Body Roundness Index and Waist-Hip Ratio Result in Better Cardiovascular Disease Risk Stratification: Results From a Large Chinese Cross-Sectional Study

Ying Li; Yongmei He; Lin Yang; Qingqi Liu; Chao Li; Yaqin Wang; Pingting Yang; Jiangang Wang; Zhiheng Chen; Xin Huang

doi:10.3389/fnut.2022.801582

Body Roundness Index and Waist-Hip Ratio Result in Better Cardiovascular Disease Risk Stratification: Results From a Large Chinese Cross-Sectional Study

Front Nutr. 2022 Mar 10:9:801582. doi: 10.3389/fnut.2022.801582. eCollection 2022.

Authors

Ying Li¹, Yongmei He², Lin Yang^{3

4}, Qingqi Liu⁵, Chao Li⁶, Yaqin Wang¹, Pingting Yang¹, Jiangang Wang¹, Zhiheng Chen¹, Xin Huang⁷

Affiliations

¹ Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, China.
² Department of Health Management, Aerospace Center Hospital, Beijing, China.
³ Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.
⁴ Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁵ Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC, United States.
⁶ Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, China.
⁷ Department of Epidemiology, School of Medicine, Hunan Normal University, Changsha, China.

Abstract

Background: The appropriate optimal anthropometric indices and their thresholds within each BMI category for predicting those at a high risk of cardiovascular disease risk factors (CVDRFs) among the Chinese are still under dispute.

Objectives: We aimed to identify the best indicators of CVDRFs and the optimal threshold within each BMI category among the Chinese.

Methods: Between 2012 and 2020, a total of 500,090 participants were surveyed in Hunan, China. Six anthropometric indices including waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), waist-hip ratio (WHR), hip circumference (HC), and waist-height ratio (WHtR) were evaluated in the present study. Considered CVDRFs included dyslipidaemia, hypertension, diabetes mellitus (DM), and chronic kidney disease (CKD). The associations of anthropometrics with CVDRFs within each BMI category were evaluated through logistic regression models. The area under the receiver operating characteristic curve (AUROC) was used to assess the predictive abilities.

Results: For the presence of at least one CVDRFs, the WHR had the highest AUROC in overweight [0.641 (95%CI:0.638, 0.644)] and obese [0.616 (95%CI:0.609, 0.623)] men. BRI had the highest AUROC in underweight [0.649 (95%CI:0.629, 0.670)] and normal weight [0.686 (95%CI:0.683, 0.690)] men. However, the BRI had the highest discrimination ability among women in all the BMI categories, with AUROC ranging from 0.641 to 0.727. In most cases, the discriminatory ability of WHtR was similar to BRI and was easier to calculate; therefore, thresholds of BRI, WHR, and WHtR for CVDRFs identification were all calculated. In men, BRI thresholds of 1.8, 3.0, 3.9, and 5.0, WHtR thresholds of 0.41, 0.48, 0.53, and 0.58, and WHR thresholds of 0.81, 0.88, 0.92, and 0.95 were identified as optimal thresholds across underweight, normal weight, overweight, and obese populations, respectively. The corresponding BRI values in women were 1.9, 2.9, 4.0, and 5.2, respectively, and WHtR were 0.41, 0.48, 0.54, and 0.59, while the WHR values were 0.77, 0.83, 0.88, and 0.90. The recommended BRI, WHtR, or WHR cut-offs could not statistically differentiate high-risk CKD or hypercholesterolemia populations.

Conclusions: We found that BRI and WHR were superior to other indices for predicting CVD risk factors, except CKD or hypercholesterolemia, among the Chinese.

Keywords: ABSI; BRI; WHR; WHtR; cardiovascular disease risk factors; hip circumference; waist circumference.