Key result
Higher Body Roundness Index is linked to ~33% higher cardiometabolic multimorbidity risk per SD, outperforming BMI.
Why the study?
Evidence on the association of Body Roundness Index with cardiometabolic multimorbidity remains limited.
Does higher Body Roundness Index (BRI) predict cardiometabolic multimorbidity better than BMI in adults free of major cardiometabolic conditions?
Cohort (n=3,348)
Does higher Body Roundness Index (BRI) predict cardiometabolic multimorbidity better than BMI in adults free of major cardiometabolic conditions?
Odds Ratio: 1.33 (95% CI 1.17–1.53)
Both BRI and BMI are independently associated with an increased risk of cardiometabolic multimorbidity, with BRI showing slightly stronger predictive performance.
BRI may refine CMM risk stratification beyond BMI; leaves open its superiority for guiding prevention in prospective studies.
BACKGROUND AND AIMS: Evidence on the association of Body Roundness Index (BRI), an anthropometric indicator of body fat and visceral adiposity, with cardiometabolic multimorbidity (CMM) remains limited. This study aimed to compare the associations and predictive utilities of BRI and body mass index (BMI) for CMM. METHODS AND RESULTS: We analyzed data from 3348 adults (mean age 63 years; 45.1 % male) in the English Longitudinal Study of Ageing, free of major cardiometabolic conditions at baseline (2008-2009). BRI was derived from height and waist circumference. CMM was defined as having ≥2 of the following by 2021-2023: hypertension, cardiovascular disease, diabetes, or stroke. Multivariable odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated. During 12-15 years of follow-up, 197 participants (5.9 %) developed CMM. Both BRI and BMI showed linear dose-response relationships with CMM risk (p for nonlinearity >0.05). Higher BRI was associated with increased odds of CMM (per 1-SD: OR 1.33, 95 % CI 1.17-1.53; top vs bottom tertile: OR 1.89, 95 % CI 1.23-2.90), with similar findings for BMI. Adding BRI to conventional risk models modestly improved discrimination (ΔC-index = 0.0082, p = .26) and significantly improved model fit (p < .001). Gains for BMI were smaller (ΔC-index = 0.0049, p = .46), with BRI offering a slightly greater improvement in predictive performance (Δ = 0.0033, p = .40). CONCLUSION: Both BRI and BMI were independently and linearly associated with an increased risk of CMM. BRI showed slightly stronger predictive performance than BMI.
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A 2025 study conducted a cohort in Cardiometabolic multimorbidity (n=3,348). Body Roundness Index (BRI) vs. Lower Body Roundness Index was evaluated on Cardiometabolic multimorbidity (≥2 of: hypertension, cardiovascular disease, diabetes, or stroke) (OR 1.33, 95% CI 1.17-1.53). Higher Body Roundness Index was associated with increased odds of cardiometabolic multimorbidity (OR 1.33 per 1-SD; 95% CI 1.17-1.53) and showed slightly better predictive performance than BMI.
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