Body Roundness Index and Cardiometabolic Multimorbidity: Findings from the English Longitudinal Study of Ageing

Setor K. Kunutsor; Atanu Bhattacharjee; Sae Young Jae; Jari A. Laukkanene

doi:10.1016/j.numecd.2025.104475

Body Roundness Index and Cardiometabolic Multimorbidity: Findings from the English Longitudinal Study of Ageing

Setor K. Kunutsor (Lead / Corresponding author)
, Atanu Bhattacharjee
, Sae Young Jae
, Jari A. Laukkanene

Population Health and Genomics

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

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Abstract

Background and aims: Evidence on the association of Body Roundness Index (BRI), an anthropometric indicator of body fat and visceral adiposity, with cardiometabolic multimorbidity (CMM) remains limited. This study aimed to compare the associations and predictive utilities of BRI and body mass index (BMI) for CMM. Methods and results: We analyzed data from 3348 adults (mean age 63 years; 45.1 % male) in the English Longitudinal Study of Ageing, free of major cardiometabolic conditions at baseline (2008–2009). BRI was derived from height and waist circumference. CMM was defined as having ≥2 of the following by 2021–2023: hypertension, cardiovascular disease, diabetes, or stroke. Multivariable odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated. During 12–15 years of follow-up, 197 participants (5.9 %) developed CMM. Both BRI and BMI showed linear dose–response relationships with CMM risk (p for nonlinearity >0.05). Higher BRI was associated with increased odds of CMM (per 1-SD: OR 1.33, 95 % CI 1.17–1.53; top vs bottom tertile: OR 1.89, 95 % CI 1.23–2.90), with similar findings for BMI. Adding BRI to conventional risk models modestly improved discrimination (ΔC-index = 0.0082, p = .26) and significantly improved model fit (p < .001). Gains for BMI were smaller (ΔC-index = 0.0049, p = .46), with BRI offering a slightly greater improvement in predictive performance (Δ = 0.0033, p = .40). Conclusion: Both BRI and BMI were independently and linearly associated with an increased risk of CMM. BRI showed slightly stronger predictive performance than BMI.

Original language	English
Article number	104475
Number of pages	8
Journal	Nutrition, Metabolism and Cardiovascular Diseases
Volume	36
Issue number	4
Early online date	27 Nov 2025
DOIs	https://doi.org/10.1016/j.numecd.2025.104475
Publication status	Published - Apr 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

body roundness index
cohort study
cardiometabolic multimorbidity
adiposity
body mass index
Body mass index
Adiposity
Cohort study
Body roundness index
Cardiometabolic multimorbidity

ASJC Scopus subject areas

Medicine (miscellaneous)
Endocrinology, Diabetes and Metabolism
Nutrition and Dietetics
Cardiology and Cardiovascular Medicine

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Cite this

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title = "Body Roundness Index and Cardiometabolic Multimorbidity: Findings from the English Longitudinal Study of Ageing",

abstract = "Background and aims: Evidence on the association of Body Roundness Index (BRI), an anthropometric indicator of body fat and visceral adiposity, with cardiometabolic multimorbidity (CMM) remains limited. This study aimed to compare the associations and predictive utilities of BRI and body mass index (BMI) for CMM. Methods and results: We analyzed data from 3348 adults (mean age 63 years; 45.1 \% male) in the English Longitudinal Study of Ageing, free of major cardiometabolic conditions at baseline (2008–2009). BRI was derived from height and waist circumference. CMM was defined as having ≥2 of the following by 2021–2023: hypertension, cardiovascular disease, diabetes, or stroke. Multivariable odds ratios (ORs) and 95 \% confidence intervals (CIs) were estimated. During 12–15 years of follow-up, 197 participants (5.9 \%) developed CMM. Both BRI and BMI showed linear dose–response relationships with CMM risk (p for nonlinearity >0.05). Higher BRI was associated with increased odds of CMM (per 1-SD: OR 1.33, 95 \% CI 1.17–1.53; top vs bottom tertile: OR 1.89, 95 \% CI 1.23–2.90), with similar findings for BMI. Adding BRI to conventional risk models modestly improved discrimination (ΔC-index = 0.0082, p = .26) and significantly improved model fit (p < .001). Gains for BMI were smaller (ΔC-index = 0.0049, p = .46), with BRI offering a slightly greater improvement in predictive performance (Δ = 0.0033, p = .40). Conclusion: Both BRI and BMI were independently and linearly associated with an increased risk of CMM. BRI showed slightly stronger predictive performance than BMI.",

keywords = "body roundness index, cohort study, cardiometabolic multimorbidity, adiposity, body mass index, Body mass index, Adiposity, Cohort study, Body roundness index, Cardiometabolic multimorbidity",

author = "Kunutsor, \{Setor K.\} and Atanu Bhattacharjee and Jae, \{Sae Young\} and Laukkanene, \{Jari A.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2026",

month = apr,

doi = "10.1016/j.numecd.2025.104475",

language = "English",

volume = "36",

journal = "Nutrition, Metabolism and Cardiovascular Diseases",

issn = "0939-4753",

publisher = "Elsevier",

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T1 - Body Roundness Index and Cardiometabolic Multimorbidity

T2 - Findings from the English Longitudinal Study of Ageing

AU - Kunutsor, Setor K.

AU - Bhattacharjee, Atanu

AU - Jae, Sae Young

AU - Laukkanene, Jari A.

PY - 2026/4

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N2 - Background and aims: Evidence on the association of Body Roundness Index (BRI), an anthropometric indicator of body fat and visceral adiposity, with cardiometabolic multimorbidity (CMM) remains limited. This study aimed to compare the associations and predictive utilities of BRI and body mass index (BMI) for CMM. Methods and results: We analyzed data from 3348 adults (mean age 63 years; 45.1 % male) in the English Longitudinal Study of Ageing, free of major cardiometabolic conditions at baseline (2008–2009). BRI was derived from height and waist circumference. CMM was defined as having ≥2 of the following by 2021–2023: hypertension, cardiovascular disease, diabetes, or stroke. Multivariable odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated. During 12–15 years of follow-up, 197 participants (5.9 %) developed CMM. Both BRI and BMI showed linear dose–response relationships with CMM risk (p for nonlinearity >0.05). Higher BRI was associated with increased odds of CMM (per 1-SD: OR 1.33, 95 % CI 1.17–1.53; top vs bottom tertile: OR 1.89, 95 % CI 1.23–2.90), with similar findings for BMI. Adding BRI to conventional risk models modestly improved discrimination (ΔC-index = 0.0082, p = .26) and significantly improved model fit (p < .001). Gains for BMI were smaller (ΔC-index = 0.0049, p = .46), with BRI offering a slightly greater improvement in predictive performance (Δ = 0.0033, p = .40). Conclusion: Both BRI and BMI were independently and linearly associated with an increased risk of CMM. BRI showed slightly stronger predictive performance than BMI.

AB - Background and aims: Evidence on the association of Body Roundness Index (BRI), an anthropometric indicator of body fat and visceral adiposity, with cardiometabolic multimorbidity (CMM) remains limited. This study aimed to compare the associations and predictive utilities of BRI and body mass index (BMI) for CMM. Methods and results: We analyzed data from 3348 adults (mean age 63 years; 45.1 % male) in the English Longitudinal Study of Ageing, free of major cardiometabolic conditions at baseline (2008–2009). BRI was derived from height and waist circumference. CMM was defined as having ≥2 of the following by 2021–2023: hypertension, cardiovascular disease, diabetes, or stroke. Multivariable odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated. During 12–15 years of follow-up, 197 participants (5.9 %) developed CMM. Both BRI and BMI showed linear dose–response relationships with CMM risk (p for nonlinearity >0.05). Higher BRI was associated with increased odds of CMM (per 1-SD: OR 1.33, 95 % CI 1.17–1.53; top vs bottom tertile: OR 1.89, 95 % CI 1.23–2.90), with similar findings for BMI. Adding BRI to conventional risk models modestly improved discrimination (ΔC-index = 0.0082, p = .26) and significantly improved model fit (p < .001). Gains for BMI were smaller (ΔC-index = 0.0049, p = .46), with BRI offering a slightly greater improvement in predictive performance (Δ = 0.0033, p = .40). Conclusion: Both BRI and BMI were independently and linearly associated with an increased risk of CMM. BRI showed slightly stronger predictive performance than BMI.

KW - body roundness index

KW - cohort study

KW - cardiometabolic multimorbidity

KW - adiposity

KW - body mass index

KW - Body mass index

KW - Adiposity

KW - Cohort study

KW - Body roundness index

KW - Cardiometabolic multimorbidity

U2 - 10.1016/j.numecd.2025.104475

DO - 10.1016/j.numecd.2025.104475

M3 - Article

C2 - 41478746

SN - 0939-4753

VL - 36

JO - Nutrition, Metabolism and Cardiovascular Diseases

JF - Nutrition, Metabolism and Cardiovascular Diseases

IS - 4

M1 - 104475

ER -

Body Roundness Index and Cardiometabolic Multimorbidity: Findings from the English Longitudinal Study of Ageing

Abstract

UN SDGs

Keywords

ASJC Scopus subject areas

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