Associations of trajectories in body roundness index with incident cardiovascular disease: a prospective cohort study in rural China
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SUBMITTER: Zhang S
PROVIDER: S-EPMC10914955 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundSeveral previous cross-sectional studies suggested that body roundness index (BRI) may be associated with cardiovascular disease (CVD). However, the association should be further validated. Our study aimed to assess the association of the BRI trajectories with CVD among middle-aged and older Chinese people in a longitudinal cohort.Methods and resultsA total of 9935 participants from the CHARLS (China Health and Retirement Longitudinal Study) with repeated BRI measurements from 2011 to 2016 were included. The BRI trajectories were identified by group-based trajectory modeling. The primary outcome was incident CVD (stroke or cardiac events), which occurred in 2017 to 2020. Cox proportional hazards regression models were used to examine the association of BRI trajectories with CVD risk. Participants were divided into 3 BRI trajectories, named the low-stable BRI trajectory, moderate-stable BRI trajectory and high-stable BRI trajectory, accounting for 49.81%, 42.35%, and 7.84% of the study population, respectively. Compared with participants in the low-stable BRI trajectory group, those in the moderate-stable and high-stable BRI trajectory groups had an increased risk of CVD, with multivariable adjusted hazard ratios of 1.22 (95% CI, 1.09-1.37) and 1.55 (95% CI, 1.26-1.90), respectively. Furthermore, simultaneously adding the BRI trajectory to the conventional risk model improved CVD risk reclassification (all P<0.05).ConclusionsA higher BRI trajectory was associated with an increased risk of CVD. The BRI can be included as a predictive factor for CVD incidence.
| S-EPMC11681446 | biostudies-literature
Project description:BackgroundBody roundness index (BRI) is an anthropometric measure related to obesity, combining waist circumference (WC) and height to more accurately reflect body fat. This study aims to investigate the relationship between BRI and the risk of hypertension using data from a prospective cohort study in Southwest China.MethodsData for the study were derived from Guizhou Population Health Cohort Study (GPHCS), established in 2010. A total of 9,280 participants (aged 18 to 95 years, mean 41.53 ± 14.15 years) from 48 townships across 12 districts/counties were surveyed at baseline through multistage stratified random cluster sampling. Cox proportional risk models were employed to analyze the association between BRI and the risk of hypertension, estimating hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for confounding factors. The relationship between BRI and the onset time of hypertension was analyzed using the time failure acceleration model.ResultsOver a median follow-up period of 6.64 years, 1,157 participants were diagnosed with hypertension. After adjusting for confounding variables, each unit increase in BRI was associated with a 17% increase in hypertension risk (HR = 1.17, 95% CI: 1.11, 1.24, P for trend < 0.001). Compared to participants in the first quartile (Q1) of BRI, the risk of hypertension for those in the third quartile (Q3) and fourth quartile (Q4) was 1.31 (95% CI: 1.10, 1.56) and 1.53 (95% CI: 1.28, 1.84), respectively. Each unit increase in BRI advanced the onset of hypertension by 0.26 years (95% CI: 0.16, 0.35).ConclusionThis study indicates that BRI has a positive association with hypertension and can accelerate the onset of hypertension in the Chinese population. It is suggested that reducing BRI by controlling abdominal fat may be one of the effective measure to prevent hypertension.
| S-EPMC11411781 | biostudies-literature
Project description:BackgroundThe body rounds index (BRI), an innovative obesity indicator integrating waist circumference (WC) and height, offers a two-dimensional assessment of obesity. The relationship between BRI trajectories and cancer has been overlooked in previous studies. This study aims to explore the association between BRI trajectories and the incidence of cancer.MethodsThis study included 42,022 participants with a median age of 48.91 years. Based on the changes in participants' BRI during the period from 2006 to 2010, three BRI trajectory patterns were identified: low-stable, medium-stable, and high-stable. The primary outcome was cancer incidence and the secondary outcome was cancer-specific deaths. The association between BRI trajectories and cancer incidence and death was explored by cox regression analysis in the total, sex-specific and age-specific populations, respectively. Additionally, we further investigated the relationship between BRI and site-specific cancer incidence. Sensitivity analyses were applied to exclude interferences and ensure the stability of the results.ResultsAfter a median follow-up time of 11.04 years, high-stable BRI trajectory was significantly associated with increased risk of cancer occurrence compared to low-stable BRI trajectory. This association was more pronounced in middle-aged men (men: HR = 1.46, 95% CI = 1.21-1.77, p < 0.001; age < 65: HR = 11.38, 95% CI = 1.15-1.66, p = 0.001). Additionally, high-stable BRI trajectory was significantly associated with a substantial increase in the risk of site-specific uterine cancers (HR = 4.92, 95% CI = 1.69-14.33, p = 0.004). Sensitivity analysis confirmed the stability of the results.ConclusionOur study identified a significant association between a high-stable BRI trajectory and cancer incidence, with this association being most pronounced in middle-aged men. Moreover, the high-stable BRI trajectory was strongly associated with uterine site-specific cancer development. Our findings underscore the importance of implementing lifestyle modifications and monitoring BRI values and their changes to provide effective health guidance.
| S-EPMC11602755 | biostudies-literature
Project description:Objective: Individuals with both hypertension and diabetes have been confirmed to significantly increase the risk of cardiovascular disease morbidity and mortality compared with those with only hypertension or diabetes. This study aimed to evaluate the potential of different anthropometric indices for predicting diabetes risk among hypertensive patients. Methods: The study group consisted of 6,990 hypertensive adults without diabetes who were recruited in China. Demographic and clinical assessment, physical examinations, laboratory tests, and anthropometric measurements, including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and novel indices (ABSI, AVI, BAI, BRI, CI, WWI, and WHHR), were performed at baseline and during the (median) 3-year follow-up. Cox regression analyses were conducted to estimate effects from these indices for the onset of diabetes. Receiver operator characteristic (ROC) analyses were conducted to assess the predictive capacities of the anthropometric indices and determine the optimal cut-points. Results: A total of 816 (11.7%) developed diabetes during our prospective study. Multivariate Cox regression analyses revealed weight, WC, WHR, WHtR, BAI, BRI, and WWI as the independent risk factor for diabetes among hypertensive patients, regardless of whether it was treated as a continuous or categorical variable (P < 0.05). Further Cox analyses combining BMI and different central obesity indices showed that elevated WC, WHR, WHtR, AVI, BRI, CI, regardless of the general obesity status, were found to be each independently associated with increased diabetes risk (P < 0.05). Dynamic increases of BRI < 5.24 to BRI ≥ 5.24 were associated with increased risk (HR = 1.29; 95% CI, 1.02, 1.64), and its reversal was associated with reduced risk (HR = 1.56; 95% CI, 1.23, 1.98) compared with the others (HR = 1.95; 95% CI, 1.63, 2.32). ROC analysis indicated that the areas under the ROC curves (AUC) of the anthropometric indices ranged from 0.531 to 0.63, with BRI (cut-off value = 4.62) and WHtR having the largest area. Conclusions: Based on this novel study, BRI was the most superior predictor and independent determinant for diabetes onset among the hypertensive population. Hypertensive patients with BRI > 4.62, regardless of general obesity status, were at high risk of diabetes. Thus, the prompt screening and diagnosis of diabetes should be carried out among these patients for timely integrated intervention.
| S-EPMC8638826 | biostudies-literature
Project description:It is unclear whether there are different body mass index (BMI) trajectories among a population with normal BMI levels, and the association between BMI patterns and incident hypertension is not well characterized. This prospective cohort study includes surveys conducted at baseline and three follow-ups. 3939 participants who are free of hypertension at baseline or first two follow-ups were enrolled. At baseline, the age of participants ranged from 35 to 82 years and the mean age was 45.9 years. The BMI trajectories were identified using latent mixture modeling with data from the baseline and first two follow-ups. The effects of different BMI trajectories on the development of hypertension were analyzed using a Cox proportional hazard model. Four distinct BMI trajectories were identified over the study period (2004-2010): normal-stable (n = 1456), normal-increasing (n = 2159), normal-fluctuated (n = 166), and normal-sharp-increasing (n = 158). Relative to the normal-stable BMI group, the hazard ratios (HRs) and 95% confidence intervals (CIs) after adjustment for confounding factors of the normal-increasing, normal-fluctuated, and normal-sharp-increasing groups were 1.244 (1.103-1.402), 1.331 (1.008-1.756), and 1.641 (1.257-2.142), respectively. Additionally, subgroup analysis showed that the normal-fluctuated BMI trajectory was associated with a significantly higher risk of hypertension only in women (HR = 1.362; 95% CI = 1.151-1.611). The BMI trajectories were significant predictors of hypertension incidence, and increasing BMI trajectories within the currently designated normal range were associated with an increased hypertension risk, especially in women.
| S-EPMC8678668 | biostudies-literature
Project description:ImportanceBody mass index (BMI) trajectories before the onset of mild cognitive impairment (MCI) and during the progression from MCI to dementia remain unclear.ObjectiveTo assess the long-term BMI trajectories preceding incident MCI and dementia and explore whether they are associated with brain pathologies.Design, setting, and participantsThe Rush Memory and Aging Project (MAP) was an ongoing community-based cohort study. This study included cognitively intact participants aged 60 to 90 years at baseline with annual follow-up from October 1997 to December 2020 (maximum follow-up of 22 years). During the follow-up, participants underwent brain autopsies. Data were analyzed from August 2021 to February 2022 using mixed-effect models.ExposuresBMI was calculated using height and weight measured at baseline and follow-ups.Main outcomes and measuresIncident MCI and dementia were diagnosed following standard criteria. Neuropathological assessments (including global Alzheimer disease and vascular pathology) were performed for autopsies.ResultsA total of 1390 participants (mean [SD] age, 78.4 [6.5] years; 1063 female [76.5%]) were included in the study. In the analysis of BMI trajectories before MCI (n = 939), during the follow-up (median [IQR] duration, 6 [3-9] years), 371 participants (39.5%) developed MCI, of whom 88 (23.7%) progressed to dementia. Those who developed MCI were older (mean [SD] age, 79.6 [5.9] years vs 76.9 [6.6] years), consumed less alcohol (median [IQR] consumption, 0 [0-5.8] g/day vs 1.1 [0-6.9] g/day), had a lower BMI (mean [SD], 27.2 [4.9] vs 28.2 [5.9]), and were more likely to be apolipoprotein E (APOE) ε4 carriers (89 of 371 [24.0%] vs 98 of 568 [17.3%]) compared with those who remained cognitively intact over follow-up. Those who developed dementia were older (mean [SD] age, 81.0 [5.2] years vs 79.1 [6.0] years), had a lower level of physical activity (median [IQR] activity, 1.0 [0-2.5] h/week vs 1.8 [0.2-3.8] h/week), and were more likely to be APOE ε4 carriers than those who were dementia-free (33 of 88 [37.5%] vs 56 of 283 [19.8%]). Compared with participants who remained cognitively intact, in those with incident MCI, BMI tended to decline earlier and faster. From 7 years before diagnosis, people with incident MCI had an associated significantly lower BMI (mean difference, -0.96; 95% CI, -1.85 to -0.07) than those who were cognitively intact. Among people with incident MCI, the slopes of BMI decline did not differ significantly between those who did and did not develop dementia (β, -0.03; 95% CI, -0.21 to 0.15). In the analysis of BMI trajectories before autopsy (n = 358), BMI was associated with a faster declination among participants with a high burden of global Alzheimer disease pathology (β for pathology × time highest vs lowest tertile, -0.14; 95% CI, -0.26 to -0.02) or vascular pathology (β for pathology × time2 highest vs lowest tertile, 0.02; 95% CI, 0-0.05).Conclusions and relevanceResults of this cohort study suggest that among cognitively intact people, significantly lower BMI occurs beginning approximately 7 years before MCI diagnosis. After MCI diagnosis, BMI declines at the same pace in people who develop dementia and those who do not. High brain pathologies may underly the BMI decline preceding dementing disorders.
| S-EPMC9608028 | biostudies-literature
Project description:ObjectiveThe body roundness index (BRI) and circadian syndrome (CircS) are considered new risk factors for cardiovascular disease (CVD), yet it remains uncertain whether elevated BRI is associated with CVD incidence in CircS patients. In this study, we investigated the association between BRI and CVD occurrence among CircS participants.MethodsWe conducted a retrospective cohort study involving 8,888 participants aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS 2011-2020 wave). CircS was evaluated with a combination of the International Diabetes Federation (IDF) MetS, along with short sleep duration and depression. The threshold for CircS was established at ≥4. In the first phase, the receiver operating characteristic (ROC) curves were used to evaluate the accuracy of diagnosing CircS according to baseline BRI. During the 9-year follow-up, the associations between BRI and CVD incidence in CircS patients were explored by employing logistic regression, restricted cubic spline (RCS) analysis, and subgroup analysis.ResultsBRI demonstrated an independent association with CircS, and multivariable-adjusted restricted cubic spline analyses suggested "J-shaped" associations between BRI and risk of CircS. BRI demonstrated better diagnostic performance in diagnosing CircS compared to general obesity indices such as ABSI (AUC: 0.617), BMI (AUC: 0.746), and WC (AUC: 0.722), with an AUC of 0.760. After a 9-year follow-up, BRI was found to be independently associated with the occurrence of CVD in CircS patients, and the associations between incident CVD and the second, third, and fourth BRI quartiles were 1.30 (95% CI: 0.99~1.69), 1.32 (95% CI: 1.01~1.72), and 1.59 (95% CI: 1.21~2.08), respectively, relative to the first BRI quartile. Then, we assessed the relationship between other obesity indices and the CVD occurrence, and likewise observed a significant effect in the fourth quartile.ConclusionBRI was independently associated with CircS, outperforming obesity indices such as BMI and WC in identifying individuals with CircS. During the 9-year follow-up, elevated BRI levels was significantly associated with CVD incidence among CircS patients, especially in men. Thus, early identification of high-risk populations with CircS and elevated BRI levels may help promote healthy aging among middle-aged and elderly individuals.
| S-EPMC11893425 | biostudies-literature
Project description:ObjectivesThe body roundness index (BRI) is a novel anthropometric index that is a better indicator for predicting fat distribution than the body mass index (BMI). The longitudinal study can repeatedly collect measured results for the variables to be studied and then consider the potential effects of intraindividual changes in measurement. However, few population-based, longitudinal studies of BRI have been conducted, especially among the Chinese population. The study aimed to investigate the association of BRI and its longitudinal trajectories with all-cause and cardiovascular mortality.MethodsA total of 71,166 participants with four times BRI measurements between January 2010 and December 2019 were included in this longitudinal study, with a median follow-up was 7.93 years, and 11,538 deaths were recorded, of which 5,892 deaths were due to cardiovascular disease (CVD). A latent class growth mixture modeling (LCGMM) was used to identify BRI trajectories. Cox proportional hazard models were used to estimate associations between BRI trajectories and the risk of all-cause and cardiovascular mortality.ResultsIn the restricted cubic spline regression models, a U-shaped relationship between BRI and all-cause and cardiovascular mortality was observed. Three BRI longitudinal trajectories of low-stable (mean BRI = 2.59), moderate-stable (mean BRI = 3.30), and high-stable (mean BRI = 3.65) were identified by LCGMM. After being adjusted for potential confounders, the HRs for all-cause mortality were 1.18 (1.13-1.24) for the moderate-stable group and 1.74 (1.66-1.82) for the high-stable group compared to the low-stable group. The HRs for cardiovascular mortality were 1.12 (1.05-1.18) for the moderate-stable group and 1.64 (1.53-1.75) for the high-stable group compared to the low-stable group.ConclusionA nonlinear association of BRI with all-cause and cardiovascular mortality was observed, and participants in the higher BRI longitudinal trajectory group were significantly associated with an increased risk of all-cause and cardiovascular mortality.
| S-EPMC10076882 | biostudies-literature
Project description:Background: A single measurement of grip strength (GS) could predict the incidence of cardiovascular disease (CVD). However, the long-term pattern of GS and its association with incident CVD are rarely studied. We aimed to characterize the GS trajectory and determine its association with the incidence of CVD (myocardial infarction, angina, stroke, and heart failure). Methods: This study included 5,300 individuals without CVD from a British community-based cohort in 2012 (the baseline). GS was repeatedly measured in 2004, 2008, and 2012. Long-term GS patterns were identified by the group-based trajectory model. Cox proportional hazard models were used to examine the associations between GS trajectories and incident CVD. We identified three GS trajectories separately for men and women based on the 2012 GS measurement and change patterns during 2004-2012. Results: After a median follow-up of 6.1 years (during 2012-2019), 392 participants developed major CVD, including 114 myocardial infarction, 119 angina, 169 stroke, and 44 heart failure. Compared with the high stable group, participants with low stable GS was associated with a higher incidence of CVD incidence [hazards ratio (HR): 2.17; 95% confidence interval (CI): 1.52-3.09; P <0.001], myocardial infarction (HR: 2.01; 95% CI: 1.05-3.83; P = 0.035), stroke (HR: 1.96; 95% CI: 1.11-3.46; P = 0.020), and heart failure (HR: 6.91; 95% CI: 2.01-23.79; P = 0.002) in the fully adjusted models. Conclusions: The low GS trajectory pattern was associated with a higher risk of CVD. Continuous monitoring of GS values could help identify people at risk of CVD.
| S-EPMC8481887 | biostudies-literature
Project description:BackgroundBody roundness index (BRI) is one of the obesity-related anthropometric indices. However, studies on the relationship between BRI and diabetes risk is limited. The purpose of this study was to explore the relationship between baseline BRI and incident type 2 diabetes mellitus (T2DM) in the Japanese population.MethodsA retrospective longitudinal study of 15,310 participants in a physical examination program at Murakami Memorial Hospital in Japan from 2004 to 2015. The association between BRI levels and incident T2DM was analyzed by Cox proportional-hazards regression, smooth curve fitting, subgroup analyses, and a set of sensitivity analyses. Receiver operating characteristic curve analysis was used to assess the ability of BRI to predict diabetes.ResultBaseline BRI levels were elevated in participants who developed T2DM. Baseline BRI levels were positively associated with incident T2DM after adjusting confounding variables (HR = 1.570, 95% CI 1.360-1.811). Additionally, we did a set of sensitivity analyses to ensure the robustness of the results. There was also a non-linear relationship between BRI and incident diabetes in both genders, and the inflection point of BRI was 4.137 in females and 3.146 in males. We found a strong positive correlation between BRI and the incidence of diabetes on the right of the inflection point (Male: HR = 1.827, 95% CI 1.449-2.303; Female: HR = 4.189, 95% CI 1.862-9.421). What's more, among the anthropometric indices, BRI showed the optimal capability to predict T2DM (Male: AUC = 0.706, 95% CI 0.674-0.738; Female: AUC = 0.735, 95% CI 0.676-0.795).ConclusionAn elevated BRI level in baseline was independently associated with incident T2DM. Baseline BRI improves the identification of patients at risk of T2DM and may enable early and optimized therapy to improve their outcomes.
| S-EPMC8900386 | biostudies-literature