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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1515067
This article is part of the Research Topic Nutrigenetics of Cardiovascular Health: Understanding Individual Responses to Dietary Interventions View all 3 articles

Temporal trends, associated risk factors and longitudinal cardiovascular outcomes of body roundness among middle-aged and older Chinese adults: from the China Health and Retirement Longitudinal Study 2011 to 2018

Provisionally accepted
Ying-Yuan Gan Ying-Yuan Gan 1Yun-Dan Luo Yun-Dan Luo 1Lu Zhai Lu Zhai 2Rong-Rui Huo Rong-Rui Huo 3Xia Dai Xia Dai 4Qian Liao Qian Liao 5*
  • 1 Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China
  • 2 Guangxi Health Science College, Nanning, Guangxi Zhuang Region, China
  • 3 Guangxi Medical University Cancer Hospital, Nanning, China
  • 4 First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
  • 5 Guangxi Medical University, Nanning, Guangxi Zhuang Region, China

The final, formatted version of the article will be published soon.

    Background: Obesity is a major global health issue, driving high morbidity and mortality rates. The body roundness index (BRI), which includes waist circumference, offers a more accurate measure of visceral and total body fat. However, despite evidence of BRI's effectiveness in predicting obesity-related diseases, national-level data, especially from non-Western populations like China, remain limited. Methods: This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a large, nationally representative cohort of Chinese adults, to examine the temporal trends of BRI, identify associated risk factors, and investigate the longitudinal associations between BRI and cardiovascular disease (CVD) outcomes. BRI was calculated using height and waist circumference measurements. Temporal trends and risk factors were analyzed cross-sectionally, while longitudinal associations were examined using Cox proportional hazards models adjusted for confounders. Mediation analyses were conducted to assess the role of intermediate factors such as hypertension and diabetes in the relationship between BRI and CVD. Results: A total of 12,902 participants were included for risk factor analysis, 10,525 for longitudinal analysis, and 7,310 for cumulative analysis. BRI continued to rise slowly across survey cycles but was higher in women, older adults, and urban residents. Multivariable analysis identified age, alcohol consumption, elevated blood pressure, and diabetes as positive predictors of BRI, while male sex, rural residence, and smoking were negatively associated. Higher baseline BRI was significantly associated with increased CVD risk (HR: 1.44, 95% CI: 1.22-1.69), stroke (HR: 1.49, 95% CI: 1.12-1.98), and heart disease (HR: 1.47, 95% CI: 1.22-1.77). Cumulative BRI similarly predicted increased risks of CVD, stroke, and heart disease. Mediation analysis showed that hypertension accounted for 20.69% of the association between BRI and CVD risk. Conclusions: BRI is a robust predictor of CVD risk. Targeting hypertension and other metabolic conditions could mitigate the elevated CVD risk associated with high BRI in Chinese adults. These findings underscore the importance of incorporating BRI into public health strategies to better manage obesity-related health risks in China.

    Keywords: Obesity, cardiovascular disease, China, cohort study, Body roundness index

    Received: 22 Oct 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 Gan, Luo, Zhai, Huo, Dai and Liao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Qian Liao, Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Region, China

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