Body roundness index: an alternative for analysing cardiovascular risk in men and women

Abstract Introduction The body roundness index (BRI) is a metric for assessing cardiometabolic risk, which is used as a more accurate alternative to traditional measurements such as body mass index (BMI) and waist circumference (WC). Recent studies have shown that BRI is associated with a higher risk of cardiovascular disease (CVD). However, this relationship is still controversial at a population level. Objective To determine associations between CVD and BRI, comparing the results with more common metrics such as BMI and WC. Methods This cross-sectional study included 1.713 community-dwelling adult participants (55.05±14.68 years). For anthropometric calculations, BRI and BMI were determined using validated formulas, while WC was measured to assess body fat distribution. The participants were divided into men (55.01±14.43 years) and women (55.08±14.95 years). For CVD, the following were considered: angina, acute myocardial infarction and stroke. Statistical analysis: The statistical analysis compared the distributions of BRI, WC and BMI between participants with and without CVD (binary variable). Due to the lack of normality in the variables, the Mann-Whitney U test was used to check for significant differences between the medians of the groups. Logistic regression was applied to explore associations between BRI, WC and BMI as potential predictors of CVD, with the results presented as odds ratios (OR) and 95% confidence intervals (95% CI). The discriminatory capacity of the model was assessed using the ROC curve, with the area under the curve (AUC) used as a performance indicator. Results Among men, BRI was significantly higher in the group with a history of CVD (p0.001), with a relevant adjusted association (OR=2.11; p0.001). Although WC and BMI also showed significant differences, their associations were less significant. Among women, although BRI and WC were higher in the group with a history of CVD (p=0.019 and p=0.012, respectively), no significant association was found in the adjusted analysis. BMI, on the other hand, showed no relevant differences between the groups and no impact on the logistic regression. The ROC curve analysis indicated larger areas under the curve for BRI, with significant values in both genders (AUC=0.639 for men and 0.578 for women). Conclusions BRI was associated with a twofold higher risk of CVD among men, with better discrimination in the ROC curve, WC and BMI, although widely used, showed less consistent associations, with no impact for women. The BRI stood out as a more effective alternative, especially for men.