Clinical Report: Body Roundness Index and Cardiovascular-Kidney-Metabolic Outcomes

Overview

This systematic review and meta-analysis of 93 studies across 13 countries demonstrates that the Body Roundness Index (BRI) is significantly associated with multiple cardiovascular-kidney-metabolic (CKM) outcomes. BRI shows particularly strong risk associations and good discriminatory ability for metabolic syndrome, while its predictive value for chronic kidney disease, cardiovascular disease, and mortality is more limited.

Background

Cardiovascular-Kidney-Metabolic (CKM) Syndrome encompasses interconnected metabolic, renal, and cardiovascular pathologies driven largely by visceral fat accumulation. Traditional anthropometric measures like BMI and waist circumference inadequately capture visceral adiposity and its risk implications. The Body Roundness Index (BRI) was developed to better quantify body fat distribution, especially visceral fat, and may improve risk stratification for CKM-related outcomes. Prior studies have focused on isolated diseases, but comprehensive evaluation of BRI across the CKM spectrum has been lacking.

Data Highlights

Key Findings

• BRI is significantly associated with increased risk of multiple CKM-related outcomes.
• Strongest and most consistent associations observed for metabolic syndrome across overall and gender subgroups.
• BRI demonstrates good discriminatory performance for identifying metabolic abnormalities.
• Predictive ability of BRI for chronic kidney disease, cardiovascular disease, and mortality is relatively limited.
• BRI provides incremental risk stratification information beyond conventional anthropometric indices like BMI and waist circumference.
• Further high-quality prospective studies are needed to define long-term predictive value and clinical utility of BRI globally.

Clinical Implications

BRI can serve as a valuable complementary tool to traditional anthropometric measures for early identification and risk stratification of metabolic abnormalities within the CKM syndrome framework. Its use may enhance clinical assessment of visceral adiposity-related risk, particularly for metabolic syndrome. However, clinicians should be cautious in relying solely on BRI for predicting chronic kidney disease, cardiovascular events, or mortality until further evidence is available.

Conclusion

This comprehensive analysis supports the clinical utility of BRI as an effective anthropometric index for assessing risk of metabolic components of CKM syndrome, with more limited predictive capacity for renal and cardiovascular endpoints. Incorporation of BRI into routine risk assessment may optimize early detection and management of CKM-related metabolic risks.

Related Resources & Content

1. Systematic Review Registration CRD420251110973 -- PROSPERO