Key result
Higher abdominal obesity linked to ~30% greater frailty progression risk, particularly in early CKM syndrome.
Why the study?
The association between abdominal obesity and frailty progression across different stages of Cardiovascular-Kidney-Metabolic syndrome was not well characterized in a nationwide longitudinal cohort.
Does higher abdominal obesity, measured by body roundness index, predict frailty progression in individuals with Cardiovascular-Kidney-Metabolic syndrome?
Cohort
Yes
Does higher abdominal obesity, measured by body roundness index, predict frailty progression in individuals with Cardiovascular-Kidney-Metabolic syndrome?
Abdominal obesity, measured by the body roundness index, is a strong predictor of frailty progression, especially in early stages of Cardiovascular-Kidney-Metabolic syndrome, and outperforms BMI in prediction models.
Should not yet change frailty monitoring; hypothesis-generating for abdominal obesity in early CKM syndrome progression.
BACKGROUND: Abdominal obesity, assessed via the body roundness index (BRI), is a critical determinant of health outcomes. This study explores the association between abdominal obesity and frailty progression across different stages of Cardiovascular-Kidney-Metabolic (CKM) syndrome in a nationwide longitudinal cohort. METHODS: Data were derived from the China Health and Retirement Longitudinal Study, including individuals aged ≥ 45 years. Participants were categorized into early and advanced CKM syndrome stages. The BRI was used to measure abdominal obesity, and frailty was assessed using the frailty index. RESULTS: Higher BRI in individuals within early CKM syndrome stages was associated with an increased risk of frailty progression compared to those with advanced stages (adjusted hazard ratio [aHR] 1.30, 95% confidence interval [CI] 1.17-1.45 vs. aHR 1.16, 95% CI 0.96-1.40). High cumulative BRI with advanced CKM stages progression and persistent advanced CKM stages over time also predicted a greater risk of frailty. Furthermore, BRI outperformed body mass index (BMI) in predicting frailty progression after combined with conventional model (area under the curve [AUC] 0.708, 95% CI 0.694-0.722 vs. AUC 0.704, 95% CI 0.690-0.718; P = 0.033). CONCLUSIONS: Abdominal obesity, indicated by BRI, is a strong predictor of frailty progression, particularly in early CKM stages. High cumulative BRI, along with advanced CKM progression and persistent advanced CKM stages, further increases frailty risk. Notably, BRI outperforms BMI in enhancing conventional frailty prediction models. These findings underscore the importance of monitoring abdominal obesity in early CKM stages to mitigate future frailty risk.
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Zhang et al. (2025) conducted a cohort in Cardiovascular-Kidney-Metabolic (CKM) syndrome. Higher body roundness index (BRI) vs. Lower body roundness index was evaluated on Frailty progression (aHR 1.30, 95% CI 1.17-1.45). Higher abdominal obesity, assessed via body roundness index, was associated with an increased risk of frailty progression, particularly in early CKM syndrome stages (aHR 1.30; 95% CI 1.17-1.45).
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