometabolic disorders, and metabolic syndrome.

    “The BRI is well-documented as a robust predictor of diabetes, including prediabetes, cardiometabolic disorders, and metabolic syndrome32–34.”

    From The nonlinear association between body roundness index and infertility in married women (2025) · cites this paper as [33]

    The Introduction (page unavailable) calls BRI a good predictor of metabolic syndrome, and the Results report that BRI discriminated diabetes and several cardiovascular risk factors in the studied Chinese population. The paper does not report prediabetes as an outcome. Its cross-sectional findings concern identification of existing conditions, rather than prediction of future diabetes, so the claim is broader than this source supports. (LLM, conf=0.88)

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Sorted by citations

Authors
Li, Y., He, Y., Yang, L., Liu, Q., Li, C., Wang, Y., Yang, P., Wang, J., Chen, Z., & Huang, X.
Affiliations
  • Central South University (CN)
  • Aerospace Center Hospital (CN)
  • Alberta Health Services (CA)
  • Georgetown University (US)
  • Hunan Normal University (CN)
Corresponding author
Huang, Xin
ORCID
Venue
Frontiers in Nutrition
Publisher
Frontiers Media SA
Published
2022-03-10
Volume
9
Pages
801582-801582
ISSN
2296-861X (ISSN-L)
DOI
10.3389/fnut.2022.801582
PMC
PMC8960742
OpenAlex
W4221119244
Cited by
84
References
2
Citations by year
2026: 18 · 2025: 30 · 2024: 23 · 2023: 11 · 2022: 2
FWCI
12.23
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Natural Science Foundation of China (81872685, 81973324, 82003537)
  • Natural Science Foundation of Hunan Province (2020JJ4439, 2020JJ5858)
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, waist-to-hip ratio, waist-to-height ratio, anthropometric indices, cardiovascular risk factors, cardiovascular risk stratification, dyslipidemia, hypertension, diabetes mellitus, chronic kidney disease, Chinese population, sex differences, underweight, overweight, obesity, abdominal obesity, visceral fat, body shape index, hip circumference

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