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High body roundness index associated with higher odds of prevalent stroke in Chinese adults

High body roundness index associated with higher odds of prevalent stroke in Chinese adults
Photo by Navy Medicine / Unsplash
Key Takeaway
Note: Cross-sectional association between high BRI and stroke requires prospective validation.

This cross-sectional, observational study analyzed data from 6,858 adults in a community-based screening sample from the ChinaHEART cohort branch. The study examined the association between body roundness index (BRI), a waist-height-derived anthropometric indicator, and prevalent stroke. Participants were categorized as having low BRI (<4.6) or high BRI (≥4.6), with the primary outcome being self-reported physician-diagnosed stroke.

Among all participants, 192 (2.8%) reported a prior stroke. In a fully adjusted multivariable model, high BRI was associated with higher odds of prevalent stroke (OR 1.766, 95% CI 1.279–2.438). The analysis identified an optimal BRI cutoff of 4.597 (95% CI 4.149–4.798) for discriminating stroke status. However, BRI alone showed limited discrimination for prevalent stroke, with an area under the curve (AUC) of 0.584. The fully adjusted model, which included BRI and other variables, achieved higher discrimination (AUC 0.740).

Safety and tolerability data were not reported. Key limitations stem from the cross-sectional design, which cannot establish causality or temporal sequence. The stroke outcome was based on self-report rather than validated medical records, which may introduce misclassification. The study population was from a specific community screening program in China, limiting generalizability. The authors note BRI may offer complementary discriminatory information for community screening or triage, but prospective studies with validated outcomes are warranted to confirm any clinical utility.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundStroke remains a major cause of disability and death. While central adiposity may contribute to vascular risk, the role of the body roundness index (BRI) (a waist-height-derived anthropometric indicator) in community screening populations is not well defined. We therefore investigated the association between BRI and prevalent stroke in a community-based screening sample.MethodsUsing data from a ChinaHEART cohort branch (6,858 adults), BRI was calculated from anthropometric measurements. Prevalent stroke was ascertained by self-reported physician diagnosis. Receiver operating characteristic (ROC) analysis was used to determine the optimal BRI cutoff. Logistic regression, adjusted for age, sex, marital status, smoking, alcohol use, hypertension, diabetes, blood pressure, fasting glucose, and lipid parameters, was performed to examine the association between BRI and prevalent stroke. Restricted cubic spline (RCS) analysis and subgroup/interaction analyses were further conducted.ResultsAmong 6,858 participants, 192 (2.8%) reported prior stroke. The bootstrap-derived BRI cutoff was 4.597 (95% CI 4.149–4.798). High BRI (≥4.6) was associated with higher odds of prevalent stroke in the fully adjusted model (OR 1.766, 95% CI 1.279–2.438). BRI alone showed limited discrimination (AUC 0.584), while multivariable models achieved higher AUC (0.740 in the fully adjusted model). Adding BRI produced ΔAUC increases. RCS showed no evidence of nonlinearity.ConclusionsOur findings support BRI as a simple, non-invasive anthropometric measure that may offer complementary discriminatory information for community screening/triage; prospective studies with validated outcomes are warranted to confirm clinical utility.
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