Introduction
Body roundness index (BRI) is a novel anthropometric measure that combines waist circumference and height to assess body fat distribution and overall health status. Unlike traditional measures like body mass index (BMI), BRI provides a more comprehensive evaluation of an individual's body shape and visceral fat levels. Several recent studies have investigated the potential of BRI as a predictor of various health outcomes. Here, we summarize the key research findings on BRI and its relationship with cardio-metabolic risk factors, mortality, and other health implications.
Predicting Cardio-metabolic Risk
Multiple studies have demonstrated the effectiveness of BRI in identifying individuals at high risk of cardio-metabolic abnormalities, including hypertension, diabetes, dyslipidemia, and metabolic syndrome (MetS).
A cross-sectional study of 17,360 Chinese adults found that BRI had superior predictive capacity compared to other anthropometric indices like BMI, waist circumference (WC), and waist-to-height ratio (WHtR) in discriminating high cardiometabolic risk. The optimal BRI cutoff values were 3.49 for men under 60 years, 3.46 for men 60 years and older, 3.47 for women under 60, and 3.60 for women 60 and older.
In a study of 585 Chinese adults with type 2 diabetes, BRI was strongly associated with the odds of having MetS in both men and women, even after adjusting for age, diabetes history, and BMI. The optimal BRI cutoffs were 3.85 for men (76.5% sensitivity, 82.1% specificity) and 4.05 for women (76.4% sensitivity, 70.3% specificity).
A systematic review and meta-analysis concluded that BRI is an effective indicator for screening MetS and is correlated with MetS in various populations.
Association with Mortality
Emerging evidence suggests that BRI may be a promising predictor of mortality risk:
A longitudinal study involving 71,166 Chinese participants found a U-shaped relationship between BRI and all-cause and cardiovascular mortality. Compared to the low-stable BRI trajectory group, the high-stable group had a 74% higher risk of all-cause mortality and a 64% higher risk of cardiovascular mortality after adjusting for confounders.
In a cohort study of 32,995 US adults, the association between BRI and all-cause mortality also followed a U-shaped pattern. Both the lowest and highest BRI groups experienced significantly increased all-cause mortality risk compared to the middle groups.
A systematic review and meta-analysis of observational studies concluded that BRI and a body shape index (ABSI) are effective in predicting hypertension, a major risk factor for mortality.
Other Health Implications
BRI has also been linked to various other health outcomes:
A study in South African young adults found that BRI, ABSI, and conicity index were associated with nutritional status and cardiovascular risk factors.
In a Chinese population, each unit increase in BRI was associated with a 17% higher risk of developing hypertension and accelerated the onset of hypertension by 0.26 years.
BRI was found to be a relevant predictor of diabetes onset in a Chinese population, outperforming BMI, WC, and WHtR.
Conclusion
The body of research suggests that BRI is a promising anthropometric measure that provides valuable insights into an individual's body fat distribution and overall health status. BRI demonstrates superior predictive ability compared to traditional indices like BMI in identifying cardiometabolic risk factors and mortality risk. As a simple, non-invasive tool, BRI holds potential for clinical and public health applications in screening and monitoring obesity-related health outcomes. However, further longitudinal studies are needed to establish the utility of BRI in diverse populations and settings.
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