ArticleDiabetology & metabolic syndrome2025
Association of body roundness index with cardiovascular disease in early Cardiovascular-Kidney-Metabolic syndrome stage 0-3: mediation by the triglyceride-glucose index in a national cohort study.
Article in Diabetology & metabolic syndrome, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk association and diagnostic value of body roundness index for cardiovascular-kidney-metabolic-related outcomes: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Mitochondrial Dysfunction at the Intersection of CKM Syndrome: Molecular Mechanisms and Path-to-Target Therapies.International journal of molecular sciences · 2026Review
- Association of Body Roundness Index with all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3: a cohort study.American heart journal plus : cardiology research and practice · 2026Article
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Abstract
backgroundCardiovascular-Kidney-Metabolic (CKM) syndrome, encompassing metabolic dysfunction, chronic kidney disease, and cardiovascular disease (CVD), represents a growing global health challenge. Body Roundness Index (BRI) is an index representing viscera obesity, and its prospective association with CVD across CKM stages and mediation by insulin resistance remain unexamined.
objectiveThe aim of the study was to explore the association between BRI and CVD among the population of CKM syndrome stage 0-3, and discover the potential mediation of insulin resistance.
methodsThis prospective cohort study included 7,214 participants from the China Health and Retirement Longitudinal Study (CHARLS). BRI was calculated using waist circumference and height. CKM stages (0-3) were classified according to the American Heart Association criteria. CVD was defined as new-onset myocardial infarction, angina, coronary heart disease, heart failure, or other physician-diagnosed cardiac events during follow-up and was reported by participants. Cox models adjusted for demographics and metabolic factors assessed BRI-CVD associations. Restricted cubic splines tested nonlinearity, and mediation analysis quantified the contribution of TyG index.
resultsAmong participants (mean age 59.8 ± 9.4 years, 52.9% female), each 1-unit BRI increase elevated CVD risk by 12.2% (HR = 1.122, 95% CI:1.080-1.166). The highest BRI quartile (vs. lowest) showed 58% higher CVD risk (HR = 1.585, 95% CI:1.351-1.859). A linear dose-response relationship was observed (P nonlinear > 0.05). Stronger relationship between BRI and CVD was observed in CKM stage 1-2. TyG index mediated 22.7% of the BRI-CVD association (P = 0.008).
conclusionsBRI positively linear associated with CVD, especially in early CKM syndrome population. Insulin resistance mediated the BRI-CVD association. The findings highlight BRI's potential for early risk stratification and the multifactorial pathophysiology linking adiposity to CVD.
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