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February 27, 2026SHILAP Revista de lepidopterología1 citationsOpen Access

Body roundness index outperforms traditional obesity metrics in predicting cardiometabolic risk among children and adolescents: the EMSNGS study

QHQifa HuZXZhongwei XuZSZhe Su

Key Points

  • The study aims to assess the effectiveness of the body roundness index (BRI) in predicting cardiometabolic risk among children and adolescents.
  • Conducted a large-scale cross-sectional study including 4,794 participants aged 6-17 years.
  • Utilized quantile regression models to analyze BRI and ABSI factors.
  • Evaluated associations between the obesity indices and cardiometabolic risk index (CMRI) using logistic regression and ROC curves.
  • 1,971 participants exhibited CMRI ≥1, with BRI showing an association with both pubertal development and weight status.
  • BRI was significantly associated with CMRI ≥1, while ABSI was not.
  • BRI at the 75th percentile demonstrated optimal sensitivity-specificity balance, outperforming traditional metrics like BMI.

Abstract

Objective Novel obesity indices, the body roundness index (BRI) and a body shape index (ABSI), have been proved to be superior over body mass index (BMI) for predicting metabolic syndrome and cardiovascular events in adults. However, their performance in pediatric populations remains unexplored. Study design A large-scale cross-sectional study, Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen (EMSNGS) project, was conducted in 2021 including 4,794 children and adolescents aged 6–17 years. Quantile regression models were used to analyse factors influencing ABSI and BRI. Associations between the 2 novel obesity indices and cardiovascular metabolic risk index (CMRI) were evaluated using logistic regression and receiver operating characteristic (ROC) curves. Results In total, 1,971 participants (1,131 boys, 840 girls) exhibited CMRI ≥1. BRI was associated with pubertal development and weight status in both sexes. ABSI was only associated with weight status. BRI was associated with CMRI ≥1, whereas ABSI was not ( P 0.05). Compared with waist-to-hip ratio, waist-to-height ratio, and BMI, BRI at the 75th percentile (BRI P75th) demonstrated optimal sensitivity–specificity balance. The area under the ROC curve (95% CI), sensitivity, specificity, and Youden index were 0.752 (0.732–0.771), 71.3%, 79.1%, and 0.504 for boys and 0.693 (0.670–0.716), 61.8%, 76.8%, and 0.386 for girls, respectively. Conclusion After adjustment for sex and pubertal stages, BRI P75th remained significantly associated with elevated cardiometabolic risk in children and adolescents, supporting its potential utility as an early screening indicator.

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Cite This Study

Hu et al. (2026) studied this question.

synapsesocial.com/papers/69a1344fed1d949a99abe1bdhttps://doi.org/10.3389/fnut.2026.1760511
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